Ethical Decision Making in Nursing: Uustal's Nine-Step Model
This paper applies Uustal's (1993) nine-step ethical decision-making model to a real clinical dilemma encountered in nursing practice. The scenario involves a child diagnosed with a brain tumor whose parents administered marijuana without physician knowledge or consent. Drawing on virtue ethics, the paper walks through each step of Uustal's framework — from identifying the problem and clarifying personal ethical values to evaluating alternatives, selecting an acceptable course of action, and assessing outcomes. The paper also addresses the role of the American Nurses Association Code of Ethics in shaping nurses' professional duties and guiding morally sound clinical decisions.
- Introduction to the Ethical Dilemma: Clinical scenario involving child, brain tumor, and unauthorized marijuana
- Applying Uustal's Model: Steps One Through Five: Problem identification, personal ethics, alternatives, and consequences
- Applying Uustal's Model: Steps Six Through Nine: Selecting, planning, implementing, and evaluating the ethical action
- The Role of Fundamental Nursing Duties in Ethical Decision Making: ANA code and professional obligations shaping nursing practice
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What makes this paper effective
- The paper grounds an abstract ethical framework in a concrete, real-world clinical scenario, making the application of Uustal's nine steps tangible and easy to follow.
- It explicitly names the ethical theory being used (virtue ethics) and connects it to specific values such as honesty, integrity, and compassion, rather than leaving the ethical stance implicit.
- The paper evaluates multiple alternatives rather than jumping to a single solution, demonstrating systematic ethical reasoning consistent with the model being applied.
Key academic technique demonstrated
The paper demonstrates framework-driven ethical analysis — the practice of using a named, structured decision-making model to organize and justify moral reasoning. By progressing through each of Uustal's nine steps in sequence and explicitly labeling them, the writer shows how a theoretical tool can be applied methodically to a messy real-world situation, which is a core competency in applied nursing ethics.
Structure breakdown
The paper opens by introducing the clinical scenario and identifying it as an ethical dilemma. It then moves systematically through Uustal's nine steps across two main analytical sections, grouping the earlier steps (problem identification, personal ethics, and alternatives) before the later steps (evaluation, implementation, and assessment). A brief concluding section connects the analysis to the broader professional framework of nursing duties and the ANA Code of Ethics.
Introduction to the Ethical Dilemma
Uustal (1993) proposed a decision-making model that offers tangible steps for arriving at a morally acceptable solution when experiencing an ethical dilemma. Generally, nurses are frequently faced with ethical dilemmas that are largely attributed to the nature of their work. One ethical dilemma encountered in a clinical setting involved a child diagnosed with a brain tumor. Before the diagnosis, the child had been severely ill and went several days without eating, which increased the severity of his condition. Even though the physicians were doing their best to save the child's life, the family became extremely worried. As a result, his parents gave him marijuana based on their extensive knowledge of its medical benefits. While the decision proved beneficial in the short term, the child faces the risk of experiencing a recurrence of the brain tumor (James, 2011).
References
Dahnke, M. D. (n.d.). The role of the American Nurses Association Code in ethical decision making. Retrieved September 13, 2013, from
James, S. D. (2011, May 5). Montana dad gives cancer-stricken boy marijuana behind doctor's back. ABC News. Retrieved September 13, 2013, from http://abcnews.go.com/Health/montana-father-medical-marijuana-cancer-stricken-toddler-son/story?id=13529490&singlePage=true
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