Recognize an Ethical Issue
1. Could this decision or situation be damaging to someone or to some group? Does this decision involve a choice between a good and bad alternative, or perhaps between two “goods” or between two “bads”?
2. Is this issue about more than what is legal or what is most efficient? If so, how?
Get the Facts
3. What are the relevant facts of the case? What facts are not known? Can I learn more about the situation? Do I know enough to make a decision?
4. What individuals and groups have an important stake in the outcome? Are some concerns more important? Why?
5. What are the options for acting? Have all the relevant persons and groups been consulted? Have I identified creative options?
Evaluate Alternative Actions
6. Evaluate the options by asking the following questions: n Which option will produce the most good and do the least harm? (The Utilitarian Approach) n Which option best respects the rights of all who have a stake? (The Rights Approach) n Which option treats people equally or proportionately? (The Justice Approach) n Which option best serves the community as a whole, not just some members? (The Common Good Approach) n Which option leads me to act as the sort of person I want to be? (The Virtue Approach)
Make a Decision and Test It
7. Considering all these approaches, which option best addresses the situation?
8. If I told someone I respect—or told a television audience—which option I have chosen, what would they say?
Act and Reflect on the Outcome
9. How can my decision be implemented with the greatest care and attention to the concerns of all stakeholders?
10. How did my decision turn out and what have I learned from this specific situation? Markkula Center for Applied Ethics scu.edu/ethics Copyright ©
Suggested Format
Paragraph 1- Introduction/Recognize and Ethical Issue. Describe an ethical issue that you have faced in your clinical practice or as a nurse leader. Describe if this issue is about what is legal or what is most efficient.
Paragraph 2- Get the Facts- What are the relevant facts? What facts are not known? Do I know enough to make a decision? What individuals and groups have an important stake in the outcome? What are the options for acting? Have all relevant persons and groups been consulted?
Paragraphs 3 & 4- Evaluate Alternative Actions- Which option best respects the rights of all who have a stake? (The Rights Approach). Which option treats people equally or proportionately? (The Justice Approach). Which option best serves the community as a whole, not just some members? (The Common Good Approach). Which option leads me to act as the sort of person I want to be? (The Virtue Approach).
Paragraph 5- Make a Decision and Test It- Considering all these approaches, which option best addresses the situation? If I told someone I respect—or told a television audience—which option I have chosen, what would they say?
Paragraph 6-Act- How can my decision be implemented with the greatest care and attention to the concerns of all stakeholders?
Paragraph 7- Reflect on the Outcome- How did my decision turn out and what have I learned from this specific situation?
Paragraph 8- Write a final reflection paragraph for a conclusion addressing how you can use this decision-making framework in your future work as a DNP-prepared nurse. Include implications for future practice or leadership roles.
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