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. 2021 Feb 23;44(3):183–194. doi: 10.1097/ANS.0000000000000355

Table. The American Nurses Association (ANA) Code of Ethics Provisions Intersections With Biopower, Conscientization, and Structural Competency.

ANA Code of Ethics Provisions6 Agamben's Biopower in Contrast to ANA Code of Ethics Provisions Strategies: How Critical Conscientization and Structural Competency Might Mitigate Biopower
Provision 1
“The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.”
A person who is devolved to homo sacer is denied their inherent dignity, worth, and unique attributes. Through critical conscientization and structural competency, the nurse reclaims their practice to resist devolution of individuals to homo sacer.
Provision 3
“The nurse promotes, advocates for, and protects the rights, health and safety of the patient.”
The nation-state, under the guise of democracy, enacts biopower and allegiance to the state through negation of the “rights to rights,” which often occurs in states of exception such as civil unrest or pandemics. Critical conscientization and structural competency are strategies for nurses to resist biopower and to advocate and protect the rights, health, and safety for patients.
Provision 5
“The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional growth.”
Biopower denies patients' wholeness of character and integrity. Nurses operate at the juncture of biopower, having to choose between bios and zoe in a system designed to reward efficiency.12 Critical conscientization requires continued personal and professional growth and can be promoted by the use of the Peace and Power Framework.39
Provision 6
“The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality healthcare.”
The normalization of and complicity with biopower prevent nurses from creating ethical environments that are conducive to safe, quality health care for all. Structural competency provides a framework for nurses to understand how larger structural factors impede health. The pedagogy of conscientization and structural competency provides the framework for nurses' capacity to act for a more ethical environment for safe, quality health care and transformative change.
Provision 8
“The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.”
Biopower and the condition of zoe signify that human rights are secondary to the sovereignty of the state. Under biopower, power is totalitarian and can be enacted with impunity during States of Exception. Conscientization is the awareness of injustice and structural competency provides the pedagogical tools for nurses to act in alignment with this ANA provision.
Provision 9
“The profession of nursing collectively through its professional organizations must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.”
Biopower negates justice by categorizing groups of people unworthy of dignity and respect with impunity. In contrast to biopower's impunity, professional organizations and nurses should be accountable to maintain the integrity of the profession and integrate principles of social justice. Conscientization and structural competency guide nurses to praxis.

Abbreviation: ANA, American Nurses Association.