This paper considers the dilemmas faced by mental health nurses when they encounterdifficult ethical decisions. using a case study, the author analyses the patient’s right to autonomy and the nurse’s duty of care. theories of decision-making are assessed fortheir relevance to the work of mental health nurses. the author proposes that Hare’s(1981) theory of universal prescriptivism offers an appropriate framewor andexamplesfrom clinical practice are described to support this argument

The UKCC Code of Professional Conduct (1992)requires that nurses ‘act always in a manner to promote and safeguard the interests and well-being ofpatients and clients’. Nurses, the UKCC suggests, arepersonally accountable for their actions and a nursefailing to act in a patient’s best interest may be accusedof breaching the code. However, ethical codes havetheir limitations and never more so than when nursesare dealing with human difficulties and the best interestof the patient may not necessarily coincide with thepatient’s human and social rights. The case study (Box 1) is used throughout the article to illustrate thefollowing ethical principles: