Ethical Decision Making

Ethical Decision Making

Applying an Ethical Decision Making Model


The practice of nursing has been lately faced by several ethical concerns which limit operations. This study will analyze these issues and how they have affected practice of nursing. People going to seek treatment have been the most affected by the decisions made relating to health care and in result a model should be developed to reduce the complexity of decision making especially in relation to unstable and vital scenarios in the hospitals such as the intensive care. There should be transparency and efficiency in communication among nurses, doctors, patients and families of the patients when choices have to be ethically made regarding the life of the patient in question.

Nurses ought to receive training which is sufficient and use the right devices and other instruments so that they can be able to made ethical decisions easily and with care needed. An expert in health care who is not morally approvable is regarded unsuitable for the practice of nursing heedless to his or her superiority in clinical medicine cognizance and abilities. The judgments made by the healthcare professional affect the patients directly in terms of their safety and overall heath and therefore nurses should be morally upright to be able to make good decisions that will not harm their patients in any way. The subject of discourse in this paper is to out bring the present relevant information relating to effects of ethics on nursing practice, a model of decision making and the importance of transparent communication in health care facilities.


Ethical Issues, Ethical Model, Stakeholders and Addressing the Issues

A number of problems are encountered by nurses in their practice for instance where the patients cannot defend themselves. This is an ethical problem since the nurse has to make the right decision for that patient without bias or intentional desire to harm him or her. Majority of the ethical problems faced in healthcare relate to disagreements with families, firmness of conviction, ranking and the policies set by the staff of that particular health facility (Arnold, 2015). These issues should not be taken lightly as they are wide in extent and scope and can take a lot of time to find a solution for them. When nurses are involved in such ethical issues, they may experience long term exhaustion and diminished interest in their career especially when they do not find a motivation to it and they therefore need to be adequately informed on how to deal with such issues.

The high level of complicacy and the quick evolvement of the healthcare environment have rendered morally upright decision making to become more demanding and therefore nurses should use a model to enable easier decision making. The model comprise of six steps that have beneficial uses that aim for maximum performance:

“(1) Establishment of the ethical problem;

(2) Gathering of supplemental information to establish the problem and create solutions;

(3) Creation of alternative choices for analysis and evaluation of similarities and differences

; (4) Choosing the best alternative and explanation which provides morally acceptable support for behavior;

(5) Development of dissimilar, applicable ways to implement morally upright decisions and actions; and

(6) assessment of the effects and development of plan of action in order to curb the occurrence of the same problem (Chism, 2017). The quality of decisions made should be evaluated from the process of decision making to the quality of decisions made after implementing the model.

The model can in overall improve the decisions made by the nurses involved although they may vary due to personal beliefs, gender and expertise. For instance, female nurses tend to be tender with patients and can hence make decisions that seem less harsh on their patients. On the other hand, male nurses can seem handy and make decisions that they feel the patient can handle especially by use of justice. A clear method of decision making leads to implication of more knowledge to nurses which can in turn lead to improvement in decision making since a nurse will have to evaluate the pros and cons that will arise upon making a certain decision. The model will help nurses to be more careful and be able to make great decisions that will not affect their patients negatively.

There are situations where extremely important decisions have to be made spontaneously. These do not allow deliberation or study of the patient in question before making the decision for example in the Intensive Care Unit (Morton, 2017). He nurses who work in these sections need to be more educated on ethical decision making so that they do not bear a burden of guilt upon implication of a certain decision they may have come up with.  Development of training in heath care facilities acts as a strategy of problem solving which allows discussion of the problems being faced by nurses. The more the nurses are educated; there is probability of decrease in ethical problems in future since lessons may be obtained from the past mistakes made in health care units.

To resolve crisis in decision making, there should be transparency in communication with all the parties involved such as patients, families, co-workers, among others so that there can be reduction of conflicts since every party will feel accommodated. Before making decisions, there should be communication with these people so that none is left out and ethics are maintained. When nurses communicate with the families of patients, there is probability of learning different responses that can be related to different people and hence they are able to handle similar cases in the future (Arnold, 2015).

In intensive care, ethical decision making processes are altered slightly. Ranking problems, communication and social problems affect decisions made. ICU nurses have a different setting since visiting of the patients by families can be restricted unlike other in other sections of the heath care and hence they have to make ethical decisions on behalf of their patients appropriately (Morton, 2017). The difference in competence and moral values greatly affect the quality of decisions made by the nurses in different units in the health facility.

During end-of-life situations, effective communication is important for nurses, doctors, patients and families. It’s difficult to decide if to implement a do- not -resuscitate DNR order for the patient due to the knowledge of the quality of life of that patient. Decisions such as these require communication of the patient and families so that they can give go ahead to the doctors and nurses on the case. Close attention is paid to the spiritual and emotional needs of the family and patient to make the decision (Urden, 2017).

Another issue faced by nurses is privacy. The Health Insurance Portability and Accountability Act leave them with no choice but to protect the confidentiality of their patients at all costs. Internal conflict is also an issue faced by nurses in regard to when they are making decisions on behalf of others. Maintenance of ethics can be hence accomplished by clarity of communication, adherence to the wishes of family and the patient and a more clear treatment program.


In conclusion, ethical problems in nursing practice can be resolved in one way or another for instance through adherence, training and clear communication. The six step model is a great stepping stone in relation to solving ethical issues in healthcare. It will give directions to nurses and other health experts before making critical decisions that may question their morality.

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