Nurse Plus: Nursing Code of Ethics 2025

Every ten years the American Nurses Association updates the Code of Ethics for Nurses (Code). The latest version was released on January 29, 2025. The Code reflects the ever-evolving practice of nursing and serves as a guide to maintaining the high standards that have made the profession “the most ethical and honest” for 23 consecutive years. (Nurses have actually been #1 in the annual Gallup poll since 1999, except for the firefighters who bravely served in 2001, following the 9/11 attacks.)

What is the Code of Ethics for Nurses?

The Code is like a road map. It’s meant to help nurses make ethical decisions in their practice, no matter where they work. For 150 years, nursing has always had a strong moral foundation that holds every nurse accountable to uphold the highest values and ideals when providing patient care and serving their communities.

While the Code is a “nonnegotiable moral standard of nursing practice,” it doesn’t specify exactly how to apply the Code or dictate a particular method. Situations differ, sometimes often. So, every nurse has flexibility when acting in their individual setting.

The Code originated with the founding of the American Nurses Association in the late 1880s. It was formally put in place in 1950. As society changed and medical advancements were made, the Code has been accordingly amended and updated.

What’s in the 2025 Code?

The 2015 Code had nine provisions (principles or guidelines) that state the responsibilities and expected behaviors for a nurse. In 2025, a tenth provision has been added. Each provision has a clear definition about approaching ethical situations in practice. Most provisions focus on patients: their safety, rights, and well-being.

The provisions are described briefly below. To obtain full descriptions of the provisions, and their interpretations, the Code may be viewed online or ordered from the ANA Bookstore.

PROVISION 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

1.1 Respect for Human Dignity: Compassion for all and commitment to fair treatment.

1.2 Relationships with Patients and Recipients of Nursing Care: Establish and maintain relationships of trust and provide services according to need and without bias.

1.3 The Nature of Health: Health is a universal right and not affected by life choices, circumstances, illness, ability, socioeconomic status, or proximity to death.

1.4 Right to Self-Determination: Every person has the moral and legal right to decide what will be done with and to themselves, along with information that enables an informed decision.

PROVISION 2: A nurse’s primary commitment is to the recipient(s) of nursing care, whether an individual, family, group, community, or population.

2.1 Primary Commitment to Recipients of Nursing Care: People who receive care are prioritized over institutions. Patients can participate in their care and make decisions.

2.2 Conflicts of Interest and Conflicts of Commitment in Nursing: Conflicts of interest occur when nurses try to fulfill duties while following mandates from another authority or institution. Conflicts of commitment occur when nurses are unable to focus on their patients.

2.3 Professional Boundaries: Nurses must establish only therapeutic relationships and not become over- or under-involved with those in their care.

2.4 Issues of Safety in the Nurse-Patient Relationship: Nurses consider safety in every situation and interaction: physiological, physical, psychological, and emotional.

PROVISION 3: The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care.

3.1 Privacy and Confidentiality: Nurses must always be aware of relevant clinical data and personal information that is private. Patients are protected from unwarranted intrusion.

3.2 Advocating for Persons Who Receive Nursing Care: Patients are vulnerable and entitled to support and appropriate information when making informed decisions.

3.3 Responsibility in Promoting a Culture of Safety: Nurses must be part of developing and maintaining policies that promote health, reduce errors, and sustain a culture of safety.

3.4 Protection of Patient Health and Safety by Acting on Practice Issues: Every nurse should be aware and intercede in any situation that jeopardizes a patient or violates practice standards or employer policies.

3.5 Protection of Patient Health and Safety by Acting on Impaired Practice: Nurses always keep patients, the public, and the profession safe from potential harm from an impaired colleague.

PROVISION 4: Nurses have authority over nursing practice and are responsible and accountable for their practice consistent with their obligations to promote health, prevent illness, and provide optimal care.

4.1 Responsibility and Accountability for Nursing Practice: Nurses are responsible for fulfilling their ethical obligations by providing competent and compassionate care within their scope of practice. This includes decisions to take, or not take, action.

4.2 Addressing Barriers to Exercising Nursing Practice Authority: Nurses should identify and act on negative constraints to ethical patient care, such as rigid protocols, economic priorities, or social/political/legislative issues.

4.3 Ethical Awareness, Discernment, and Judgment: All nursing actions either support or diminish the goal of appropriate ethical behavior.

4.4 Assignment and Delegation: Nursing actions that are delegated must be consistent with standards of practice, scope of practice, and organizational policies.

PROVISION 5: The nurse has moral duties to self as a person of inherent dignity and worth including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.

5.1 Personal Health and Safety: Each nurse must define health, their level of risk tolerance, and work-life balance for themselves. They should not trade their health or safety for others.

5.2 Wholeness of Character: Nurses should be able to be their authentic selves while practicing. Prejudicial discrimination should not be tolerated.

5.3 Integrity: While practicing ethically, nurses have the right and duty to behave according to their personal and professional values without jeopardizing dignity or well-being.

5.4 Professional Competence: Nurses must remain professionally competent and continually pursue excellence, no matter their role, title, or setting.

5.5 Human Flourishing: Nurses should thrive, personally and professionally. They should nourish their own life, as well as seek interdependence in their social and work communities.

PROVISION 6: Nurses, through individual and collective effort, establish, maintain, and improve the ethical environment of the work setting that affects nursing care and the well-being of nurses.

6.1 The Environment and Virtue: Nurses can have reasonable expectations that their work environment will support and nurture the virtues of mutual caring, generosity, kindness, truth, and transparency.

6.2 The Environment and Ethical Obligation: Knowledge of the Code and a moral environment requires constant attention to possible negative factors.

6.3 Responsibility for the Healthcare Environment: Every nurse must contribute to a milieu that maintains respect, mutual support, and honest identification of difficult ethical issues.

PROVISION 7: Nurses advance the profession through multiple approaches to knowledge development, professional standards, and the generation of policies for nursing, health, and social concerns.

7.1 Contributions through Knowledge Development, Research, and Scholarly Inquiry: Every nurse can contribute to advancing nursing practice through their delivery of care.

7.2 Protection of Human Participants in Empirical Research: Nurses are professionally and ethically obligated to protect participants in research, respecting their choices and preferences.

7.3 Contributions through Developing, Maintaining, and Implementing Professional Practice Standards: Standards must reflect ethics, science, technology, and practice, as well as the values of the Code.

7.4 Contributions through Nursing, Health, and Social Policy Development: With their skills, knowledge, and ethical values, nurses can contribute to a wide variety of public policies.

7.5 Considerations Related to Ethics, Technology, and Policy: Nurses have value in respect to development and implementation of technology around ethical nursing care and research.

PROVISION 8: Nurses build collaborative relationships and networks with nurses, other healthcare and non-healthcare disciplines, and the public to achieve greater ends.

8.1 Collaboration Imperative: Every nurse must collaborate to advance nursing practice:

Networking, advocacy, leadership, and tact when dealing with others is necessary.

8.2 Collaboration to Uphold Human Rights, Mitigate Health Disparities, and Achieve Health Equity: The need for nursing care is universal, so nurses must identify and advocate for physical and mental health around the world. Human right violations must be addressed.

8.3 Partnership and Collaboration in Complex, Extreme, or Extraordinary Practice Settings:

Nurses join other professions in denouncing human right violations, such as genocide, sexual assault, human tracking, oppression, feminization of poverty, and abuse of migrant workers.

PROVISION 9: Nurses and their professional organizations work to enact and resource practices, policies, and legislation to promote social justice, eliminate health inequities, and facilitate human flourishing.

9.1 Assertion of Nursing Values: Every professional nursing organization must uphold and demonstrate the values and ethics of Provision 1.

9.2 Commitment to Society: Nursing care is based on society’s trust that competent and compassionate care will always be based on ethics.

9.3 Advancing the Nursing Vision of a Good and Healthy Society: Nurses—and communities—promote a society that treats all people with respect, dignity, and compassion.

9.4 Challenges of Structural Oppressions: Racism and Intersectionality: Nursing organizations must address racism in nursing, be accountable for ongoing harms, and develop specific strategies for inclusion, diversity, and equity.

9.5 National Policies, Programs, and Legislation: Nursing organizations must be proactive in engaging in politics, especially addressing legislative and regulatory concerns that affect the public’s health.

PROVISION 10: Nursing, through organizations and associations, participants in the global nursing and health community to promote human and environmental health, well-being, and flourishing.

10.1 Global Nursing Community: The need for nursing is universal, as well as support for shared values and sharing knowledge, practice, and standards. All nurses are recognized and included.

10.2 Global Nursing Practice: Nursing migration brings diversity, but well-resourced countries should not rely on nurses from nations that need those nurses.

10.3 Nursing Vision for Global Health: Nursing and nursing organizations are involved in activities that promote global health, sustainable environmental practices, and protection of natural resources.

10.4 Global Nursing Solidarity: Nursing organizations around the world work collectively to promote human well-being and environmental health and well-being.

10.5 Global Nursing Health Diplomacy: Global health and security are constantly threatened by terrorism, war, pandemics, and natural disasters. Nursing practice advances knowledge and practice to meet the needs of the world.