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Nurses’ views on ethical codes: a focus group study


  • Ellen Verpeet MA RN,

  • Bernadette Dierckx De Casterle PhD RN,

  • Arie Van der Arend PhD RN,

  • Chris A.E. Gastmans PhD

Chris A.E. Gastmans,
Centre for Biomedical Ethics and Law,
Catholic University of Leuven,
Kapucijnenvoer 35,
Belgium. E-mail:


Aim.  This paper reports a study exploring nurses’ views on the ‘potential’ content and functions of an ethical code for nurses in Belgium. The term ‘potential’ is used, because Belgian nurses do not have experience with an ethical code.

Background.  Ethical codes have been developed to guide nurses’ practice and to improve their professional status. Little empirical research, however, has been undertaken to determine nurses’ views on the content and functions of these codes. The available quantitative studies merely give some information on nurses’ (lack of) knowledge and use of their ethical code. No nursing ethical code currently exists in Belgium. Qualitative research exploring nurses’ views, therefore, was needed in order to find out which functions an ethical code could fulfil and what the code's content could be.

Method.  Eight focus groups were conducted with 50 nurses in different healthcare settings in Belgium. Data were generated during 2003.

Findings.  According to participants, an ethical code could fulfil several functions, including supporting their professional nursing identity (external function) and giving guidelines for nursing practice (internal function). In addition, some aspects of content were mentioned, including nurses’ responsibilities in a relational context: particular attention should be paid to the personality of the nurse and to the specificity of nursing as a relational activity. Most agreement was reached on the ‘ethical’ function of the code, namely guiding nurses’ professional moral practice. Regarding disciplinary use and the need for legalization of the ethical code, on the contrary, opinions were divergent.

Conclusions.  It is of utmost importance to take into account nurses’ views when developing an ethical code for their profession. This study gave a first picture of the views of nurses themselves. These initial findings should be completed with nurses’ views on the formulation, dissemination and promotion of the ethical code. Such evidence-based development of an ethical code will probably give more guarantees that the code will meet nurses’ expectations and will function optimally.