Exploration of Power Imbalances and Communication Are Key

The recent Current Controversies article¹ clearly identifies key aspects of Kantian ethics. I agree that Kantian ethics do not enable the patient or provider to make sound ethical decisions in every situation.

However, upon reading Day’s narrative, I was particularly disturbed by the action of the surgeon and support the valid concerns raised by the patient’s husband. My suggestion to nurses involved in this situation is 2-fold:

First, improve communication among all members including the physician and family. Compassionate and authentic communication promotes ethical decision making by building trust and respect for each participant in the process. An atmosphere of trust and respect improves the decision-making process and the decision itself.

Second, the power imbalance inherent in this narrative must be explored. Sherwin’s account on relational autonomy² enables the nurse to assist the patient’s husband to advocate for his wife. I believe that using a relational autonomy approach...