1.Is there an ethical problem ?
2.Gather the facts; clinical, situational; need more facts ? Why ?
3.What are the choices under consideration?
4.What might be the consequences of these choices to the patient, to other stakeholders?
5.What ethical principles do these choices represent ? Are they in conflict?
6.Can you think of alternatives not yet considered that might relieve the conflict
7.What should be done? How would you weigh and balance the conflicting principles