Nursing’s duty of care: From legal obligation to moral commitment

Abstract
Duty of care is a legal, ethical and professional obligation and commitment for nurses to provide quality care and protect patient safety. Although ‘giving care’ and ‘to care’ has been discussed widely in nursing literature, less attention has been given to ‘duty of care’ as a fundamental basis for practice. This narrative review, through a critical analysis of peer reviewed literature, legislation, codes, professional prescribed competencies and cases upheld by commissions and courts of law, explores the historical origins and development of ‘duty of care’, alongside nurse’s legal, ethical and professional parameters associated with duty to care. Major concepts identified include legal and common law definitions of a duty of care which are relevant to nursing, medicine and midwifery; duty of care as an evolving principle; duty of care that goes beyond legal definitions to include a moral commitment to care; and the relevance of duty of care to nursing practice in New Zealand.  This paper concludes that although the origins of a duty to care may have begun in servitude, current expectations of a duty to care are based on outcomes – that of do good and do no harm.  Nursing’s duty of care is regulated by legal, ethical and professional obligations but equally includes a moral commitment to care. These findings suggest duty to care lies at the heart of nursing practice.

Ngā ariā matua
Ko te kawenga kia āta tiaki i te tangata tētahi herenga ā-ture, ā-matatika, ā-ngaio, otirā he whakaūnga nui mā ngā tapuhi, kia hora i te toi o te tiaki mō te tūroro me te tiaki i tōna noho haumaru. Ahakoa he nui ngā kōrero mō te ‘whakarite kia tiakina’ me te ‘āta tiaki’ i roto i ngā pukapuka tapuhi, he iti iho te tirohanga mō te ‘kawenga kia āta tiaki’ hei pūhara taketake mō ngā mahi. Tā tēnei arotake ā-pūrākau he tūhura i ngā take tawhito me te whanaketanga o te ‘kawenga kia āta tiaki’ i te taha o te kawenga ā-ture, ā-matatika, ā-ngaio hoki kia tiaki i te tūroro, mā roto i tētahi arotakenga o ngā pukapuka i āta werohia e ngā hoa, o ngā ture, o ngā rārangi tikanga me ngā pūkenga nā te ao ngaio i whakahau, tae atu ki ngā whakataunga take kōti kua puta i ngā kōmihana me ngā kōti ture. Ko ētahi o ngā ariā matua o roto ko ngā whakapuaki ā-ture, ā-iwi noa hoki, kei roto nei ngā tautohutanga e pā ana ki te mahi tapuhi, ki te ao tākuta me te tapuhi whakawhānau; te kawenga kia āta tiaki hei mātāpono e tupu haere tonu nei; te kawenga kia āta tiaki e piki ana ki tētahi taumata teitei kē atu i ngā tautohutanga ā-ture noa, kia uru mai tētahi whakaūnga ā-tikanga kia āta tiaki; me te hāngai o te kawenga kia āta tiaki ki ngā mahi tapuhi o Aotearoa. Ko te kupu whakamutunga o te pepa, ahakoa i tīmata mai te kawenga kia āta tiaki i roto i ngā here o te mahi mō tangata kē, ko ngā tūmanako i ēnei rā mō te kawenga kia āta tiaki i te tūroro ka takea kē mai i ngā putanga hua - kia mahi i tētahi mahi pai, kia kaua e mahi hē. He mea āta whakahaere te kawenga kia āta tiaki i raro i ngā here ā-ture, ā-matatika, ā-ngaio engari ka uru hoki ki roto te whakaūnga ā-tikanga kia tiaki i te tangata.  Tā ngā kitenga nei he pānui ki te ao ko te kawenga kia āta tiaki te poutokomanawa o te mahi tapuhi.

Keywords / Ngā kupu matua
Duty of care/ Te kawenga kia āta tiaki; registered nurses/ ngā tapuhi rēhita; professional standards/ ngā paerewa ngaio; legislation/ ngā ture; ethical/matatika; moral commitment/whakaūnga ā-tikanga.