As unpalatable as the idea may be, no patient can be tested for every single conceivable illness he or she might contract. There must be some prioritization of high-risk groups. During his or her duties, a nurse may often ration her time, prioritizing where it will do the greatest good for the greatest number of people, based upon the severity of their need. However, in other instances a nurse may need to deploy the categorical imperative and state that something is clearly wrong or right, regardless of a financial calculus. A nurse must care for all patients to the best of his or her ability and preserve patient autonomy and privacy unless the patient poses a risk to him or herself and others. The nurse must obey the law and the professional ethics of nursing.
However, within the nursing profession, perhaps the most frequently-cited term relating to ethics pertains to 'care.' Care ethics stresses the need to foster relationships with others, such as patients and colleagues. Based in the work of feminist Carol Gillian, the mostly female composition of the profession of nursing might be one reason why the word 'care' runs through so much of the language of modern nursing theory. Care ethics does not provide the prescriptive ethical values of Kant; rather it strives to promote the value of care in different ways. In many decisions a nurse must make, such as when advising...
It is highly dependent upon the nature of the family structure, the patient's state of mind, and other issues that do not easily fit into a moral calculus, other than the need to promote caring.
The ethics of care seems closely related to notions of virtue ethics, where the idea that if someone is a 'good person' he or she will make good ethical decisions is advanced. However, sometimes doing the right thing in nursing does not always feel like 'the good thing,' such as when a nurse must tell a parent that his or her child is overweight. Sometimes a nurse may need to tell a plain truth, pull rank, speak harshly, or give a painful treatment to do her work. Although this is required, the nurse often does not feel like a 'good person' in doing so.
In my experience, most nurses and most people rely on casuistry, or making ethical decisions on a situational basis, rather than applying hard and fast ethical rules in all instances. Casuistry is the ethical system that resonates the most with my own perceptions. Nurses may have a few select situations where they apply principled ethical arguments, but by and large, ethical decisions are based on gut instincts and empirical observations rather than philosophies or rules.
