Running head: Ethical Algorithm

Application of an Ethical Algorithm

Amber L. Phelps
Athabasca University

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Application of an Ethical Algorithm

Purposive behavior is a behavior that a person chooses or decides to act in; these
decisions are based on underlying values held by that person and the profession that they work
in. When a person chooses to behave unethically, they ultimately face consequences (Blais &
Hayes, 2011). In the case scenario that I am going to discuss, a highly regarded senior nurse
clinician has chosen to steal cash and other miscellaneous items from colleagues and patients
(Athabasca University, 2015). In the nursing profession, important ethical principles have been
identified in nurses professional code of ethics to assist in guiding their practice. Such ethical
principles include autonomy, respect for a person, beneficence and nonmaleficence, justice,
veracity and fidelity (Blais & Hayes, 2011, p.57). As the nurse manager of the unit that the
infringing nurse works on, I have become aware that the nurse is stealing and I feel morally
conflicted because I know she is doing wrong but, I am concerned that no one will believe me
(Athabasca University, 2015). Regardless of my constraints, using Catalanos (2006) Ethical
Decision Making Algorithm will aide in determining the best course of action in handling this
decision-focused problem (Catalano, 2006, p. 130; Blais & Hayes, 2011, p.62).
Application of Ethical Algorithm to Case Study and Identification of Ethical Issues from
Nursing Perspective
According to Blais & Hayes (2011), responsible ethical reasoning involves rational
thinking.it should not be based on emotions, intuition, fixed policies or precedents (p. 61).
When practicing ethical reasoning, one must also consider ethical principles outlined by their
governing body and civil laws determined by their government or society (Blais & Hayes, 2011).
Although the patients and staff members highly regard this senior nurse, it is not difficult to
determine that what she is doing is wrong. Theft is a criminal offence and is punishable in a court

Ethical Algorithm

of law (Justice Laws Website, 2015). Many people value relationships and fidelity as much as
they value veracity and justice, thus, I find myself experiencing an ethical dilemma. Ethical
dilemmas, as described in the Canadian Nurses Associations (2008) Code of Ethics, arise when
there are equally compelling reasons for and against two or more possible courses of action, and
where choosing one course of action means that something else is relinquished or let go (p. 6).
Firstly, if the senior nurse is confronted about stealing, the hospital could lose a valuable
resource and expert, I would lose a support person to rely on in times of conflict and the patients
would lose the exceptional care provided to them by the senior nurse clinician. The unit would
undoubtedly feel the impact of her absence. Secondly, if I ignore the situation all together, I
would not be advocating for the best interest of the clients or the other staff members, therefore
compromising my own integrity and impressing that this type of behavior is acceptable. The
Canadian Nurses Association (2008) indicates clearly in their code of ethics document that
nurses must intervene and report when other people are not respecting the clients dignity and
that to be silent and passive is to condone the behaviour (p. 13). Finally, if the nurse is reported
to the authorities, the employers human resources and the professional regulatory body, the
nurses integrity will be compromised, she may lose her nursing license and there is a chance that
she will face legal ramifications. However, as indicated in the code of ethics, nurses will take
the necessary steps to protect the safety of persons receiving care (Canadian Nurses
Association, 2008, p. 18). Although I have a personal loyalty to the nurse clinician on my unit,
Blais & Hayes (2011) point out that nurses have a legal obligation to do no harm and a duty to
act in a beneficent nature (Blais & Hayes, 2011, p. 61). Table 1.1 (p. 7) displays how I would
apply Catalanos (2006) Ethical Decision Making Algorithm as discussed in Blais and Hayes

Ethical Algorithm

(2011) textbook, Professional Nursing Practice: Concepts and Perspectives, 6th ed. (Catalano,
2006, p.130; Blais & Hayes, 2011, p. 62).
Recommended Nursing Actions and Interventions
Before an ethical decision can be made, I need to first determine what values and
principles are important to me, the patients and their families, the staff and the organization of
which I represent (Blais & Hayes, 2011, p. 63). Taking the aforementioned ethical and moral
principles into consideration, I determined the need to involve the authorities, the nurses
regulatory body and the employers human resources to ensure that an investigation is
commenced according to the policies and procedures within my facility, provincial and federal
laws and as outlined in the Health Professions Act (Government of Alberta, 2000). Something so
sensitive must be handled in such a way as to preserve the integrity of all parties involved as
much as possible. As exemplified by Bridgit Dimond in her article Duty to report: legal
implications of nurses stealing from patients (2006), I would ask any staff and patients who have
experienced theft to file a report indicating when their loss occurred, where the stolen article was
last seen and what was stolen, including its monetary value (Dimond, 2006, p.1196). Once a
complaint has been filed, I will work with the authorities in providing information as requested
and following through with actions that are requested of me by the authorities, professional
governing body and human resources, including termination of the nurses employment due to
unprofessional conduct. If the investigation returns evidence against the nurse, she will likely
have her license revoked and be criminally charged in a court of law with the punishment
dependent on the monetary value of the thefts. There is a possibility that the nurse will be found
guilty of an indictable offence and spend anywhere from two to ten years in prison (Student
Legal Services of Edmonton, 2015).

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Summary and Conclusion

In conclusion, when a person must make an ethical decision, many factors must be
considered as objectively as possible. In the case that was discussed, it was determined that the
process of deciding the nurses fate needed to include authorities, the nurses professional
regulatory college and the employers human resources department. Policies and procedures
regarding unprofessional conduct were referenced and standards maintained. Although the nurse
previously provided me with support in times of conflict and was highly regarded by colleagues
and patients alike, her lack of legal judgement outweighed her positive attributes and
compromised the safety personal belongings on the unit. The principle of justice prevailed
against my fidelity to the senior nurse and veracity was a highly valued principle taken into
account in my decision to complain to authorities and the regulatory college of her profession.
There is a risk that no evidence will be found to support my conviction against the nurse but, I
value rules and believe that laws are laid out to protect the public. I believe that every person
should be treated equally and fair, even when the consequences are not ideal. The nurses skills
and knowledge will definitely be missed on the unit but, the decision to report her infringing
actions is the right step to take to protect the patients, families and staff on the unit.

Ethical Algorithm

References
Athabasca University (2015). NURS250: Exploration of Professional Nursing Practice.
Unit 7: Ethical and Legal Foundations. [e version]. Retrieved from:
http://cnhs.lms.athabascau.ca/mod/url/view.php?id=72148
Blais, K., & Hayes, J. S. (2010). Professional Nursing Practice: Concepts and
Perspectives, 6th Edition. [VitalSource Bookshelf version]. Retrieved from
http://online.vitalsource.com/books/9781269935845
Catalano, J. T. (2006). Nursing Now : Today's Issues, Tomorrow's Trends. Philadelphia,
PA: F.A. Davis Company.
Dimond, B. (2006). Duty to report: legal implications of nurses stealing from patients.
British Journal of Nursing, 15(21), 1196-1197.
Government of Alberta. Health Professions Act. (2000) retrieved from:
http://www.qp.alberta.ca/1266.cfm?page=H07.cfm&leg_type=Acts&isbncln=9780779785339
Government of Canada. Justice Laws Website. (2015) retrieved from:
http://laws.justice.gc.ca/eng/
Student Legal Services of Edmonton. (2015). The Criminal Code Definition of Theft.
Retrieved from: http://www.slsedmonton.com/criminal/theft-fraud-posession/

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Tables
Table 1.1 Applying the Ethical Decision Making Algorithm
(Catalano, 2006, p.130; Blais & Hayes, 2011, p. 62)

Step #
1.
Collect, Analyze, Interpret

Outcome
Senior nurse clinician stealing cash and other items

data

from patients and peers

Nurse well liked and regarded by patients and peers
Often first to support manager in conflict situations
Clinical expertise and judgement best among team
Valued member of the nursing team is committing a

2.

State the Dilemma

criminal offense (stealing).

Ethical dilemma: veracity vs. fidelity vs. justice
3.
Consider the Choices of
1.
Ignore the facts
2.
Confront the nurse
Action
3.
Inform authorities
4.
Analyze the Advantages and Choice of Action
Advantages
Disadvantages
1. Ignore
-valuable
-compromise
Disadvantages of Each Course of
(Pr
experience of
managers
Action
evailing
nurse remains
integrity
principle:
-no conflict
-stealing continues
fidelity)
between nurse and -patient and staffs
manager,

belongings unsafe

relationship

-manager could be

remains

viewed as an

-nurses reputation

accomplice

not stained

-if others know

-no evidence

that manager

needed

knows, they may

think it is

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acceptable to steal
-manager will not
2. Confront
(Pr

-manager

trust nurse
-nurse may deny

acknowledging the -evidence may be

evailing
situation exists

compromised

-stealing may stop

-relationship will

-patient and staff

be deteriorated

principle:
veracity)
belongings may be between manager
safe temporarily or and nurse
permanently

-nurse may quit-

-nurse may quit

expertise and

-belongings may

judgement will be

be returned

missed, other staff

may be upset and
quit

3. Inform

-evidence may be

-nurse will be

found

fired, if evidence

-criminal charges

found

may be laid

-expertise and

-License revoked

judgment will be

-stealing may stop

missed

-manager integrity

-staff may not

(Pr
evailing
principle:
justice)

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maintained

believe conviction,

-manager

become upset and

following through

quit

with unethical

-patients may not

actions

believe and
become upset with
the nurses

5.
on It

Make the Decision and Act

absence
Based on the data collected, I have the obligation to make an
ethical decision with acceptable consequences. To solve the
dilemma, I need to involve the authorities and the nurses
regulatory body, file a complaint against the nurse and assist
authorities to collect information for their legal investigation. In
order to charge someone with theft, there needs to be evidence
that they committed the crime. Ignoring the issue will not make
it go away. Confronting the nurse could aggravate her and lead
to potential adverse outcomes and also may not solve the
problem. However, unprofessional conduct, which includes any
conduct that harms the integrity of the regulated profession
(Health Professions Act, Section 1, pp, xii, 2008) must be
investigated and the person must be disciplined according to the
laws of the province of which it occurred in. (Blais & Hayes,
2011, p. 62)