Collect data that identifies the dilemma
• Recognize that most problems have more than one component,
• Identify the facts relevant to the ethical decision
• Recognize the cultural, economic, and political contextual factors that are present
• Identify the laws, professional ethical codes, and government regulations that enter into ones choices
Identify who is responsible for making the decision (Ie who’s decision is it to make?)
• Consider who has important stakes in the decision. Consider the opinions of the major players as well as their value systems.
• Consider all claimants potentially affected by the decision, both the majority and the minority. Try to see from the other’s perspective
O = OUTLINE THE OPTIONS
• Clarify the options available and the consequences of each potential action. This step is used to better understand the options rather than make a final
• Include at least three options in the listing. (It has been noted there are always at least two options and these two often represent the extremes)
R = REVIEW CRITERIA AND RESOLVE
• Determine the best/worse case scenarios of choosing each particular alternative?
• Evaluate from the various moral perspectives of beneficence, autonomy, and justice
-Which option will produce the most good and do the least harm (beneficence)
-Which option respects the rights and dignity of all stakeholders (autonomy) ?
-Which option promotes the common good? (justice)
• Answer the questions honestly while considering all sides of the issue. Do any rules or principles (legal, professional, organizational, or other)
automatically invalidate a particular alternative?
• List options in a graph format if needed to help clarify alternatives and outcomes. Positive options can be indicated with a (+) and negative options with a
A = AFFIRM POSITION AND ACT
• Based on the above review, determine which of the options is the best to do. Use the ANA Code for Nurses to support conclusions.
• Use a specific exercise to help check your decision and confirm your thinking.
-Consider if you told someone you respect about why you chose this option, what would that person say
-Write a letter defending your decision to the party who potentially has the most to lose.
-Write a letter to your most serious detractor explaining why you’ve made the decision you’ve made
• Decide on the appropriate action and develop a plan to achieve this action.
L = LOOK BACK
• Evaluate the success of your intervention. Were personal/professional values considered? Ethical principles applied?
How did the process turn out for all involved? If it had to be done over, are there things that you would have done differently?
How would each of the nurse managers decide which nurse to assign and which nurses to retain in the individual units? Use the MORAL Model in your response.