Other Specific Guidelines

12. Care for People with Special Needs
Nurses and Midwives shold be very conscious of their advocacy role in caring for persons with special needs ensuring they are accorded due respect and dignity at all times. Nurses and Midwives should enable those who are handicapped or aged to live life fully and strive to help individuals develop their full potential.

13. Assisting Human Conception
Respect for the process of transmitting life requires that in the process of assisting conception all values involved in human sexual activity should be upheld, Natural family planning is to be valued as a method that can be employed so as to respect the integral meaning of the marital act.

14. Extra corporeal conception as is attained, for example, in the process of in-vitro fertilisation bypasses the marital relationship and is not ethically justified. The life and physical integrity of many of the generated embryos are put in grave risk of harm and destruction by the very nature of the process. Any such procedures, which do not respect the life and physical integrity of each human being from conception, violate the medical mission of safeguarding life and health and therefore are not ethically justified.

15. Protection of the Unborn
Direct abortion, that is, any procedure the direct purpose of which is to destroy the embryo at any stage of its development, either by preventing its from implantation, or removing it from the womb before it is viable, or by any other procedure, is never permitted since it constitutes the intentional killing of a human being.

16. Care for Women during Pregnancy
Healthcare for a woman during pregnancy aims at securing the well-being both of the mother and her unborn child. There are circumstances, however, in which the organic pathological conditions of the mother require operations and treatments that cannot be postponed until the unborn child is viable. These treatments may be carried out even though the unborn child may be harmed or die as a result. The purpose of the procedure is never to cause the death of the child but rather to treat the physical pathology of the mother.
17. Genetic disorders
Parents with a Genetic Disorder who decide to accept the risk of conceiving children should be supported and not subjected to discrimination or disapproval.

18. Preservation of Bodily Integrity
Procedures that induce infertility whether permanent or temporary are only ethically justified when they are immediately directed to the prevention of a serious pathological condition and are not intended to act as a means of contraception.

19. Care of the Dying and Palliative Care
In good clinical practice an awareness of the condition and prognosis for the patient may occasion a change in the focus of treatment from cure to palliative care. In the terminal phase, care aims at making the patient's life and eventual death as comfortable and as humanely and spiritually meaningful as possible. We are committed to care for every patient as a person with dignity and full humanity until his or her death naturally occurs.

20. Nutrition and hydration appropriate to the patient's condition should always be provided, even when therapy is no longer beneficial or appropriate. This may include medically assisted nutrition and hydration, provided the burden on the patient is not out of proportion with the benefit. The withdrawal of nutrition or hydration with the intention of hastening death is always unethical.

21. Palliative care involves not only relief of pain and any distressing symptoms but also through a personal presence, encourages and supports the one who now has to adjust to the process of dying, A similar support must be given to the
family as they also adjust to the fact that their loved one is dying. There is no obligation to use extraordinary means to prolong life.

22. Transplantation of Organs and of Human Tissue
The transplantation of organs is morally permissible provided the loss of such organs does not deprive the living donor of life, or of the functional integrity of his or her body. All such procedures require the free and informed consent of the recipient, the donor, or next of kin. Vital organs, that is, organs necessary to sustain life must not be removed until death has taken place.

23. The determination of the time of death must be made in accordance with responsible and generally accepted scientific criteria. In accordance with current medical practice the transplantation team should always be independent of the donor's doctor or doctors.

24. Nursing and Medical Research
The use of experimental, therapeutic descriptive or evaluative research involving surgical, medical, pharmacological or psychological techniques or procedures raises special moral issues. All experimental procedures. including those carried out solely for the purpose of research, require the informed and free consent of the patient, also the approval of the appropriate Ethics Committee. The knowledge sought through research involving human subjects must be unobtainable by any other means. Only professionals with the appropriate qualifications must carry out this research.

25. A distinction is to be made between therapeutic research, which offers the possibility of benefit to the patient concerned,
and non-therapeutic research, which is for the advancement of medical knowledge and may benefit other patients in the future.
Non-therapeutic research, however useful from a scientific point of, view, may never be carried out in respect of persons who are not themselves competent to give consent.

26. In clinical research involving the unborn, the subject of research must be given the same protection as children who are born.

Right 10 Conscientious Objection

27. Our commitment to excellence in healthcare requires of us an obligation to avoid every participation in any procedure, treatment or research that we understand will violate or be harmful to the wellbeing and integrity of the person. This obligation gives us the right to be respected in our conscientious objection to such participation.

Responsibility in the use of Resources

28. Nurses and midwives should be aware of their responsibility in the effective management of resources. They should use their influence in their place of work to promote a climate of fairness and equity in the delivery of patient care. They also share responsibility in sustaining and protecting the natural environment from pollution and destruction.