Codes of Conduct Compared: Nursing, Medical, Pharmacy, Dental and Midwifery Standards

Why each profession has its own code

The Health Practitioners Competence Assurance Act 2003 (HPCA Act) gives each responsible authority a list of functions in section 118. Paragraph (i) is the one that produces codes of conduct: each authority must "set standards of clinical competence, cultural competence (including competencies that will enable effective and respectful interaction with Māori), and ethical conduct to be observed by health practitioners of the profession." Subsection (2) adds that standards set under that paragraph are secondary legislation. Our New Zealand overview explains how the 18 authorities, recertification and complaints fit together; this guide goes one level down, into the conduct documents themselves.

That statutory origin explains three things practitioners often find confusing:

• Why there is no single "health practitioner code". The Act gives the power to each authority separately, so each profession gets a document written for its own risks. A pharmacist's code worries about commercial pressure on supply; a midwife's code worries about partnership and workload.
• Why your professional association's code is a different thing. The Medical Council says plainly that Good medical practice "is not a Code of Ethics" and that this role belongs to the New Zealand Medical Association. Association codes guide members; the authority's standards are what you are regulated against.
• Why changing a code takes time. Because these standards are secondary legislation, authorities have to follow formal publication steps. The Nursing Council says its revised Code will be "published as secondary legislation", and the Psychologists Board paused its new Code of Conduct in 2026 after legal advice on exactly this point.

Sitting above all five codes is the Code of Health and Disability Services Consumers' Rights, which applies to every provider whatever their profession. The professional codes repeat many of its duties (information, consent, dignity, complaints) and then add duties the Code of Rights does not cover, such as reporting impaired colleagues or keeping your own health in check. Where your role sits within your registration is a separate question, covered in our guide to scopes of practice under the HPCA Act.

The five codes at a glance

Before comparing duties, it helps to know what kind of document each authority actually publishes. They differ in age, in how they are organised and in whether a replacement is on the way.

Counts of numbered paragraphs, standards or clauses. They are not a measure of strictness: the Dental Council adds 11 practice standards, and the Medical Council publishes separate statements on topics such as sexual boundaries, advertising and telehealth.

The chart is a warning against reading length as rigour. The midwifery Code is short because it sets "the minimum expectations" in plain statements; the dental framework is short because the detail sits in practice standards such as Professional boundaries and Advertising; and Good medical practice points to more than two dozen Council statements, from Informed consent to Providing care to yourself and those close to you. When you compare codes, compare the whole family of documents each authority treats as its standard.

How binding is each code? Must, should and minimum standards

Practitioners regularly ask whether a "should" in their code is optional. Each authority answers that a little differently, and the answer matters when a committee reads your conduct against the text.

Duty-by-duty comparison matrix

The tables below paraphrase what each code says on 13 duties. References are to the numbered standard, paragraph or clause in the current document (Nursing Code 2012, Good medical practice 2021, Pharmacy Code of Ethics 2018, Dental Standards Framework, Midwifery Code 2010). Where a code says nothing on a topic in its core document, the cell says so and names where the authority covers it instead, if anywhere. Short quotes are verbatim.

Patients: honesty, consent, confidentiality and boundaries

What this shows. On honesty and consent the five codes say essentially the same thing as Rights 6 and 7 of the Code of Rights. Boundaries are where the wording diverges. The nursing, medical and midwifery codes extend the prohibition to people close to the patient; the Dental Council does so through its practice standard; the Pharmacy Code relies on a general anti-exploitation clause. On former patients, nobody permits a relationship outright, but the strength of the warning varies, from "inappropriate in most circumstances" (nursing) to "not advisable" (dental). Our professional boundaries course works through these differences with New Zealand scenarios.

Culture, online conduct, money and advertising

What this shows. Gifts are the clearest example of real difference. The Pharmacy Code is the strictest on paper: avoiding conflicts "by not ... accepting" gifts or hospitality. The Medical Council tests whether a gift may affect care or be seen to; the Dental Council draws a line at cash and anything more than a token; the nursing Code asks you to think about whether the gift compromises the relationship. Cultural safety looks similar across the codes, but the 2010 midwifery Code and the 2012 nursing Code predate much of the current Te Tiriti language; the Nursing Council's draft makes a stronger commitment to Te Tiriti and addresses the effects of colonisation. For how these duties feed into recertification, see our comparison of cultural safety CPD requirements.

Safety, self and the record

What this shows. Every code makes raising concerns a duty, not a courtesy, but they differ on who must hear it. The medical and dental documents are the most specific about when the regulator itself must be told; the nursing Code lets you report to your employer or the Council; the midwifery and pharmacy codes focus on raising concerns through the proper process without naming the regulator. Treating people close to you is the widest gap: the Medical Council has a full statement on it, the midwifery Code allows it with care, and the Pharmacy Code is silent. Silence is not permission. A pharmacist dispensing for their own family is still bound by the conflict of interest and professional judgement clauses. If record keeping is the weak link in your own practice, our clinical documentation course and the guide to the Health Information Privacy Code 2020 cover the detail the codes leave out.

What only one code says

Beyond the shared duties, each code carries obligations shaped by its profession's history and risks. These are the clauses colleagues from other professions are least likely to know about.

Several of these quirks are covered in depth in our profession-specific ethics modules: Ethics for Doctors (beliefs, self-treatment and commercial interests), Ethics for Nurses and Midwives (partnership, advocacy and declined care), Ethics for Pharmacists (supply decisions, CAM and conscience) and Ethics for Dental Professionals (fees, consent and disclosure).

How codes are used when a concern is raised

A code of conduct is not a list of offences. It is the benchmark that every body in the complaints system reads your conduct against. Good medical practice says the Health Practitioners Disciplinary Tribunal, the Council's Professional Conduct Committees and the Health and Disability Commissioner "may use Good Medical Practice as a standard". The Dental Council says its framework guides the Courts, the HDC, the Tribunal and the Council. The nursing Code calls itself a way for consumers, nurses, employers and the Council to evaluate nurses' behaviour, and the midwifery Code describes itself as a measure of midwives' behaviour.

1. A concern reaches the authority or the HDC

   From a patient, employer, colleague or the HDC. Complaints about care are usually assessed first against the Code of Rights; the professional code is used to judge whether the practitioner met their profession's standard.

2. The authority decides what kind of concern it is

   Conduct, competence or health. Competence concerns go down the competence review route; health concerns to the authority's health process. Conduct concerns can be referred to a Professional Conduct Committee.

3. A PCC investigates against the code

   The committee identifies which standards are in play and gathers evidence. Expect its questions to track the wording of your code closely. Our guide to Professional Conduct Committees explains the process and possible outcomes.

4. If charged, the Tribunal applies section 100

   Grounds include professional misconduct that amounts to malpractice or negligence, or that has brought or was likely to bring discredit to the profession. The code is the evidence of what the profession expects; a serious departure from it can meet those grounds.

Timing matters too. When a code changes, the conduct being examined may have happened under the old version. If your matter concerns events before a revised code took effect, ask your adviser which version the committee will apply; the nursing and dental revisions make this a live question for anyone whose conduct is examined in 2026 or 2027. More on the wider process sits in our fitness to practise guide.

What is changing in 2026

Two of the five codes are mid-revision, and related standards are moving at the Medical Council and in other professions. Here is what was published, and what is still pending, as at October 2026.

If you work across teams

Most care in New Zealand is delivered by mixed teams: a GP practice with nurses and a pharmacist, a birthing unit with midwives and obstetricians, a community dental service working alongside Well Child nurses. Each person is accountable to their own authority for their own conduct, so the same event can be judged against three different codes. A few working rules prevent most of the friction.

• Set team policies at the strictest common standard. On gifts, a practice policy built around the Pharmacy Code's wording will also satisfy the medical, nursing, dental and midwifery codes. The reverse is not true.
• Agree an escalation path that meets every code. All five make raising concerns a duty. A shared, written path (team lead, clinical director, then the relevant authority or the HDC) means no one is left choosing between loyalty and their own standard.
• Never treat a colleague's code as a ceiling. "The doctor said it was fine" is not a defence for a nurse or pharmacist whose own code says otherwise.
• Document who decided what. Good medical practice expects clear responsibility for each part of collaborative care, and every code expects accurate records. Shared notes should show which practitioner made each decision.
• Watch the online overlap. A team group chat or practice social media account is covered by every member's code, and the Health Information Privacy Code applies on top.
• Check dual registration. If you hold registration with two authorities, each can measure you against its own standards for that registration.

Self-check: which code says what?

Other HPCA Act codes, briefly

The same section 118 duty applies to every responsible authority, so allied practitioners have their own codes too. Three show how quickly this area is moving.

For CPD and recertification rules across these professions, see our allied health recertification guide.

Frequently asked questions