An enquiry into a combined approach for nursing ethics.

A definitive theory for ethical decision making in nursing is still only conjecture. The literature confirms that there have been numerous examinations of ethical decision making in nursing, with most proposing either the justice or the care orientation, or a combination of both. In the absence of a definitive theory, this exploratory work sets out, via grounded theory, to shed some light on the methods used every day by nurses to make ethical decisions in the clinical area. The data show that some factors, such as doctors, colleagues and the organization, profoundly influence ethical decision making. The informants used both care and justice to formulate decisions, which is known as the combined approach. As a result of these findings, this article concludes with tentative suggestions and recommendations for practice.