Choosing a framework for ethical analysis in advanced practice settings: the case for casuistry

Area of Science:

• Nursing Ethics
• Clinical Decision Making
• Psychiatric Nursing

Background:

• Ethical analysis is crucial for advanced practice nurses, especially in independent psychiatric and mental health settings.
• Existing literature often lacks practical frameworks for applying ethical principles to daily clinical decisions.
• This study addresses the need for actionable ethical guidance for practitioners.

Observation:

• A case study involving violence and abuse is presented to illustrate ethical challenges.
• The case highlights issues of patient privacy and the complexities of breaching confidentiality.
• The practical application of ethical reasoning in challenging clinical scenarios is examined.

Findings:

• Casuistry, or case-based reasoning, provides a practical model for ethical analysis in nursing.
• This method offers an alternative to the dominant paradigm of principilism.
• The model effectively addresses complex ethical dilemmas encountered in clinical practice.

Implications:

• Nurses can utilize case-based reasoning to navigate difficult ethical decisions in psychiatric and mental health care.
• Implementing practical ethical frameworks can improve patient care and professional practice.
• This approach supports advanced practice nurses in managing ethical complexities, particularly concerning privacy and confidentiality.