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).