Revision of the American Nurses Association Code of Ethics for Social Justice Content

This project examined the social justice content of the nursing ethical codes from the United States, Canada, and Australia. Based on this comparative review suggestions were made for revision of the current American Nurses Association (ANA) Code of Ethics. The overall aim of the project was to describe the relationship between social determinants of health, health inequities, social justice and the way in which the profession of nursing interfaces with these concepts, and disseminate this information to nursing faculty, as well as to participate in the current code of ethics revision with the findings from this project. The ANA Nursing Code of Ethics (COE) is a foundational document that guides professional nursing practice and it expresses nursing's obligation to society. As such, the code should address fundamental issues relevant to the health of society. Inequities of health and the social determinants that contribute to them are among these fundamental issues and social justice is the foundational concept that links them. Consideration given to the concept of social justice within the current code is inadequate, especially when compared to the attention given to social justice in the literature and by nursing's historical founders and leading nurse educators. The American Association of Colleges of Nursing (AACN) has described social justice as a core competency for nurses. The National League for Nursing (NLN) has outlined work to address injustices and the elimination of health disparities as a public policy goal. Nursing founders such as Florence Nightingale and Lillian Wald both addressed social justice concerns as they focused on issues of poverty, labor rights and minority representation. There is a large and growing volume of nursing literature dedicated to the concept of social justice. The ANA code of ethics must strengthen its conceptualization of social justice to align with these leading nursing voices. Explicitly and directly addressing social justice within the nursing code of ethics will give the profession a stronger foundation of support to meaningfully impact the health of society. The objectives of this project included: 1) comparison and review of social justice content in nursing codes of ethics from the aforementioned nations; 2) participation in the ANA COE revision committee, in order to give suggestions for changes to social justice content based on the review of these nations' codes; 3) submission of an article to the Utah Nurses Association regarding participation in the ANA revision committee; and 4) a presentation of the project findings to the University of Utah College of Nursing faculty. Implementation of this project was done through participation on the ANA advisory committee for revision of the code of ethics. The advisory committee participated in the revision process in an online forum Nursespace. Substantive suggestions were based on information gathered from the literature and this guided the comparative review of the international nursing ethical codes. Nursing is the largest healthcare profession in the U.S. and if unified, nurses can have an immense impact on health. There is a call for the nursing profession to be more fully involved in the provision of healthcare to society. An alignment of nurse leaders, nurses, and foundational nursing organizations acting on the ethos of social justice, the very cornerstone of the nursing profession, has the potential to significantly benefit the health of society.