Name
Chamberlain University
NR-703: Applied Organizational & Leadership Concepts
Prof. Name
Datea
The aim of this paper is to examine advanced practice leadership through the framework of the ethic of care. This approach is explored in comparison with the ethic of justice, highlighting the unique role each perspective plays in guiding ethical decision-making in healthcare. Additionally, this paper evaluates interprofessional collaboration and the influence of ethical dilemmas on leadership and organizational practices. Leadership behaviors grounded in ethical principles remain essential in addressing moral challenges, thereby minimizing burnout and demoralization in healthcare systems.
When advanced practice leaders encounter ethical dilemmas, they often turn to guiding frameworks for clarity. Two commonly applied perspectives are the ethic of justice and the ethic of care.
Ethic of Justice focuses on fairness, equity, and strict adherence to established rules or ethical principles. This framework emphasizes equal distribution of healthcare resources and ensures that all patients receive impartial treatment (Botes, 2000).
Ethic of Care underscores the significance of relationships, empathy, and attentiveness to individual needs. It emphasizes interconnectedness and a holistic approach in addressing healthcare concerns (Van Hooft, 2011).
While both perspectives are valuable, tensions may arise if they are applied in isolation. Therefore, advanced practice leaders must integrate these frameworks to achieve ethical clarity and prevent conflicts in decision-making.
The ethic of care was initially proposed by Carol Gilligan, who described it as a developmental process unfolding across three stages.
| Stage | Primary Goal | Transition |
|---|---|---|
| Pre-conventional | Focus on individual survival | From self-centeredness to responsibility |
| Conventional | Goodness achieved through self-sacrifice | Balancing self-care with care for others |
| Post-conventional | Principle of non-violence and avoidance of harm | From goodness to truth and broader moral awareness |
This framework highlights the importance of maintaining harmonious relationships, seeking compromise, and practicing holistic patient-centered care. Nurses are expected to care for patients as whole individuals, addressing not only medical needs but also psychological, emotional, and social well-being (Nordhaug & Nortvedt, 2011).
According to Lachman (2012), four foundational elements define the ethic of care:
Moral attention
Sympathetic understanding
Relationship awareness
Commitment to harmony
Nurse leaders embody this perspective by showing empathy, maintaining holistic engagement, and building relationships rooted in trust. Unlike transactional care, the ethic of care reflects an enduring commitment to meeting patient needs, regardless of reciprocity.
The ethic of justice is centered on moral principles such as fairness, equality, autonomy, and beneficence.
Fairness requires that all patients receive unbiased and equal treatment.
Autonomy recognizes the patient’s right to self-determination and informed decision-making.
Beneficence underscores the responsibility to act in the patient’s best medical interest, though practical application may present challenges.
The justice perspective stresses universal principles, such as respecting rules even when circumstances vary (Nordhaug & Nortvedt, 2011). When integrated with the ethic of care, this framework allows leaders to balance impartial fairness with compassion and empathy, resulting in more patient-centered decisions.
Caring for refers to the practical aspects of providing support—physical, emotional, and professional—requiring clinical competence and moral attentiveness.
Caring about involves an attitude of empathy, compassion, and responsiveness, showing a genuine commitment to the well-being of others.
The ethic of care integrates both approaches, emphasizing attentiveness, responsibility, competence, and responsiveness as crucial components of nursing (Lachman, 2012).
Advanced practice leaders must cultivate environments that foster ethical care. This includes:
Ensuring resources and support are available for staff and patients.
Providing designated spaces for collaboration, such as family conference rooms.
Promoting access to ethics committees or consultants for complex cases (Simola, Barling, & Turner, 2012).
These strategies strengthen interprofessional collaboration and ensure patient-centered decisions align with ethical frameworks.
Ethical dilemmas are particularly prominent in intensive care settings, where decisions often involve high-risk and emotionally charged circumstances.
Case 1: A 28-year-old Jehovah’s Witness awaiting a heart transplant refused blood products. Although the cardiothoracic surgeon honored the patient’s wishes, some staff members disagreed, believing this jeopardized patient safety. Their withdrawal of emotional support reflected a failure to fully respect the patient’s beliefs. According to the Code of Ethics for Nurses, respecting patient dignity and values remains a professional obligation (ANA, 2001).
Case 2: A 58-year-old man with advanced heart failure declined a transplant after considering his personal values and quality of life. In this case, the nurse demonstrated the ethic of care by providing emotional support, guidance, and presence, enabling the patient to make an informed, autonomous choice.
These examples illustrate how the ethic of care transforms clinical duties into meaningful acts of compassion that respect autonomy and human dignity (Edwards, 2011).
In advanced practice, ethical leadership requires a balance between care-based values and justice-oriented principles. Nurse leaders who adopt this integrative approach minimize moral distress among staff, encourage teamwork, and support patient-centered care. Care forms the foundation of human connection, and when combined with justice, it creates a holistic ethical framework.
DNP-prepared nurse leaders are uniquely positioned to implement this balance by combining advanced clinical expertise with ethical reasoning, thus ensuring patients receive comprehensive, equitable, and compassionate care.
Ethical leadership in advanced nursing practice is grounded in the dual frameworks of care and justice. While the ethic of care emphasizes empathy and relationships, the ethic of justice ensures fairness and integrity. Together, they provide advanced practice leaders with the tools to navigate ethical challenges, foster collaboration, and promote patient-centered outcomes. By embedding these principles in organizational culture, nurse leaders can uphold patient dignity, reduce moral distress, and ensure ethical clarity in healthcare delivery.
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
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
