Nurses confront a variety of ethical and legal issues in both practice and education, and questions of rights, obligations, and duties arise which can have life and death consequences. Questions reflect the conflict between patients' rights and professional obligations, and between the use of resources for one individual at the expense of others.

Nursing has come a long way. Today's professional nurse is intimately involved in virtually all areas of our expanding health care system — in the community, in industry, in clinics, in education, in hospitals, and in government. The practice of nursing today frequently entails making and participating in important and critical decisions, as well as performing a wide variety of modern clinical functions. All of this requires a sound base of sophisticated medical knowledge and a high degree of technical skill. This is a major change from the nurse of the past, who practiced primarily within the hospital setting, doing what she was told, providing bedside "service" to patients, and rarely, if ever, asking questions or making decisions.

I felt honored when I was invited to contribute to this first issue of Nursing Law & Ethics. Thinking about what I might say, I noted that it is only about two years less than twenty since I began a series entitled, "The Law and The Nurse" in the American Journal of Nursing. It appeared for more than ten years before the AJN and I came to a parting of the ways. The end of my relationship with AJN was not due to what I said in its pages. Rather it was the result of adverse reactions to my views regarding licensure of health personnel.

Nurses are concerned with doing what is “right” when faced with the complexities of today's medical care system. Doing what is “right” is what ethics is all about. Ethics is a system of moral principles or the recognized rules of conduct. While an ethical system is a general one, specific activities can raise unique issues. Thus, we can talk about nursing ethics, medical ethics, legal ethics, etc. One often finds oneself in dilemmas for which there is no legal solution — that is, there is no clear, legally enforceable duty to do or refrain from doing something, and not everyone agrees or feels that there is a right and wrong solution.

As a society, we look to the law and the courts to vindicate and protect human rights. When the courts fail, the tragedy falls not only on the victim but also on all of us; human rights must be universal or we cannot be certain of them for ourselves. A recent California case illustrates that courts too sometimes fail to vindicate the rights of the weak and helpless.* While not specifically dealing with nursing, the case is so bizarre, and has received such publicity, that all nurses should be aware of its implications.