Assess the situation (gather data)
Recognise and then describe the situation and contextual
factors that give rise to the ethical problem. This involves
the main people involved (their views and interests); the
person’s overall nursing, medical and social situation; and
relevant legal, administrative and staff considerations.
Identify the ethical problem
State the problem clearly. Identify your relationship to the
decision. Identify time parameters. Make sure that the
problem is an ethical problem as opposed to a communi-
cation or legal problem. Some suggest that, whenever
human dignity is being threatened, you have an ethical
problem.
Plan
Identify options and explore the probable short-term and
long-term consequences for each stakeholder. Use ethical
reasoning to decide on a course of action that you can justify
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Chapter 11 Values, ethics and advocacy
ethically. Decide on the course of action you are best able to
support. Consultation with a respected and wise colleague or
an institutional ethics committee may be helpful at this point.
Implement your decision
Implement your decision and compare the outcome of your
action with what you considered and hoped for in advance.
Evaluate your decision
What have you learned from this process that will help you
in the future? How can you improve your reasoning and
decision making in the future?
Ethically relevant considerations
Balance between benefits and harms in
patient care
Nurses and midwives are superbly positioned to contribute
to reasoning about what counts as the benefits or burdens
BOX 11-4 Ethics resources
The following organisations provide ethics resources for healthcare professionals:
Australasian Association of Bioethics and Health Law
Members are professionals interested in the relationship between law, bioethics, healthcare, public health, and
global health governance.
Australian Health Ethics Committee: National Health and Medical Research Council (NMHRC)
This federal committee considers ethical inquiries and guidelines surrounding human health and research.
Centre for Human Bioethics
The Centre for Bioethics conducts research into many aspects of bioethics, including reproductive ethics and end-
of-life decision making.
Department of Health and Ageing, Australian Government
Decision-making tool: Responding to issues of restraint in aged care. This document has been developed to assist
staff and management in residential aged-care facilities to make informed decisions relating to the use or non-use
of restraint when responding to behaviours of concern.
Management Support Unit (MSU)
This unit offers frameworks for ethical decision making in community development.
Medical Research Council Good Practice for Researchers Guide (UK)
Guides for ethical policy research and development.
National Reference Center for Bioethics Literature
A U.S.-based specialised collection of library resources concerned with contemporary biomedical issues in the
fields of ethics, philosophy, medicine, nursing, science, law, religion and the social sciences.
New Zealand Health and Disability Ethics Committees
This site provides information for researchers and study participants about ethical review processes in New Zealand.
St James Ethics Centre
This centre offers independent advice, reference material and counselling on ethical decision making.
