Code of Ethics with Interpretive Statements for the Certified Registered Nurse Anesthetist (1986)


American Association of Nurse Anesthetists


CSEP Library

Date Approved: 

August 15, 1986

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Code of Ethics with Interpretive Statements for the Certified Registered Nurse Anesthetist


The purpose of a code of ethics is to acknowledge a profession's acceptance of the responsibility and trust conferred upon it by society and to recognize the internal obligations inherent in that trust. It applies to those nurse anesthetists who are certified or recertified by the Councils on Certification/Recertification of Nurse Anesthetists and who are also members of the American Association of Nurse Anesthetists (AANA).

The AANA Code of Ethics is devised from the premise that as health care professionals, Certified Registered Nurse Anesthetists (CRNAs) must strive, both on an individual and collective basis, to pursue the highest possible ethical standards.

The principles set forth define the profession's expectations and responsibilities which each member of the American Association of Nurse Anesthetists has as a personal obligation to uphold and adhere to, as well as to ensure collegial conformance.

    1. Patient Care

A Certified Registered Nurse Anesthetist

      has the responsibility to preserve human dignity, respect patient rights, and support the well-being of the patient under his/her care.

Interpretive Statement:The must universally render individual anesthesia care regardless of the patient's race, color, creed, age, sex, nationality, or his or her social or economic status.

    1. Competence

A Certified Registered Nurse Anesthetist

      continually demonstrates a high level of competence. Competence is a composite of the individual's professional knowledge, judgment, values, and technological and interpersonal skills.

Interpretive Statement: CRNAs must assume the responsibility to strive for excellence and maintain that level of knowledge, judgment, technological skills, and professional values prerequisite to delivering high quality health services. CRNAs engage in life-long professional educational activities and participate in peer review and other quality assurance mechanisms as a basis for assessing quality of care/practice for purposes of public protection. While there are no mechanisms which can fully guarantee competent practice in every instance, each CRNA joins the profession in constantly reviewing practice and upgrading its standards for the public benefit.

    1. Individual Professionalism

A Certified Registered Nurse Anesthetist

      is responsible and accountable for individual professional judgments and actions and is an advocate for the patient's rights.

Interpretive Statement:

      1. Responsibility - CRNAs are individually responsible for the anesthesia care delivered.

      2. Professional Judgment-CRNAs are accountable for judgments made and actions taken in the practice of nurse anesthesia. Neither physician's orders nor institutional policies relieve the Certified Registered Nurse Anesthetist of accountability for actions taken and judgments made relative to the care of the patient.

      3. Informed Consent and Safety-As a licensed professional, the CRNA must be sure that informed consent has been obtained and that safe anesthesia care has been rendered to the patient.

    1. Societal Obligation

A Certified Registered Nurse Anesthetist

      has a two-fold obligation to society: as a professional, licensed to render selected health care services, and as a responsible member of society and the community in which he or she lives.

Interpretive Statement: As a health professional, the Certified Registered Nurse Anesthetist has an obligation beyond that of rendering high quality services for which he or she is qualified in addition to being a responsible citizen in the community. The AANA recognizes that the CRNA must maintain a complex professional stature to meet demands of health care and his or her inherent responsibility to the community.

    1. Confidentiality

A Certified Registered Nurse Anesthetist

      defends the patient's right to privacy by protecting information of a confidential nature from those who do not need such information for patient care.

Interpretive Statement: A CRNA will respect the confidentiality of information about patients learned in clinical relationships unless clearly required by law to break the confidence, such as to protect innocent parties in direct jeopardy. Appropriate written departmental or institutional guidelines and protocol are helpful in determining the manner in which confidential information is handled.

    1. Personal Conviction

A Certified Registered Nurse Anesthetist

      maintains personal integrity, acts to safeguard patients from the unethical or illegal actions of any person, and strives to establish appropriate mechanisms to protect his or her freedom of conscience as it pertains to patients and all members of the health care team.

Interpretive Statement: Anesthesia care is rendered as a collaborative effort in the broad spectrum of health care. A CRNA is obligated to be knowledgeable relative to moral and legal rights, and must resolve matters of personal conviction within this collaborative framework. That is, in situations where the CRNA's personal convictions prohibit participation in a particular procedure, the CRNA may withdraw from the case provided that such withdrawal does not harm the patient. CRNAs should avoid employment situations where frequent conflicts of personal conviction are likely to occur.

Each CRNA will assume responsibility for protecting patients and the profession against colleagues who may be incompetent and/or ethically deficient. A CRNA who exhibits incompetence or engages in illegal conduct, or otherwise fails to meet the principles of this Code of Ethics, should be exposed without hesitation to the proper authority.

    1. Endorsement

A Certified Registered Nurse Anesthetist

      may personally endorse products and services provided that he or she assumes personal accountability for their safety/quality. However, a CRNA may not infer that he or she is acting as an agent of the AANA unless duly authorized by the Board of Directors of the AANA.

Interpretive Statement: CRNAs actively represent themselves in a variety of settings to include professional, personal, public, educational, media, and social. A CRNA must exercise sound judgment in these matters, declining participation in situations where he or she will be viewed as an agent of the AANA and any chance of a conflict of interest between the CRNA and the AANA exists.

    1. Research Ethics

A Certified Registered Nurse Anesthetist

      protects the rights of patients or animals involved in research projects and conducts the projects according to accepted ethical research and reporting standards.

Interpretive Statement:

      1. The CRNA as a Researcher-As a professional, the nurse anesthetist participates in activities that identify, verify, and expand the body of knowledge forming the foundation of practice.

      2. Protection of Patient Rights -The CRNA has an obligation to protect and ensure the patient's rights. Informed consent, privacy, and protection from risk of injury must be assured. The investigation must be discontinued if it could be harmful to the subject.

      3. General Research Guidelines -Generally accepted research guidelines should be followed. These include: (1) objectives, (2) methodology, (3) approval by appropriate bodies, (4) accuracy, and (5) validity. A CRNA who participates as an investigator in a research project should receive proper recognition and should follow the policy requirements dictated by public law and by institutional procedures.

    1. Practice Settings

A Certified Registered Nurse Anesthetist

      has the right to participate in a variety of practice settings, including private practice, institutional employment, and other variations of business organization.

Interpretive Statement:

      1. Right to Practice -The CRNA has the legal right to practice in a variety of employment settings and business relationships. This right encompasses the full spectrum of professional practices, including institutional and corporate employment, and individual or group private practice.

      2. Reimbursement Responsibility -When the CRNA is a private practitioner, he or she has an ethical responsibility to the consumer to ensure responsible reimbursement policies. Fees for professional anesthesia services should be consistent with reasonable and customary charges and should reflect actual participation in and/or consultation on the procedure.

    1. Contracts and Employment

A Certified Registered Nurse Anesthetist

      participates in the profession's efforts to maintain conditions of employment and contractual relationships that are conducive to quality patient care and to ensure that compensation is commensurate with responsibility.

Interpretive Statement:

    1. Responsibility for Conditions of Practice-The CRNA must be concerned with conditions of employment and practice privileges that enable him or her to ensure optimal patient care in accordance with the standards promulgated by the profession. These standards include the preanesthesia assessment, intraoperative management, and postanesthesia care.

    2. Contractual Agreements -A CRNA may enter into contractual agreements to provide anesthesia care. Such agreements may be individual or part of a collective bargaining unit. Any agreement should be consistent with the professional standards of practice, laws, and regulations pertaining to nurse anesthesia practice.

    3. Compensation- The administration of anesthesia requires knowledge and skills in many areas. It demands the close, careful monitoring of the patient's vital signs and his or her response to anesthesia agents. The CRNA has the right to receive appropriate compensation consistent with the education and responsibility inherent in anesthesia practice.

Approved by the AANA Board of Directors on August 15, 1986.
© Copyright 1986
American Association of Nurse Anesthetists
216 Higgins Road
Park Ridge, Illinois 60068