Moral guidance, moral philosophy, and moral issues in practice.

Approaches to teaching ethics to nurses have been debated in literature for some years. Three issues in particular are commonly addressed: the intentions of such teaching; the value of examples and case studies; and the compatibility of philosophical approaches with the clinical reality experienced by students. It is argued here that moral guidance as a strategy is unacceptable, and that a basic introduction to philosophical methods is the key to effective learning of the skills required for autonomous analysis and decision making. A means for including the use of personal experiences and case study material is presented which relies upon the provision of a framework of analysis to facilitate structured thinking and the pursuit of justifiable arguments. The approach suggested is compatible with students' existing experiences and work-context, and enhances the integration of ethical reasoning into the multi-faceted totality of clinical practice.