Principles and methods of ethical decision making in critical care nursing.

Consideration of the ethical principles of autonomy, beneficence, nonmaleficence, and justice can help to equip critical care nurses to deal with ethical conflicts that arise in nursing practice. Properly understood, these principles do not function as inflexible absolutes, but instead serve as "moral compasses" that help the nurse to get his or her bearings in difficult or uncertain situations. Those who appeal to the four principles should recognize that other cultural traditions may regard other ethical values as central. Finally, to the extent that principlism neglects ethical concerns related to caring and personal relationships, this approach is incomplete. Nurses and others who invoke an ethic of caring can advance ethical understanding by contributing a careful analysis of this concept and its role in ethical decision making.