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Article American Academy of Nursing on Policy| Volume 62, ISSUE 5, P374-375, September 2014

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American Academy of Nursing: Ethics Policy-Maintaining high standards

  • American Academy of Nursing, Washington, DC

      Background

      Ethics is a branch of philosophy concerned with moral principles that guide decisions on how to live and how to behave. It is also defined as an evaluation of a moral choice based on ideas about what is morally right or wrong (
      • Beauchamp T.L.
      • Childress J.F.
      Principles of Biomedical Ethics.
      ). Ethics provides an opportunity to describe and understand standards of conduct in nursing practice. The nursing profession has long held to high ethical standards with the most recent benchmark being the development of the Code of Ethics for Nurses with Interpretive Statements (
      • American Nurses Association
      Code of Ethics for Nurses with Interpretive Statements.
      ). The current Code of Ethics reiterates the fundamental values and commitments of nurses; identifies the boundaries of duty and loyalty; and describes the duties of nurses that extend beyond individual patient encounters (

      NursingWorld. (n.d.). Afterword. Code of ethics for nurses with interpretive statements. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses.

      ). An entire body of literature is dedicated to ethics in the nursing profession, but little has been discussed about ethical expectations of members of Fellows programs within nursing organizations.
      Ethical infractions by members of Fellows programs are rare; however, Fellows programs without formal ethics policies in place have little guidance on how to respond to alleged infractions. In an attempt to remedy this lack of guidance in 2011, Fellows of the American Academy of Nurse Practitioners ([FAANP] henceforth referred to as Fellows of the American Association of Nurse Practitioners), brought together representatives of healthcare professional Fellows programs in a one-day think tank to answer the question, “What are the ethical expectations of members of healthcare professional Fellows programs?” The underlying assumption was that Fellows are leaders in their profession that are possibly held to the highest ethical expectations. Present at this think tank were representatives from nursing, including the American Academy of Nursing (AAN), medicine, and occupational therapy.
      Think tank attendees participated in an interactive, facilitated discussion about ethical expectations of members of Fellows programs. One important theme of the discussion was that Fellows are expected to uphold the highest ethical standards and serve as role models and leaders. The group identified heightened ethical expectations of Fellows in five categories: abuse of power; competing interests; publication and research misconduct; and fraudulent behavior. Personal misconduct was an added area of discussion because of the impact of personal reputation on professional reputation (

      Fellows of the American Association of Nurse Practitioner (FAANP) Think Tank Summary. (2011). What are the ethical expectations of members in healthcare professional fellows programs? Proceedings from an interdisciplinary Think Tank hosted by the AANP Fellows Program. Retrieved from www.aanp.org/images/documents/fellows/LeadershipEthics.pdf.

      ). The outcome product from the think tank served as a template for an ethics policy for Fellows programs and FAANP subsequently created an ethics policy for their own group.

      Academy Ethics Task Force

      In 2013, the president of the Academy appointed an Ethics Task Force to answer three questions: 1) Should AAN have an ethics policy?; 2) Should AAN consider the FAANP Ethics Policy as a model?; and 3) What procedures should be followed in dealing with reported infractions? Subsequently, the appointed AAN Task Force (members listed below) held three telephone conferences to respond to their charge.
      Consensus developed early in the group's work to support development of an ethics policy specific to AAN and modeled after the FAANP Ethics Policy. Through the Task Force's deliberations, an official ethics policy was crafted that included ethical dilemmas (abuse of power; personal misconduct; conflict of interest; publication and research misconduct; fraudulent behavior; and loss of professional nursing license). In addition, the Task Force recommended the creation of an AAN Ethics Committee, sanctions, timeline, and a detailed process to guide responses to allegations of infractions by Fellows who are believed to be in good standing. These recommendations were considered by the AAN Board and led to proposed revisions to the AAN bylaws, specifically 1) noting that ethical conduct is a required attribute for being a “member in good standing” of the Academy and 2) proposing to establish a standing Ethics Committee. See the policy at http://www.aannet.org/policy-on-ethical-behavior-of-fellows. These changes were presented to the fellowship and passage was approved in a vote taken in January 2014.
      The AAN Ethics Task Force recommendations included the development of a procedure to support the upholding of the Ethics Policy. To that end, as part of the induction process the Academy will require that each incoming Fellow signs a statement agreeing to abide by the Ethics Policy. All other Fellows will electronically sign the agreement to abide by the Ethics Policy when they renew their annual membership. This process will highlight that ethical behavior is a prominent value and requirement of all Fellows, rather than simply an assumption.
      Fellows of the American Academy of Nursing serve the public and nursing profession by advancing health policy, research and practice scholarship through the generation, synthesis, and dissemination of nursing knowledge. Widely recognized as the foremost nursing leaders, it is essential that all Fellows uphold the highest ethical standards. With the implementation of the AAN Ethics Policy and creation of a standing Ethics Committee charged with reviewing the findings in response to a reported infraction, the American Academy of Nursing has moved positively toward assuring ongoing ethical conduct of its members.

      Acknowledgments

      Task Force members: Catherine Gilliss (chair), Judith Berg, Mona Counts, Anne Davis, Joanne Pohl, and Connie Ulrich; David Keepnews (Board Liaison) and Cheryl Sullivan (Academy staff).

      References

        • American Nurses Association
        Code of Ethics for Nurses with Interpretive Statements.
        Author, Washington, DC2001
        • Beauchamp T.L.
        • Childress J.F.
        Principles of Biomedical Ethics.
        7th ed. Oxford University Press, New York, NY2013
      1. Fellows of the American Association of Nurse Practitioner (FAANP) Think Tank Summary. (2011). What are the ethical expectations of members in healthcare professional fellows programs? Proceedings from an interdisciplinary Think Tank hosted by the AANP Fellows Program. Retrieved from www.aanp.org/images/documents/fellows/LeadershipEthics.pdf.

      2. NursingWorld. (n.d.). Afterword. Code of ethics for nurses with interpretive statements. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses.