Broadly understood, ethics consist of principles, which direct the conduct of individuals, groups or professions (Wilkins 2007). Nurses as professionals make independent decisions on the care of patients. But they are still answerable to their profession as a whole as regards these independent decisions. A nurse's conduct has been under scrutiny from the start. The famous Florence Nightingale pledge in 1893 included the vow to "abstain from anything deleterious and mischievous... or harmful drug." The profession evolved into a very complex arena in the last century. Nurses now must confront life-and-death decisions and in short periods, even on an hourly basis. Medical advancements in new technology have the equal potential of benefit and harm. Today's nurse makes her own decisions, that is, without the influence of her employer. But how she does is under the control of a Code of Ethics to which she swears (Wilkins).
             In general, nurses are employed by a hospital, clinic or some private entity (Wilkins 2007). Yet seemingly "independent" decisions made on patient care not really totally independent. Each decision, especially a critical or end-of-life decision, creates a ripple effect, which extends to anyone in the health care sphere. A code of ethics enables nurses to remain attuned to perspective and retain a balanced view in making decisions. That Code, however, cannot remain stagnant. There will always be changes in the professions and healthcare practice. These unavoidable changes must be appropriately and promptly confronted and incorporated into or included in the Code's formal statement. On the other hand, it is the responsibility of professional nurses to know changes made to the Code and to incorporate these into their daily practice (Wilkins).
             The American Nurses Association is the oldest, biggest and perceived to be the best professional organization of registered nurs...