1. Identify the concern/issue that may be an ethical problem, uneasiness, uncertainties and/or conflicts.
2. Gather relevant facts about the problems(s). Medical date: Objective and subjective data; Contextual Date: circumstances/people involved; Institutional Policies; State and Federal Laws
3. Determine if the problem is an ethical dilemma
4. Propose actions/options to assist in resolving the ethical dilemma
5. Apply methods of ethical justification to each action/option to assist in resolving the ethical dilemma. Consequentialism consequences; Deontology duty Principalism principles; Care relationships; Casuistry cases; Virtue character.
6. Identify and clarify values, rights, and duties of patient, self and significant persons associated with the dilemma.
7. Prioritize the identified actions/options to assist in resolving the dilemma
8. Identify and use relevant interdisciplinary resources. Ethics committee, clergy, ethicist, consultants? literature, lawyers, colleagues, literature, etc.
9. Prioritize the identified actions/options to assist in resolving the dilemma

PLAN OF ACTION
10. Select an ethically justified action/option from those identified

IMPLEMENTATION
11. Act upon/support the action/option selected

EVALUATION
12. Evaluate the selected action/option taken. Short and Long Term

©Framework:ASEAS Instrument: Cassells, J.M.
& Silva; M. 1990.
Revised EAF/Nursing process: Cassells, J.D.,
Johnson, E & Littlehohn, J. 1996.
Revised EAF: Cassells, J.M. & Gaul, A.L. 1997,
1998

DEFINITION OF TERMS

ETHICAL CONCERN
An active state of uneasiness, uncertainty, or conflict about how to determine a response to a situation that may have moral implications.

ETHICAL ISSUE
A situation that requires a judgment that considers questions and controversial implications about what moral standards or norms or conduct apply.

ETHICAL DILEMMA
A forced choice between two equally desirable or equally undesirable alternatives that have moral dimensions.

METHODS OF ETHICAL JUSTIFICATION
An examination of morality, standards of conduct, and social practices as a basis for reasoning about an ethical dilemma.

COMMON METHODS OF ETHICAL JUSTIFICATION
Consequentialism (consequences)
An ethical theory that proposes that the ethical value of an action be determine by the results or consequences of that action and not the action itself.

DEONTOLOGY (duty)
An ethical theory proposes that an ethical action have an inherent ethical or moral value in and of itself regardless of the consequences.

CARE (relationships)
An approach to ethical reasoning that is grounded in relationships and bases ethical justification on what is required of an individual in a caring relationship.

CASUISTRY (cases)
A method of ethical justification that identifies central principles and requires the decision-maker to determine which principle should take precedence when they are in conflict.

PRINCIPALISM (principles)
A method of ethical justification that identifies central principles and requires the decision-maker to determine which principle should take precedence when they are in conflict.

Respect for Persons
Respect for self-determination.
Nonmaleficience
Do no harm.
Beneficience
The moral requirement to actively promote good and provide benefits.
Justice
Fair and equitable determination of what is owed to a person including distribution of resources and fair treatment for individuals and society.

VIRTUE
An approach to ethical justification that states that morally desirable character traits should be cultivated and demonstrated in morally desirable actions.