Choosing a framework for ethical analysis in advanced practice settings: the case for casuistry.
The need for advanced practice nurses to incorporate ethical analysis into case management is becoming more apparent -- particularly for the increasingly independent practice settings of psychiatric and mental health nursing. The nursing literature contains many articles dealing with the more abstract treatment of clinical ethics, but for the practitioner there is unfortunately little information available that uses ethical principles in a practical framework, which addresses the concrete reality of daily, difficult clinical decision making. This article applies a model of reasoned analysis to an actual case study using the concepts of casuistry or case-based reasoning. This method offers an alternative to the more popular paradigm of principilism. Complicated by the existence of violence and abuse, the case examines several ethical issues including patient privacy and legitimate breaches of patient confidentiality.
University of Texas Health Science Center at San Antonio, Graduate School of Biomedical Sciences, School of Nursing, USA.
K E
KE
Artnak
J H
JH
Dimmitt
D000293:Adolescent; D032764:Casuistry; D002755:Choice Behavior; D003219:Confidentiality; D026689:Ethical Analysis; D026690:Ethics, Clinical; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D035846:Law Enforcement; D008128:Logic; D028642:Persons with Psychiatric Disorders; D016294:Models, Nursing; D009014:Morals; D009720:Nurse Clinicians; D028662:Principle-Based Ethics; D011568:Psychiatric Nursing; D011788:Quality of Life; D012945:Social Values; D013179:Spouse Abuse / Q000517:prevention & control; D035502:Trust; D035862:Vulnerable Populations