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Canadian Nurses Association

Appendix A. Ethical Models

An Ethical Model for Reflection: Questions to Consider



points to the need for nurses to engage in ethical reflection and discussion.

Frameworks or models can help people order their approach to an ethical problem

or concern, and they can be a useful tool to guide nurses in their thinking about a

particular issue or question.

When it is appropriate, colleagues in nursing and other disciplines, ethics committees,

ethicists, professional nurses associations and colleges of nurses and other experts

will be included in discussions of ethical problems. Legislation, standards of practice,

policies and guidelines of nurses’ unions and professional associations and colleges

may also be useful in ethical reflection and decision-making.

Ethical reflection (which begins with a review of one’s own ethics and judgment) is

required to determine how a particular value or responsibility applies in a particular

nursing context. There is room within the profession for disagreement among nurses

about the relative weight of different ethical values and principles. More than one

proposed intervention may be ethical and reflective of good ethical practice. Discussion

and questioning are extremely helpful in the resolution of ethical problems and issues.

Ethical models can facilitate discussion among team members by opening up a moral

space for everyone to participate in the conversation about ethics. There are many

models for ethical reflection and for ethical decision-making in the health-care ethics

literature, and some of these are noted in this section. The model provided here


was selected because it promotes reflection, offers a nursing model for considering

ethics issues in practice and is applicable to all types of ethical situations.


This model is adapted from Oberle and Raffin Bouchal (2009).