6.8 The Code of Professional Conduct
Moreover, the standard of care required by ethics is higher than that needed to
avoid the danger of litigation. The law is, again by its nature, concerned with
maintaining the minimum that patients or clients are entitled to expect and with
dealing with failures to maintain that minimum. Ethics has to go beyond this in a
number of ways. To begin with, the professional codes themselves set a higher
standard than the law. Thus the UKCC Code of Professional Conduct for the
Nurse, Midwife and Health Visitor )1992) sets a standard of care that in both its
negative and positive requirements goes well beyond the requirement to avoid
negligence in the legal sense. Three passages may be used to illustrate this.
The first is the second clause of the Code, which is a version of what is often
called the principle of non-maleficence, the principle that all health care workers
have a duty not to harm patients or clients:
`As a registered nurse, midwife or health visitor ... you must ensure that no
action or omission on your part, or within your sphere of responsibility, is
detrimental to the interests, condition or safety of patients and clients.'On the positive side, with regard to beneficence ± to positively helping the patient
or client ± the Code says twice, both in the brief preamble and the first clause, that
the nurse, midwife or health visitor must act always in such a manner as to promote and safeguard the interests and well-being of patients and clients' )clause 1). )The preamble is similarly worded but refers toindividual patients'.)
In these passages, even the negative one, the Code goes well beyond what is
required by the law. The section on legal negligence says )clause 2.1):
`To succeed in an action for clinical negligence, a claimant must show ... c) that
the breach of duty has caused some injury, loss or damage to the claimant of a
type which the law acknowledges.'This sets a limit )admittedly not defined at this point) to the kinds of harm one has
alegal duty to guard against, whereas the Code has no such restriction. Not only
this, but the Code requires the professional to go beyond doing no harm and
beyond merely safeguarding the `interests and well-being' of patients and clients,
and in addition to actively promote their interests and well-being.
6.9 Personal ethics
The Code sets a high standard, but ethics seems to require still more. It would
seem that even a minimal standard of personal ethics would in some ways go
beyond not only the legal requirements but also the requirements of the Code. To
take just one example, the Code could be read as not absolutely requiring the
nurse to be unduly concerned for the patient's comfort, if the discomfort was of a
kind that did not affect their recovery. It could be seen as compatible with the
attitude of the fictional matron played by the actress, the late Hattie Jacques, who
informed the patients, `You are not here to enjoy yourselves. You are here to get
Negligence 91