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As a nurse ethicist and educator, I teach students about nursing codes of professional ethics, explaining why codes are noble norms for just about every endeavor that grapples with ideals of professionalism. Codes offer practitioners self-regulation, identify standards of practice, detail provision of particular services, and address fiduciary relationships that are essential hallmarks of any profession.


Because of their complexity, codes can be stuporously boring, stultifyingly arrogant, and mind-numbingly generic. Codes, like some sermons, don't seem to have appreciable relevance to Monday morning reality. In fact, professional codes appear virtually interchangeable, hatchlings from a sort of "good scout" prototype cell: "The ______ (fill in professional's title/role) must always be compassionate, respectful, honorable, loyal, faithful, and true in practice toward everyone everywhere, unrestricted by considerations of massive credit card debt, generalized geekiness, or warts."


Nursing codes struggle with the same problems that burden other professions: conflicting moral obligations (e.g., patient vs. family, self vs. others), ill-defined terms, and lack of clarity for managing moral dilemmas. Nurses who face moral distress-doubt and anxiety about what is right or the exhausting powerlessness that comes from knowing what is right but being unable to do it-have difficulty finding help in professional codes of ethics.


Yet moral distress haunts nurses. Last year in this column, I presented the troubling case of Terri Schiavo (Life and death disagreements. JCN, 24(1), 38-40) in which Christians were among the many who, with the most honorable of commitments, found themselves pitted against one another. Even if Terri Schiavo had a right to die, court decisions honoring her moral right did so at the terrible expense of obligating her mother to watch Terri die slowly from starvation and dehydration, rendered powerless as appeal after legal appeal was denied. Did the Code of Ethics for Nurses help nurses caring for Terri Schiavo?


I believe a Code of Ethics for Christian Nurses can point nurses toward a way out of moral distress and relativism. But I have great fear that a "Christian Code" might turn into nothing more than the "same-old, same-old" type of code. I don't want a compilation of rules and duties. What I long for is the sort of affirmation that explains to nurses the absolute difference between ethical theories and Christian ethics.


Scripture makes this difference clear. Christian ethics is not a theory, model, framework, or human or divine intellectual construct. Christian ethics is qualitatively different from the ethics of any world religion. Every ethical philosophy presents ideas (propositions) about right and wrong. Either these are human ideas or they are purported to be divine. In either case, human beings are supposed to take these moral mandates and run with them.


A commentary section in The Daily Bible (1984) notes:


In paganism, virtue is not associated with religion. Religious practices are for the purpose of warding off demons and evil ancestors-not for the purpose of becoming a better person. Paul [the Apostle] sees that this notion of religion can influence even Christian [ethics] in which slavish adherence to supposed spiritual standards misses the point of one's being transformed into the likeness of Christ. To Paul, the Christian life is much more than simply giving up bad habits. It is acquiring a newness of mind which comes from setting your heart and mind on Christ Jesus.


Christian ethics is about "who we are called to be" rather than a set of "rules" or "who we want to be." And who we are called to be is in Christ Jesus. We are created anew to do good things he has planned (Ephesians 2:10), to "live in him [horizontal ellipsis] [and] see to it that no one takes [us] captive through hollow and deceptive philosophy, which depends on [horizontal ellipsis] the basic principles of this world rather than on Christ," (Colossians 2:6-8, NIV). We know "God works for the good of those [horizontal ellipsis] who have been called according to his purpose," to be conformed into Christ's likeness (Romans 8:28-29, NIV). As Christ's ambassadors, God makes his appeal to the world through us (2 Corinthians 5:20).


Would there be value in a Christian Code of Ethics for Nurses? If you want to share your thoughts, contact JCN at or write: JCN, P.O. Box 7895, Madison, WI, 53707.


The Daily Bible (New International Version) Commentary by F. LaGard Smith (1984). Eugene, OR: Harvest House Publishers.