Background: Ethical codes are guidelines that orient nurses and ensure that their decisions are in
accordance with the values of the professional system. These codes show that there is a connection
among values, patients’ rights, and nurses’ duties.
Objectives: This study aimed to compare the viewpoints of patients, nurses, and nurse managers regarding
the extent to which clinical ethical codes are observed.
Research design: In this descriptive–comparative study, data were collected using three questionnaires
based on Iranian nurses’ ethical codes with a focus on clinical care. The reliability of the questionnaire was
verified by test–retest method (r ¼ 0.9). The patients were interviewed by the researcher, but nurses and
managers completed the questionnaires themselves. After all, the data were analyzed using the SPSS
statistical software (v 15).
Participants and research context: In all, 100 patients, 100 nurses, and 30 managers from internal and
surgical wards of two major hospitals in Shiraz, Iran, participated in 2014.
Ethical considerations: This research was approved by the Ethics Committee of Shiraz University of
Medical Sciences. All the participants signed written informed consents.
Findings: According to the results, 70% of the patients, 86% of the nurses, and 53.3% of the nurse managers
rated nurses’ adherence to ethical codes as satisfactory. The mean scores (standard deviation) of the level of
adherence to ethical codes were 38.44 (6.91) in the patients, 41.08 (4.82) in the nurses, and 37.83 (6.98) in
the nurse managers. The results of analysis of variance revealed a significant difference between the
attitudes of the nurses and the other two groups (p ¼ 0.001).
Discussion: Nurses’ adherence to ethical codes was satisfactory in all three groups. Accordingly, our
findings agree with the results of some national and international studies, although there are still
controversies in this regard.
Conclusion: Although the nurses rated their performance in certain fields more satisfactory compared to
the patients and managers, all the three groups agreed that clinical ethical codes were properly observed in
the internal and surgical wards. Nurses can improve the quality of care by considering the viewpoints of
patients and managers about their ethical performance.