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Like physicians, nurses hold a primary ethical obligation to promote patients’ well-being. Nurses’ training, expertise, and scope of practice complement physicians’ professional commitments and expertise. 

While physicians have overall responsibility for the quality of care that patients receive, good nursing practice requires that nurses voice their concerns when, in the nurse’s professional judgment, a physician order is in error or is contrary to good medical practice. 

In light of their shared professional commitments, physicians’ relationships with nurses should be based on mutual respect and trust. As leaders of the health care team, physicians should: 

  1. Listen respectfully and take seriously the concerns a nurse raises about the physician’s order and explain the order to the nurse and modify if appropriate. 
  2. Recognize nurses’ professional responsibility not to follow orders that are contrary to good medical practice. 
  3. Acknowledge that in an emergency situation when the physician is not immediately available, nurses may have a professional obligation to take prompt action contrary to the physician’s order to protect the patient’s health. 
  4. Seek assistance from the ethics committee or other institutional resource to resolve disagreement in nonemergent situations when disagreement about patient care persists. 
AMA Principles of Medical Ethics: IV, V
Read the Principles

Council Reports