Enhancing your ethical reasoning.

There is nothing a nurse does more frequently than make decisions, and in intensive care most of these decisions have ethical ramifications. Critical care nurses and other health care professionals must be more effectively prepared to resolve the complex ethical problems that are a natural by-product of health care in the 1990s. Each of us has an obligation as a patient advocate to use a systematic decision-making process, not just an emotive one, when faced with difficult ethical dilemmas. This article presents a decision-making process that is based on the steps of the nursing process, the theories of deontology and utilitarianism, and the strengths in the steps of the valuing process. A difficult case is shared at the end of the article that challenges the reader to examine his or her decision-making capabilities from a systematic and ethical perspective.