NR 703 Advanced Practice Leadership from an Ethic of Care
Student Name
Chamberlain University
NR-703: Applied Organizational & Leadership Concepts
Prof. Name
Date
Advanced Practice Leadership from an Ethic of Care
The purpose of this paper is to critically analyze advanced practice leadership through the lens of the ethic of care. This exploration includes a comparison between the ethic of care and the ethic of justice, along with an evaluation of interprofessional collaboration and the impact of ethical dilemmas on organizational and leadership practices. Leadership behaviors rooted in ethical principles play a critical role in resolving moral and ethical dilemmas, thus reducing demoralization in healthcare delivery systems.
Description of Ethic of Care versus Ethic of Justice Perspectives
When advanced practice leaders make ethical decisions, they often rely on guiding perspectives. Two commonly used frameworks are the ethics of justice and the ethics of care.
- Ethic of Justice emphasizes fairness, equality, and adherence to rules or principles. It includes dimensions such as equitable allocation of healthcare resources and ensuring impartial treatment of patients (Botes, 2000).
- Ethic of Care prioritizes relationships, empathy, and attentiveness to the needs of others. This perspective underscores the importance of interconnectedness and holistic approaches in healthcare (Van Hooft, 2011).
Both perspectives are essential, but conflict may arise if they are not balanced. Therefore, leaders must integrate both frameworks to ensure ethical clarity and avoid misunderstandings in healthcare decision-making.
Ethic of Care
Carol Gilligan proposed that the ethic of care develops in three stages:
| Stage | Goal | Transition |
|---|---|---|
| Pre-conventional | Focus on individual survival | From self-centeredness to responsibility |
| Conventional | Goodness achieved through self-sacrifice | Transition to balance self and others’ needs |
| Post-conventional | Principle of non-violence and no harm | From goodness to truth |
The ethic of care emphasizes harmonious relationships, compromise, and holistic patient-centered practices. Nurses caring for patients are tasked with responsibility for the whole person, not merely medical needs (Nordhaug & Nortvedt, 2011).
According to Lachman (2012), the four key elements of the ethic of care include:
- Moral attention
- Sympathetic understanding
- Relationship awareness
- Harmony
Nurse leaders are expected to demonstrate empathy, holistic involvement, and dedication to harmonious relationships. Unlike transactional care, this approach is not based on reciprocity but rather a commitment to meeting patient needs, even when they cannot return care.
Ethic of Justice
The ethic of justice is centered on principles such as fairness, equality, autonomy, and beneficence.
- Fairness ensures patients receive unbiased and equal treatment.
- Autonomy emphasizes respecting patients’ rights to self-determination.
- Beneficence highlights doing what is right and medically necessary, though applying this principle consistently can be complex in clinical practice.
Ethic of justice focuses on integrity, such as following universal rules (e.g., “stealing is wrong”) regardless of situational factors (Nordhaug & Nortvedt, 2011). When combined with the ethic of care, this framework provides balance between fairness and compassion in patient-centered care.
Reflection on the Application from an Ethic of Care Perspective
Question: What is the difference between caring for and caring about?
- Caring for involves the skills and practices of providing physical, emotional, and professional support to patients. It requires moral attention and clinical competence.
- Caring about reflects an individual’s attitude toward care, including empathy, attentiveness, and willingness to act in the best interest of others.
The ethic of care perspective integrates both concepts, emphasizing attentiveness, responsibility, competence, and responsiveness as essential components of nursing practice (Lachman, 2012).
Nurse leaders play a critical role in creating an environment that supports ethical practice. This may involve:
- Ensuring access to necessary resources.
- Creating spaces for collaboration, such as family conference rooms for discussing care plans.
- Facilitating the presence of ethics committees or ethicists to support decision-making (Simola, Barling, & Turner, 2012).
Such measures promote interprofessional collaboration and ensure decisions reflect both ethical frameworks and patient-centered values.
Case Reflections from Intensive Care Practice
Working in intensive care units often presents challenging ethical dilemmas. For example, a 28-year-old Jehovah’s Witness awaiting a heart transplant raised significant debate. While the cardiothoracic surgeon agreed to the procedure despite the patient’s refusal of blood products, many nurses disagreed, believing the decision compromised medical safety. Unfortunately, this led to some staff distancing themselves from the patient, failing to fully honor his beliefs. The Code of Ethics for Nurses emphasizes the importance of respecting every patient’s dignity and rights (ANA, 2001).
NR 703 Advanced Practice Leadership from an Ethic of Care
In another case, a 58-year-old male with advanced heart failure decided against a transplant after careful reflection on his life circumstances. Here, the ethic of care was demonstrated by the nurse who offered emotional support and guidance, helping the patient make an informed choice. This highlights the therapeutic role nurses play by offering comfort, presence, and time to patients in distress.
These examples demonstrate how the ethic of care transforms care from a task-oriented duty into a meaningful commitment that respects patient autonomy, values, and dignity (Edwards, 2011).
Conclusion
Ethical leadership in advanced nursing practice requires balancing the principles of care and justice. Leadership behaviors rooted in ethics help resolve dilemmas, foster collaboration, and prevent moral distress in healthcare settings. Care is foundational to human existence, and when combined with justice, it provides a comprehensive ethical framework for advanced practice leaders. The DNP-prepared nurse leader integrates developmental nursing principles, medical expertise, and doctoral-level training to ensure holistic, ethical, and patient-centered care delivery.
References
American Nurses Association (ANA). (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author.
Botes, A. (2000). A comparison between the ethics of justice and the ethics of care. Journal of Advanced Nursing, 32(5), 1071-1075.
Edwards, S. D. (2011). Three versions of an ethics of care. Nursing Philosophy, 10(4), 231-240. https://doi.org/10.1111/j.1466-769X.2009.00415.x
Lachman, V. (2012). Applying the ethics of care to your nursing practice. MedSurg Nursing, 21(2), 112-116.
Nordhaug, M., & Nortvedt, P. (2011). Justice and proximity: Problems for an ethics of care. Health Care Analysis, 19(1), 3-14. https://doi.org/10.1007/s10728-010-0159-3
NR 703 Advanced Practice Leadership from an Ethic of Care
Simola, S., Barling, J., & Turner, N. (2012). Transformational leadership and leaders’ mode of care reasoning. Journal of Business Ethics, 108(2), 229-237. https://doi.org/10.1007/s10551-011-1080-x
Van Hooft, S. (2011). Caring, objectivity and justice: An integrative view. Nursing Ethics, 18(2), 149-160. https://doi.org/10.1177/0969733010388927