Thursday, July 12, 2007
This presentation is part of : Ethical Issues
Best Practice: Ethical Decision Making Model into Practice in the Palliative Care of the older adult at end of life
Susan A. Ruzicka, RN, PhD, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
Learning Objective #1: identify definitions associated with ethics, ethical core principles, and ethical decision-making in relation to nursing practice.
Learning Objective #2: apply an ethical decision making model to a case study of palliative care for older adult at end of life.

Nurses are in a profession requiring special knowledge, skill and preparation. Ethical decision making is one such skill that is called into nursing practice daily. It is the discernment of the best choice of practice in the context of the given environment, patient values, family values, health care professional values and the resources available to all involved. Nurses are faced with daily ethical dilemmas in delivery of care for patients and their families. Empowered with a firm understanding of the core principles guiding ethical decisions and an ethical decision making model easily implemented in the work setting, the professional nurse can confidently provide quality care based in science and caring. These models offer a practical framework in which to clarify the clinical problem, identify the ethical problem of the clinical situation, clarify the nursing role, clarify values of nurse, patient and family, discern the benefits and harms that each course of action potentially produces, and which alternative will lead to the best overall consequences. Awareness and implementation of ethical decision making models in the work setting minimize ambiguity the nurse may experience. The nurse practicing guided by an ethical framework grounds her practice with each ethical decision she is involved in, rather than feeling burnt out at the end of the day. Outline: 1) review key concepts of the professional nursing Code of Ethics 2) review the key principles of ethics : respect for autonomy, nonmaleficence, beneficence, and justice 3) present and discuss two ethical decision making models: Murphy and Murphy Decision Making Model and the Framework for Moral Decision Making 4) present a case study specific to palliative care in the older adult at end of life and have the participants apply the ethical decision making model of their choice in working through the case 5) Question and answer