Letter from the Chair: Professor PAUL WAINWRIGHT (Summer 2009)

Dear Colleagues,

This will, I think, be my last contribution to the Ethics Forum Newsletter. This is because, as many of you will know, in the course of re-structuring the forums, the RCN has decided that there should not be an Ethics Forum. Ethics is not seen as the kind of activity that should be the focus of a forum - ethics is everyone's business and should be on the agenda of all forums. I am not sure exactly when the forum will cease to exist, but it seems certain that it will not continue beyond October.

There will still be ethics activity in the RCN as part of the governance and policy work of the college. There will be a professional adviser with ethics in their remit, and there will be an Ethics Committee to advise the RCN on ethical issues. These developments are something the Ethics Forum and the Advisory Panel have campaigned for over the last ten years, so they are welcome. I think it is inconceivable that a health care royal college could be a credible organisation without a formal ethics function at the centre. Ethics is a central concern in modern health care, nursing is an ethical practice and the RCN must be capable of giving an informed view, on behalf of members, on issues such as dignity, beginning and end of life care, resource distribution, health and social care policy and the many issues that crop up on a regular basis. The forum has done its best to contribute to these debates but this is not necessarily the function of a membership entity, which depends for its existence on the level of interest among RCN members to sustain it. The formulation of RCN policy and the RCN's response to such issues requires a substantive entity, which must be part of the formal committee structure.

Whether ethics is something that does not warrant a national forum is a more contentious question. What follows are my personal views, not necessarily those of the RCN or of my fellow steering committee members.

I agree that ethics should be part of the discussions of all forums. Each, in taking forward expert practice in their field, will be confronted by specific ethical issues. Many forums have demonstrated their ability to do this - the Children and Young People's Forum, the Fertility Nurses, the Learning Disability Forum, and the Research Society are just a few that come to mind which have tackled major ethical issues within their own areas. But if nursing ethics has any existence as a field of enquiry, it must address the shared questions that confront nurses, regardless of their specialty. The Nursing and Midwifery Council (NMC) sets Standards for Conduct, Performance and Ethics for the whole profession, not for separate areas of practice. There is no NMC Code for children's nurses, or learning disability nurses - nursing is a profession that comes together in common purpose and shares common values. If the study of nursing ethics is to develop, the insights gained within specialist debates must be brought together so that the whole subject can move forward, and this requires a dedicated arena in which that can happen.

Perhaps an RCN forum is not the appropriate place for this to happen. There are other options. I do not think this will be a primary function of the new Ethics Committee, although I may be wrong. But ethics is a field of research, so the Research Society could take it on, or the RCN Institute. The first three clauses of the RCN's Charter as a royal college state that the purposes for which the College was established are:

To promote the science and art of nursing and the better education and training of nurses and their efficiency in the profession of nursing.
To promote the advancement of nursing as a profession in all or any of its branches.
To promote the professional standing and interests of Members of the nursing profession.

It seems to me that providing a forum for members to study, research and develop nursing ethics would be quite within the spirit of the Charter.

It remains only for me to express my heartfelt thanks to everyone who has served and supported the forum over many years, steering committee members, forum members and RCN staff. I look forward to seeing how the next chapter will unfold.