Theoretical Medicine

, Volume 12, Issue 2, pp 157–170

An integrative model of clinical-ethical decision making

  • Rivka Grundstein-Amado

DOI: 10.1007/BF00489796

Cite this article as:
Grundstein-Amado, R. Theor Med Bioeth (1991) 12: 157. doi:10.1007/BF00489796


The purpose of this paper is to propose a model of clinical-ethical decision making which will assist the health care professional to arrive at an ethically defensible judgment. The model highlights the integration between ethics and decision making, whereby ethics as a systematic analytic tool bring to bear the positive aspects of the decision making process. The model is composed of three major elements. The ethical component, the decision making component and the contextual component. The latter incorporates the relational aspects between the provider and the patient and the organizational structure. The model suggests that in order to arrive at an ethically, justifiable sound decision one make reference to those three elements.

Key words

decision making processethical clinical decision making modelsmedical ethicsmoral thought processorganizational structureprofessional-patient relationshipvalue theory

Copyright information

© Kluwer Academic Publishers 1991

Authors and Affiliations

  • Rivka Grundstein-Amado
    • 1
  1. 1.Department of PsychiatryBaycrest Centre for Geriatric CareNorth YorkCanada