The ANA Code of Ethics, Nursing with Moral Courage, and Current Global Affairs
As a child, I grew up during the Iran-Iraq War. I clearly remember when Iran, with the aid of the United States, invaded Iranian borders. Millions were killed, and an entire generation was devastated. I still remember the bombs that were falling from the skies with the anti-aircraft guns shooting into the air, sitting in a blacked-out room with all the lights off, with hopes the bombs were not going to fall on your home!
I grew up with war, and after immigrating to the United States with my mom’s hopes of a better future for me, I joined the military. Something very familiar to me, even though I had first-hand seen the devastation it caused.
However, I never saw myself taking a life, and luckily, never found myself in a situation where I had to. As a Corpsman (medic), I was part of the privileged few who were tasked with saving lives regardless of nationality, ethnicity, gender, political beliefs… I was “Doc” to my Marines.
As a Nurse, as part of the most ethical and trusted profession, I take my responsibilities with great pride. So, needless to say, when I see my profession, especially professional nursing organizations, silent and complacent, it is deeply ethically and morally troubling for me. To be a witness to the Palestinian holocaust and see nurses in the US seemingly unencumbered by the world's atrocities, lacking the historical context, failing to understand their role, and how to engage politically in a profession that is highly political!
The ANA recently published the latest revision of the code of ethics for nursing and has been touring it throughout conferences and social media, yet I question if the organization has even read what they have published and understands its role outside the 4 walls of hospitals. I see individual nurses or state-level organizations living the code, but I don’t see any nursing national organization taking the bold step… afraid to be singled out or lose federal funding? Shameful…
I’ve been wanting to write this piece for a while, and the only thing keeping me was that I had not read the new code of ethics for nursing… Finished reading it today… and wanted to share a few brief thoughts as some of the provisions of the code call on the nursing profession to be courageous at this hour in the midst of so much death and destruction on the global stage.
Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.
Provision 3: The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care.
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.
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.
Provision 8: Nurses build collaborative relationships and networks with nurses, other healthcare and non-healthcare disciplines, and the public to achieve greater ends.
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.
Provision 10: Nursing, through organizations and associations, participates in the global nursing and health community to promote human and environmental health, well-being, and flourishing.
As nurses, we cannot ethically detach ourselves from the unfolding violence and humanitarian failures impacting vulnerable populations around the world. The devastation in Gaza, the ongoing war in Ukraine, the inhumane treatment of immigrants and asylum seekers within U.S. borders, and now the military strikes against Iran, all represent violations of human rights and threats to global health, dignity, and justice. These events are not isolated; they reflect systemic choices that undermine the values at the heart of our profession. According to Provisions 1 and 3, we are required to honor human dignity and advocate for the safety and rights of all individuals, regardless of political or national affiliation. When governments, including our own, inflict harm or remain complicit in violence, we must respond not with silence but with moral clarity. Provisions 5 and 6 remind us that we are also accountable to ourselves and our colleagues, charged with maintaining ethical practice environments even when political conditions threaten our core values. Provisions 8, 9, and 10 collectively call upon nurses to be advocates for global health equity, social justice, and human rights, extending our influence far beyond hospitals and clinics. We are not only permitted but obligated to challenge policies that perpetuate war, occupation, racialized violence, and systemic neglect. Nursing is inherently political because health is inherently political. The attack on Iran, like the humanitarian crises elsewhere, jeopardizes civilian lives and public health infrastructures. Nursing’s response must be bold: reject complicity, demand accountability, and lead with moral courage. This is not partisanship; it is the practice of ethical, human-centered care. In moments like this, our code does not suggest action; it requires it.
