RCN Ethics Committee

The purpose of the Ethics Committee is to provide guidance to the nursing profession on ethical issues.

The Ethics Committee does not consider or discuss individual cases.

The Committee advises you to consult the NMC code in the first instance.

You could also be able to get support from:

RCN Direct advice service

If you find that your case could be clarified by legal or employment advice, please contact RCN Direct. This flagship information and advice helpline is open seven days a week, 365 days a year from 8.30am to 8.30pm - 0345 772 6100. Advice is also available through the RCN Direct online advice page.

RCN counselling service

The RCN counselling service is also based at RCN Direct. To access the service please telephone the counselling line on 0345 769 7064.  An initial assessment appointment can then be made for you with an RCN counsellor. Visit the counselling service page for more information.

Raising concerns

If you are considering raising a concern, please refer to your organisational policy in the first instance and the Raising concerns section of the RCN website.

Media contact

If you are a journalist seeking further information, interviews or illustrations, please contact our Press office

RCN ethical impact assessment tool

Please follow this link to access the RCN ethical impact assessment tool

RCN Ethics Network

The RCN is establishing an Ethics Network to act as a sounding board for the RCN Ethics Committee.  It will be led by the committee and the network will have the opportunity to feed into and inform the committee’s work.  The purpose of the Ethics Committee is to provide guidance to the nursing profession on ethical issues.

The network will consist of both RCN members and external advisers. Communications will mostly be virtual, but the committee intends to hold an annual meeting with members of the network to encourage greater networking and the exchange of expertise and to build stronger working links with committee members and their work programme.

If you would like to join the Ethics Network, please complete the application form below and return it by email to governance.support@rcn.org.uk or by post to the Governance Adviser (Ethics Committee), Governance Support Department, Royal College of Nursing, 20 Cavendish Square, London W1G 0RN.

Ethics Committee seminar: Deprivation of Liberty Safeguards 11 September 2015

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Toby Williamson, Head of Development & Later Life at the Mental Health Foundation posed the question whether the Deprivation of Liberty Safeguards (DoLS), are an ‘ethical rollercoaster’, at an important and illuminating seminar, organized by the RCN Ethics Committee on 11 September. He briefly mentioned the historical background to the Safeguards, in particular, the influence of European Human Rights legislation, before exploring them in the context of the Mental Capacity Act 2005 (MCA 2005), general ethical principles (such as respect for autonomy, fairness, and justice), and finally the requirements of the NMC code. He reminded his audience that, in the words of the House of Lords Committee Report in 2014 on the MCA, the Act was ‘a visionary piece of legislation for its time’ marking a ‘turning point in the statutory rights of people who may lack capacity…..placing the individual at the heart of decision-making’. The Act had the ‘potential to transform the lives of many’.

But both Toby and Alex Ruck Keene, barrister, honorary research lecturer at Manchester University, and leading expert on mental capacity law, also agreed with the Committee that the Act suffered from ‘a lack of awareness and a lack of understanding’ and that in both health and social care sectors, ‘the prevailing cultures of paternalism (in health) and risk-aversion (in social care) have prevented the Act from becoming widely known or embedded’ in practice.

The central aim of the seminar was to discuss the implications of the recent Supreme Court judgment in what has become known as the ‘Cheshire West’ case. Alex explained the requirements of Article 5 of the European Convention on Human Rights, and the response of the then Government to the gap in legislative protection identified by the European Court in the ‘Bournewood’ case. This involved an informal, compliant, psychiatric patient, unable to consent, who was deprived of his ‘liberty’. The Government then tacked on, in what is widely considered an ill-thought through way, the DoLS regime to the MCA 2005.

In Cheshire West the Supreme Court then asked whether ‘liberty’ means something different to an adult who is unable (for reasons of disability) to take advantage of it, or does ‘liberty’ mean the same for all? In answering (in only a majority decision), yes it means the same, the Court then went on to pose the ‘acid test’: is the patient under continuous supervision and control, and does she lack the freedom to leave? If so, the patient is deprived of her liberty, and entitled to the protection of DoLS.

The judgment has provoked ‘howls’ of protest from health and social care providers, who have struggled to apply the now legal test to a range of situations, such as women in labour in hospitals, or patients in intensive care units etc. Applications for DoLS have rocketed, and the whole exercise has become a reactive, tick-box affair, without any consideration of the fundamental principles underpinning the MCA.

Alex and Toby both included key messages for delegates such as ‘ensure proper MCA compliant care delivery first, and then you will be able to justify a deprivation of liberty’; organisations should have appropriate policies in place to address this issue, and not leave it solely to the judgments of individual health care professionals; advance consent is now so important; and so on.

Finally, both speakers highlighted the current Law Commission consultation on DoLS and urged delegates to respond to the same, with their invaluable practical experience of working with patients who may, in particular situations, lack the capacity to make a decision about a specific health or social care intervention.

Watch the the seminar, and read the links to expert advice and information on this critical area of the law and health care practice.