Ethics Discussion Guide for Duty to Provide Care and a Safe Work Environment

Balancing the Duty to Provide Care and the Duty to Provide a Safe Work Environment

In response to the identified tensions that many healthcare providers, health teams and health organizations are experiencing with respect to balancing the duty to provide care and the duty to provide a safe work environment, NSHEN has developed the materials provided below for your use.

These include (please click on title for full guide):

Rapid response (summary) Ethics Discussion Guide – designed as a supplementary tool for groups who already have an ethics framework and are comfortable with the use of such tools

Duty to care – Detailed version – includes additional questions designed to assist with the discussion about these two duties; an introduction to these duties and how they may conflict and/or be in tension; and, several appendices with additional information and references

“Demonstration” cases – two cases have been described to provide examples of the type of discussion and analysis that may occur when using the Ethics Discussion Guide

Case #1: Bed bugs and community care

Case #2: Providing care for a patient who is racist?

Additional cases – four cases are provided, without analysis, for your use and practice

When should I/we use this Ethics Discussion Guide?

1. Does the dilemma or issue involve some aspect of the health care provider’s/health care team’s and/or the organization’s understanding of the duty to provide care for one or more patients?

2. Is there tension or conflict between how the health care provider/team and/or the organization understand their obligations with respect to the duty to provide care in this situation?

3. Does the situation involve concern about a risk of harm to a health care provider/health team and/or the organization and is this risk for harm associated with some aspect of the workplace environment in a physical, psychological, relational and/or cultural sense?

4. Are the responsibilities arising from the duty to provide care and the duty to provide a safe work environment in tension or conflict such that there is no clear or obvious option for resolving the difficulty?

If you answered yes to any of the above questions, the Ethics Discussion Guide may be helpful for you. Feel free to use either the rapid response (summary) or detailed version of the Ethics Discussion Guide.

What if I have feedback on or questions about the Ethics Discussion Guide?

These materials are regarded as “living” documents. They have already benefitted from feedback from participants at the 2013 October NSHEN pre-conference. We will continue to update and revise what is provided based on your feedback. We welcome any feedback and questions you may have. Please contact: or 902-494-4038.