Introduction

In today’s ever changing world it is essential that advanced practice nurses are equipped with legal and ethical reasoning skills. Healthcare is only becoming more complex and ethical issues often do not have a textbook right or wrong solution, especially when it comes to end of life care decisions. When a situation involves the terminally ill in severe and intractable pain, the issue can be exponentially more challenging. As nurses, it can be difficult balancing our obligation to facilitate relief of suffering with our responsibility to do no harm (American Nurses Association, 2001). In addition, health care policy is rapidly changing and with it brings new regulations that impact nursing practice. Klaassen, Smith, & Witt (2011) explain that legal actions against nurses have significantly increased over the last 15 years. Included in these increased numbers is a rise in nurse judgment violations (Klaassen, Smith, & Witt, 2011). Practicing the application of ethical and legal principles to real situations helps cultivate confidence in nursing judgment. To illustrate the process of ethical and legal reasoning, a case study and examination of the practice of palliative sedation is presented.