Ethical Reasoning

     End of life care promotes many ethical issues in all healthcare workers. Physicians, nurses, social workers, etc. have to be able to decide where they stand on certain issues to be able to protect the patient as well as themselves. Nurses, especially, have to look at what they believe and what they think should happen in end of life care because they are the ones which work closest with the patient.

Ethical reasoning seeks truth, fosters ethical decision making, and leads to ethical nursing practice (Callister, Luthy, Thompson, & Memmott, 2009). Ms. Woods believes that Mr. Delmar has the right to physician assisted suicide and wishes to help him because she believes in the ethical principle of autonomy. Ms. Woods believes that the patient should be able to make his own decisions regarding his end of life care and that he should be able to have all resources available to him to make this happen.

Pseudo-ethics deal with the ethical decisions which might be twisted to fit the situation. Pseudo-ethics in this situation works with the ethical reasoning of beneficence. In one sense Ms. Woods thinks she is caring properly for the patient, by following his wishes and allowing him to die with dignity. However, Ms. Woods may not be able to fully consider all the aspects of Mr. Delmar's illness and may in fact make mistakes in providing a second opinion for this patient. 

Ethical reasoning has some elements which provide a guideline for the health care worker to follow. These steps include recognizing that there is an event to which to react, defining the event as having an ethical dimension, deciding that the ethical dimension is of sufficient significance to merit an ethics-guided response, taking responsibility for generating an ethical solution to the problem, figuring out what abstract ethical rule(s) might apply to the problem, deciding how these abstract ethical rules actually apply to the problem so as to suggest a concrete solution, preparing for possible repercussions of having acted in what one considers an ethical manner, and acting (Sternberg, 2012). In this case Ms. Woods knows that the event is the notion of physician assisted suicide for her patient. Ms. Woods believe that the ethical principle of autonomy fits well for Mr. Delmar and the care he should receive. Ms. Woods will then have to decide if autonomy for a patient outweighs her regard for the law. If Ms. Woods decides to go against the law and sign as a consult on the case, she will have to face the ethical principles of what autonomy means and how far she will go to protect it, and will then have to face the consequences of her decision.

The logic of ethical reasoning helps to be able to tie all of the information together. It can help to define what the nurse feels versus what is right. It also can help to define what ethical principles are able to withstand a specific situation. It can help the nurse to make a proper ethical decision, without going on gut instinct. It can provide information on how other areas of care were handled and how each ethical principle helped to solve the problems faced.

Ethical reasoning has both advantages and disadvantages. The disadvantages of ethical reasoning pertain to the nurse and having to reevaluate their essence of care. The nurse may feel as though certain things should be done and ethical reasoning may point out to them that it is not right. The nurse may also have a conflict of interest in regards to the reasoning being implicated in a case. Although some disadvantages do exist, some advantages exist as well. The nurse who is undergoing ethical reasoning may find that they are not in alignment with what the proper usage of ethical principles includes. The nurse then can align themselves to what the principle mandates as proper care, and in the end can better care for the patient. Another advantage is that the nurse will have the ability to learn what other nurses do in the same situations. This can help to better the continuity of care across the nursing field in all areas.