Introduction

At the 1st World Federation of Critical Care Nurses (WFCCN) meeting in Cambridge in 2004 the WFCCN chose to develop a position statement on Rights of the Critically Ill Patient. The existing situation was considered and similar documents from other organisations were examined. This was then discussed further at the 2nd Congress of WFCCN in Buenos Aires, August 2005.

The current position statement aims to inform and assist critical care nursing associations, health services, educational facilities and other interested parties in the development of patient's rights for the critically ill.

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I. Preamble

In 1948 the United Nations proclaimed the Universal Declaration of Human Rights. The rights of individuals have been proclaimed and expanded since then in many statements and nations. The specific rights in health care have been stated by many nations and some health care groups.

Critical care nursing is specialised nursing care of critically ill patients who have manifest or potential disturbance of vital organ functions.

The World Federation of Critical Care Nurses (WFCCN) has considered the rights of critically ill patients. WFCCN have agreed that the statement on patient's rights from the International Council of Nurses (ICN) covers the requirements for a position statement on the rights of the critically ill patient.

The WFCCN accept and support the ICN position statement on Nurses and Human Rights reproduced below.

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II. Nurses and Human Rights

ICN Position:

The International Council of Nurses (ICN) views health care as a right of all individuals, regardless of financial, political, geographic, racial or religious considerations. This right includes the right to choose or decline care, including the right to accept or refuse treatment or nourishment; informed consent; confidentiality, and dignity, including the right to die with dignity. It involves both the rights of those seeking care and the providers.

Human Rights and the Nurse's Role

Nurses have an obligation to safeguard and actively promote people's health rights at all times and in all places. This includes assuring that adequate care is provided within the resources available and in accordance with nursing ethics. As well, the nurse is obliged to ensure that patients receive appropriate information in understandable language prior to consenting to treatment or procedures, including participation in research.

Nurses are accountable for their own actions and inactions in safeguarding human rights, while National Nurses Associations (NNAs) have a responsibility to participate in the development of health and social legislation related to patient rights.

Where nurses face a "dual loyalty" involving conflict between their professional duties and their obligations to their employer or other authority, the nurse's primary responsibility is to those who require care.

Nurses' Rights

Nurses have the right to practice in accordance with the nursing legislation of the country in which they work and to adopt the ICN Code of Ethics for Nurses or their own national ethical code. They also have a right to practice in an environment that provides personal safety, freedom from abuse and violence, threats or intimidation.Nurses individually and collectively through their national nurses associations have a duty to speak up when there are violations of human rights, particularly those related to access to essential health care and patient safety.

National nurses' associations need to ensure an effective mechanism through which nurses can seek confidential advice, counsel, support and assistance in dealing with difficult human rights situations.

Background:

Nurses deal with human rights issues daily, in all aspects of their professional role. As such, they may be pressured to apply their knowledge and skills in ways that are detrimental to patients and others. There is a need for increased vigilance, and a requirement to be well informed, about how new technology and experimentation can violate human rights. Furthermore nurses are increasingly facing complex human rights issues, arising from conflict situations within jurisdictions, political upheaval and wars. The application of human rights protection should emphasise vulnerable groups such as women, children, elderly, refugees and stigmatised groups. To prepare nurses to adequately address human rights, human rights issues and the nurses' role need to be included in all levels of nursing education programmes.

ICN endorses the Universal Declaration of Human Rights[1] and ICN addresses human rights issues through a number of mechanisms including advocacy and lobbying, position statements, fact sheets, and other means.

Adopted in 1998
Revised in 2006

(Replaces previous ICN Position: "The Nurse's Role in Safeguarding Human Rights", adopted 1983, updated 1993).

1 Universal Declaration of Human Rights (1948), New York: United Nations

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