Patient safety, ethics and whistleblowing: a nursing response to the events at the Campbelltown and Camden Hospitals.

IN NOVEMBER 2002, in what stands as one of the most significant whistleblowing cases in the history of the Australian health care system, four nurses went public with concerns they had about the management of clinical incidents and patient safety at two hospitals in Sydney, New South Wales. The handling of this case and its aftermath raises important moral questions concerning the nature of whistleblowing in health care domains and the possible implications for the patient safety and quality of care movement in Australia. This paper presents an overview of the case, the moral risks associated with whistleblowing, and some lessons learned. The International Council of Nurses (2000) Code of Ethics stipulates that nurses have a stringent responsibility to "take appropriate action to safeguard individuals when their care is endangered by a eo-worker or any other person". Other local and international nursing codes of ethics and standards of professional conduct likewise obligate nurses to take appropriate action to safeguard individuals when placed at risk by the incompetent, unethical or illegal acts of others including the system. Despite these coded moral prescriptions for responsible and accountable professional conduct, taking appropriate action when others are placed at risk (including making reports to appropriate authorities) is never an