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Nursing Ethics
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A Model for Conceptualizing the Moral Dynamic in Health Care

Susan Foley Pierce

University of North Carolina, Chapel Hill, NC 27514-7460, USA

Ethics involves an organized, reasoned approach to gathering and processing data in order to arrive at decisions about what to do, what to value, and/or what virtues to cultivate. A model is proposed for conceptualizing this complex dynamic, which incorporates elements of both rule-and-principle ethics and the ethic of care. The model suggested here has two levels. The first level identifies the components that comprise philosophical reasoning; the second contextualizes and operationalizes the model in relation to the processor’s philosophical stance on the nature of knowing. Three philosophical stances are identified and described: science-dominant, person-dominant, and science-person equilibrium. Physicians tend to process patients from first perspectives, nurses from second. Hence, health team collaboration in moral problem solving is critically important.

Key Words: models • moral dynamic • nature of knowing • philosophical reasoning

Nursing Ethics, Vol. 4, No. 6, 483-495 (1997)
DOI: 10.1177/096973309700400605
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