Thinking about ethics is an integral part of service delivery for all involved in health care, from the bedside to the boardroom. Ethics is about making morally justifiable choices and providing reasons for those choices. Unfortunately, which options are ‘right’ or ‘good,’ can be unclear. It is for this reason that the IDEA Framework was developed. This framework provides a fair, step- by-step process to assist in the navigation and resolution of complex ethical issues that arise in the delivery of health care.


The IDEA Decision-Making Framework

Step 1: Identify the Facts

Identify what is known versus what is not known.

      • Medical Indications
      • Client Preferences
      • Quality of Life
      • Contextual Features

Users of the framework should take into account all of the relevant considerations and stakeholders; this often includes facts that may not be known initially.

Step 2: Determine Ethical Principles in Conflict

Identifying the ethical principles in conflict will not provide solutions; however, this step will assist in further clarifying and articulating the issues.


Common ethical principles to consider might include, but are not limited to:

      • Autonomy
      • Beneficence (or doing good)
      • Non-maleficence (or doing no harm) or
      • Justice

Step 3: Explore Options

Brainstorm different options and consider the potential outcomes and impacts of each one (e.g., evaluate the potential positive and negative considerations of each option).

Do the options fit with the patient’s preferences and ethical principles from Step 2?

Do the options comply with corporate policy, regulations, and the law?


Step 4: Act and Evaluate

Develop and document the action plan in the patient’s chart.

Self-evaluate your decision. What have you learned?

Evaluate the plan. Were the intended results obtained, or is additional follow-up and/ or action required? Ongoing documentation and communication of the evaluation is necessary.