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Virtually every action that a nurse takes has an ethical component. Yet, very few nurses could explicate what guides their ethical behavior or what process they use to help patients/families make ethical decisions for themselves or to make ethical decisions for their patients when this is necessary. Because patients are so vulnerable, they need to have a nurse who can protect them, act for them according to their own unique desires, and help them in making difficult bioethical decisions. Nurses, themselves, need a way of practicing that will give them a feeling of efficacy. The bioethical theory of Symphonology, an ethic of agreement, is a practice-based approach to help guide nurses in caring for patients and to enhance the practice of nursing for each nurse.

Symphonology holds that all interaction between nurse and patient is ethically held together by an agreement. The preconditions of this agreement are the bioethical standards of autonomy, freedom, objectivity, self-assertion, beneficence, and fidelity. The contextual application of these standards to individual patients in their unique situations forms this ethical interaction. Through the use of a simple case study, this will be demonstrated.