Nurses' moral decision-making in practice through Kantian duty ethics

Area of Science:

• Nursing Ethics
• Moral Philosophy
• Healthcare Practice

Background:

• Nurses face frequent ethical dilemmas and moral distress, balancing duties, values, and constraints.
• Deontological ethics, specifically Kant's ethics of duty, provides a framework for duty-based moral action.
• Empirical research on nurses' understanding and application of Kantian principles in practice is limited.

Purpose of the Study:

• To explore nurses' understanding and enactment of Kantian ethics of duty in clinical decision-making.
• To investigate how Kantian principles shape nurses' moral judgment, sense of duty, and professional integrity.
• To examine the influence of clinical practice on nurses' ethical frameworks.

Main Methods:

• Qualitative descriptive research design.
• Semi-structured in-person interviews with 17 nurses in Slovenia (November-December 2025).
• Thematic analysis using Braun and Clarke's approach.

Main Results:

• Five themes emerged: nursing work demands, understanding of duty, ethical decision-making, emotional dimensions, and organizational challenges.
• Nurses largely enact Kantian ethics via internalized values and commitment to patient dignity.
• Organizational and systemic factors significantly impede nurses' autonomous moral action.

Conclusions:

• Nurses' ethical practice is rooted in internalized professional values and patient dignity.
• Enhancing ethical practice requires improved working conditions and professional autonomy.
• Structured support through ethics education, supervision, and reflection is vital for strengthening ethical nursing.