This document outlines the MORAL model for ethical decision making in nursing. The MORAL model is a 5-step process: 1) Collect data to identify the dilemma, relevant facts, and contextual factors. 2) Identify who is responsible for the decision and consider stakeholders' opinions. 3) Outline available options and their potential consequences. 4) Review criteria like beneficence, autonomy, and justice to evaluate options. Consider rules that may invalidate options. 5) Affirm the best option, develop an action plan, and later evaluate the outcome.

1. Ethics in Nursing
Ethics in NursingMORAL MODEL FOR ETHICAL DECISION MAKINGCollect data that
identifies the dilemma• Recognize that most problems have more than one
component,• Identify the facts relevant to the ethical decision• Recognize the cultural,
economic, and political contextual factors that are present• Identify the laws, professional
ethical codes, and government regulations that enter into ones choicesIdentify who is
responsible for making the decision (Ie who’ s decision is it to make?)• Consider who has
important stakes in the decision. Consider the opinions of the major players as well as their
value systems.• Consider all claimants potentially affected by the decision, both the
majority and the minority. Try to see from the other’ s perspectiveO = OUTLINE THE
OPTIONS• Clarify the options available and the consequences of each potential action.
This step is used to better understand the options rather than make a
finaldecision.• Include at least three options in the listing. (It has been noted there are
always at least two options and these two often represent the extremes)R = REVIEW
CRITERIA AND RESOLVE• Determine the best/worse case scenarios of choosing each
particular alternative?• Evaluate from the various moral perspectives of beneficence,
autonomy, and justice-Which option will produce the most good and do the least harm
(beneficence)-Which option respects the rights and dignity of all stakeholders (autonomy)
?-Which option promotes the common good? (justice)• Answer the questions honestly
while considering all sides of the issue. Do any rules or principles (legal, professional,
organizational, or other)automatically invalidate a particular alternative?• List options in
a graph format if needed to help clarify alternatives and outcomes. Positive options can be
indicated with a (+) and negative options with a(-).A = AFFIRM POSITION AND
ACT• Based on the above review, determine which of the options is the best to do. Use the
ANA Code for Nurses to support conclusions.• Use a specific exercise to help check your
decision and confirm your thinking.-Consider if you told someone you respect about why
you chose this option, what would that person say-Write a letter defending your decision to
the party who potentially has the most to lose.-Write a letter to your most serious detractor
explaining why you’ ve made the decision you’ ve made• Decide on the appropriate
action and develop a plan to achieve this action.L = LOOK BACK• Evaluate the success of
your intervention. Were personal/professional values considered? Ethical principles
applied?How did the process turn out for all involved? If it had to be done over, are there
things that you would have done differently?How would each of the nurse managers decide

2. which nurse to assign and which nurses to retain in the individual units? Use the MORAL
Model in your response.