Ethical Decision-Making Using Trauma Informed Principles: A Case Example

Required reading for all learners: Implicit Bias impacts patient outcomes

This article explores ethical decision-making utilizing trauma-informed (TI) principles through case examples. A TI approach to ethical practice is aligned with nursing goals of promoting, protecting, and restoring health and relieving suffering and with the perspective of humanizing the health care environment. It emphasizes that an inability to bounce back from traumatic events is not a character flaw or a moral weakness for which a person can be blamed. Practical guiding principle as for trauma-informed approaches to care and problem resolution. The assumptions, which they call the 4 R's, are: realizing that trauma is pervasive; recognizing signs of trauma; responding to trauma through trauma-informed care; and resisting retraumatization by remaining aware of this possibility. Along with the 4 assumptions, there are 6 principles that provide more direction. For the current case, and paraphrased from the US Government’s Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines, 4 of these are more pertinent to the patient and 2 of them are more pertinent to the clinicians and health care team.