Ethical Frameworks Essay: Nursing Ethics and Decision-Making Analysis

This essay explores the application of the "Four Topics Approach" (or Four Box method) to ethical decision-making within a nursing context. It begins by defining the four-box method, which encompasses medical indications, patient autonomy, beneficence and non-maleficence, and considerations of justice. The essay then delves into how this method is used in ethical decision-making, highlighting its role in critical thinking and resolving ethical dilemmas. It emphasizes the model's principle-based reasoning, considering ethical values and obligations. The essay further discusses the validity of the four-box approach in medical practice, underscoring its holistic nature and focus on patient-centered care. The author's note and the provided references support the analysis, demonstrating the practical application of ethical frameworks in healthcare scenarios and their impact on shaping decisions in nursing practice.

Running head: Ethical Frameworks Essay 1
Ethical Frameworks Essay
Name of Student:
Name of University:
Author’s Note:

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Table of Contents
Explaining what is 4 box method....................................................................................................2
How 4 box applies to ethical decision making................................................................................2
Validity of the process within medical practise...............................................................................3
Reference.........................................................................................................................................4

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Explaining what is 4 box method
The four box method is a process of decision making that encompasses a holistic approach to
patient care. The initial step is to collect the required information and divide them accordingly.
The first box refers to the medical diagnosis and medical problems of the patient. The second
box respects autonomy of the patient (Martinez et al. 2019). The third box refers to the events of
Beneficence and Nonmaleficence while respecting the events of autonomy. Finally, it becomes
important to understand the fact that fair justice within the domains of treatment is equally
important and must be provided without discrimination
How 4 box applies to ethical decision making
4 box model provides suggested mechanism in areas in relation to critical thinking, while
simultaneously planning for resolving ethical dilemma. The mentioned model can help
healthcare professionals to develop an ability to think and arrive at ethical conclusion. The
subjective goal of the chosen model provides a framework for making decision within a
particular scenario with which the physician is confronted (Heintz et al. 2015)
The 4 box model makes use of principle based reasoning for the event of ethical decision
making. The model chosen considers ethical values, obligations and even principles. As stated by
Heintz et al. (2015), few ethical framework makes use of 4 or even 5 steps; however, the prime
intervention remains the same; for resolving dilemma through careful reasoning. The model
suggests the simple 4 step approach obtained from decision making literature as clearly
interpreted by Sharma & Reimer-Kirkha (2017), suggests that decision making model is based
on principle and theory. In similar regard, it would be fair enough to state that the process of
decision making is dynamic and undergoes continuous evolution as the professional is subjected

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to additional information. Physicians are often bombarded with series of questions to consider,
requiring adherence to ethical code of conduct of their principles and values before arriving at a
decision. The process of evaluation involved in ethical dilemma is not unlike that takes place
when a medical professional is subjected to clinical problems.
Validity of the process within medical practise
The validity of the 4 box approach is on high demand as encompasses a series of holistic
approach that makes use of aspects of autonomy and medical care to ensure positive health
outcomes. Medical professionals should exhibit clear knowledge about the ongoing process of
healthcare. As pointed out by Sharma & Reimer-Kirkha (2017), patients are often concerned
about the healthcare practises being executed as per their cultural and religious norms. For
example, the Catholic principles often acknowledges the suffering of Jesus and believes that
suffering brings an individual close to God. However, Bible should not be considered as a
medical manual and deserves a different form of respect outside the domain of medical science
The holistic approach to healthcare using the 4 box method respects the autonomy of patient and
often reflects the importance of patient centred care. Physicians are often seen to overlook the
importance of culture and feel that patients do not need to gain information about their medical
treatment. However, the mentioned framework abolishes the mentioned thought process and
aims to establish a better environment of care (Martinez et al. 2019). Nevertheless, the use of
ethical framework in nursing or even medical practises may fail to reflect the experiences of the
medical professionals

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Reference
Martinez, E. Z., Silva, A. S. D., Giglio, F. M., Terada, N. A. Y., & Zucoloto, M. L. (2019).
Religiosity and patterns of alcohol consumption among users of primary healthcare
facilities in Brazil. Cadernos Saúde Coletiva, (AHEAD).
Heintz, E., Lintamo, L., Hultcrantz, M., Jacobson, S., Levi, R., Munthe, C., ... & Sandman, L.
(2015). Framework for systematic identification of ethical aspects of healthcare
technologies: the SBU approach. International journal of technology assessment in
health care, 31(3), 124-130.
Sharma, S., & Reimer-Kirkham, S. (2015, March). Faith as social capital: Diasporic women
negotiating religion in secularized healthcare services. In Women's Studies International
Forum (Vol. 49, pp. 34-42). Pergamon.