2013 Volume 5 Issue 1 Pages 84-102
The practice of ethical decision-making in nursing is illustrated using two cases. This includes the ability to identify situations of values conflict and ethical uncertainty, gather the aspects of the case essential to understanding, perform methodic analysis, and use the virtue of relational skill to achieve better ethical outcome.
Situations vulnerable to ethical uncertainty and values conflict are identified including patients with unhealthy behaviors, patients with preference sensitive conditions, and situations of marginal certainty. The five aspects essential to full understanding of situations of ethical uncertainty discussed are: 1) The facts; 2) The decisions required to resolve the issue; 3) Identifying the critical distinctions needed to resolve the issue; 4) Identifying the influence of social context; and 5) Identifying relevant lines of power and authority. Ethical analysis is described as the balancing of multi-factorial continua. The value of relational skill is illustrated by comparing a combined approach of principles with skillful-ethical use of relationship to a rights-only approach to values conflict and ethical uncertainty.
