Frequently Asked Questions

The CNA Code of Ethics is for all nurses in Canada, including licensed and registered practical nurses (LPNs and RPNs), nurse practitioners (NPs), registered nurses (RNs), and registered psychiatric nurses (RPNs), regardless of their role, setting, or location. While it serves as a foundational document for nurses, the Code can be utilized by educators, employers, regulators, researchers, and members of the public to build a deeper understanding of ethical nursing in Canada.

The Code was developed through a rigorous, inclusive process starting March 2024 to publication in July 2025. The process involved national consultation with nurses, regulators, educators, researchers, and members of the public. Feedback from equity-denied groups and community partners helped ensure the content reflects diverse experiences and ethical priorities across Canada’s health systems.

The development of the Code of Ethics was shaped by a wide-ranging and inclusive consultation process designed to reflect the diversity of the nursing profession and those it serves. CNA engaged key informants across Canada through focus groups, one-on-one sessions, and targeted outreach. These consultations included:

• Nurses from all licence streams across the continuum of care and across Canada (including rural, remote, and northern communities)
• CNA Fellows and members of CNA’s action councils, including those focused on Indigenous health, francophone perspectives, anti-racism, the future of nursing, and student and early-career nurses
• Nurses and others in formal health leadership roles, including executives, clinician scientists, and chief nursing officers
• Nurses from the 2SLGBTQIA+ and BIPOC communities, including members of the Rainbow Nursing Interest Group, Philippine Nurses Association, Canadian Black Nurses Alliance, and others
• Internationally educated nurses (IENs)
• Francophone nurses and organizations
• Indigenous nurses and leaders from First Nations, Inuit and Métis communities
• Nursing associations, unions, regulatory bodies, and schools of nursing/educational institutions
• Service recipients and patient advocacy groups

By drawing on such a wealth of knowledge and expertise, the Code reflects not only ethical principles but also the practice realities of today’s nursing professionals and the lived experiences of the communities they serve.

CNA has a free version of the Code available online with all values and principles accessible to all.

The full PDF version of the Code is available for a nominal fee ($25 members, $32 non-members) that allows for easy scrolling, offline access, and keyword searching (e.g., using Ctrl+F). This version also includes the foreword, introduction, acknowledgements, and glossary that support a deeper understanding of the values and guiding principles. The nominal fee offsets the costs associated with development, design, formatting, and digital production.

The CNA Code of Ethics is being offered as a digital publication to ensure broad accessibility and ease of navigation. A web-based format allows nurses to access the Code anytime, anywhere.

For those interested in bulk purchases, you can email us at members@cna-aiic.ca with the following subject line: Code of Ethics Bulk Purchase Request

No. The Code is not legislation; it is a guidance document. Nursing bodies — including regulators, employers, and educators across Canada — can use the Code to guide education, professional practice, and practice guidelines. It serves as an ethical compass for all nurses, regardless of specialty, setting or location.

The Code of Ethics is grounded in professional, evidence-informed ethics — not political ideology. It reflects the evolving realities of nursing practice and the populations we serve. Naming systemic inequities is a matter of ethical responsibility, not partisanship. The Code is designed to support nurses in delivering safe(r), culturally responsive, and respectful care for all.

The 2025 CNA Code of Ethics reflects the evolving realities of nursing and society. While it builds on the foundational principles of the 2017 Code, it introduces several important updates to better support nurses in today’s complex practice environments including, but not limited to, reconciliation and anti-racism, expectations for self-care and psychologically safe workplaces, explicit ethical guidance for contemporary issues, ethical obligations in formal and informal leadership roles and, finally, clearer, more inclusive terminology.

Please note, the 2025 Code of Ethics supersedes the 2017 version and, where possible, should be used as the most current ethical framework for nursing practice in Canada.

Nursing practice in Canada is regulated at the provincial and territorial levels. Some regulatory bodies utilize the CNA Code of Ethics to inform and update their practice guidelines as well as their professional standards and code of conduct. The Code is broadly recognized by nurses across the country as a highly relevant, practical, and meaningful resource in their practice.

If at any time a regulated nurse is unclear about their professional obligations or the requirements of their ethical standards of practice, they are encouraged to contact the nursing regulator in their province or territory.

Yes. We will be hosting a webinar to inform nurses about the key changes and updates in the 2025 Code of Ethics. In addition, we are planning to release a series of case studies to accompany the Code that can be used to support implementation and practice across health-care sectors.

CNA draws on the World Health Organization’s definition of health, as outlined in its constitution: “Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity” (World Health Organization, n.d.).

Not at all. Western medicine has contributed significantly to health and well-being in Canada and around the world. Acknowledging harm means recognizing that no system is perfect or neutral — and historical policies and practices favoured certain values while sidelining others — and this had real consequences for many equity-denied populations. We have a responsibility to include diverse perspectives and practices, especially those that have been previously excluded or undervalued. Expanding our approach improves care for everyone. We encourage readers to learn more by visiting CNA’s Racism in Health Care web page.

Equity means recognizing people don’t all start with the same access to resources, supports, or opportunities in life. Treating everyone the same might look fair, but it can make inequality worse. The Code emphasizes equity so that each person gets the specific support they need to thrive — especially those who have been systemically left out or underserved in the past — and so nurses have the tools to put this into practice. This also ensures that any new and emerging equity denied groups are also considered. Ultimately, we must progress towards justice by fundamentally shifting health systems and the way in which they are organized.

Historically, nursing education in Canada often excluded critical conversations about colonization, systemic racism, and cultural safety. Today, there is clear and growing recognition that factors such as race, income and socioeconomic status are not just social or political concerns — they are determinants of health that have long lasting impacts on health outcomes. The chief public health officer of Canada’s 2019 report highlights that people who experience stigma are more likely to delay or avoid seeking care, and more likely to receive lower quality treatment, which directly results in poorer health outcomes. The Truth and Reconciliation Commission of Canada similarly identified systemic racism in health care as a legacy of colonialism and called on health professionals to confront these harms in education and practice. Updating the Code ensures that nurses are equipped to meet the ethical and practical demands of contemporary practice.

Sample evidence of harm is listed below:

• In the 1940s and 1950s, Canadian researchers — with the involvement of some health professionals, including nurses — conducted unethical nutrition experiments on Indigenous children in residential schools. These children were intentionally denied proper nutrition to study the effects of malnourishment. These experiments informed early versions of federal nutrition policy, including what eventually became the Canada Food Guide (Mosby, 2013; MacDonald et al., 2014 ).
• Black Canadians have also faced harms rooted in biased health systems. Research shows that some health professionals continue to hold false beliefs — for example, that Black people feel less pain — which leads to under-treatment and inadequate care (Hoffman et al., 2016; Boakye et al., 2024; Williams et al., 2024).
• Inuit in Canada were found to have a life expectancy at birth up to 14 years shorter for males and 11 years shorter for females compared to the overall Canadian population — a gap tied to the legacy of colonization and systemic inequities (Public Health Agency of Canada, 2019).

Medical assistance in dying (MAID) is a complex and evolving area of nursing practice that raises profound ethical considerations related to patient autonomy, moral distress, conscientious objection, and end-of-life care. Since its legalization in 2016, and its initial inclusion in the 2017 Code of Ethics, the legal, clinical, and ethical landscape of MAID has continued to shift — shaped by legislative changes, court rulings, and public discourse. The 2025 Code responds to this evolving context by providing nurses with explicit, values-based guidance to navigate their roles and responsibilities, whether they are directly involved or indirectly supporting care.