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Managing Ethically

There are many areas in contemporary nursing that involve far-reaching ethical issues—such as informed consent, substitute decision-making, effective use of health-care resources, moral distress of staff, and conflict between staff and patient’s family members. This chapter examines some common ethical issues that nursing managers face, the notion of a moral community and ways to combat moral distress among staff.


  • Introduction
  • The nature of ethical issues
  • Ethical, practical, legal and administrative problems
    • Moral uncertainty
    • Moral distress
    • Moral residue
  • Moral integrity
    • Critical thinking
    • Coherence
    • Commitment to act in a principled way
  • Building moral communities
  • Resource allocation
    • Micro-allocation decisions
    • Meso-allocation decisions
    • Macro-allocation decisions
  • Resources for nurse managers in ethical decision-making
    • Principles for decision-making
    • Professional associations
    • Codes of ethics
    • Past issues and cases
    • Bioethicists and health-care ethics centres
    • Religious and chaplaincy services
    • Educational institutions and departments
    • Core organisational values and policies
    • The law
  • Conclusion
  • References
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Author / Editor Biographies

Laurie Hardingham's qualifications include a post-basic certificate in ICU-Cemergency nursing from the University of Alberta, Canada; a bachelor of nursing from the University of Calgary, Canada; a master's degree in philosophy and completion of course work towards a Ph.D. in philosophy at the University of Calgary. She has completed a fellowship in clinical ethics with the University of Toronto Joint Centre for Bioethics and a senior fellowship in clinical ethics with the Toronto Rehabilitation Institute/University of Toronto Joint Centre for Bioethics. She has been published in journals, is ...

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