Clinical is most important. Clinical decisions are the substance of ethical decisions.

Clinical decision making is always ethical decision making too. Decision making always has an ethical value. It should be clear, in my opinion, that good decision making is not possible without having developed a good ethical reasoning.

Hi Esraa

The clinical decision in cases in which unwanted and uncontrollable consequences by the patient is foreseeable is important to be taken from the hand of clearly explicit ethical principles. This is not to say that it should always be good clinical decisions, what you want to indicate is that there is a respect for the human condition or in any case a interest by the person

Both are intwined with each other. Recognition of our ethical values and standards underpin our practice and therefore our clinical decision making.

Both clinical and ethical decision making are interdependent. Becoming aware of our ethical values, the ethics of the health care setting, the ethical values of patients is necessary to make a sound clinical decision, which is beneficial for patients. I think ethical decision making is a subset of clinical decision making.

Researchers come to the scientific environment /community with an already intact value system. They enter with goals and aspirations. Some values and goals might be motivated by financial gain or fame. These motives will influence ethical decisions. It is my belief that personal values and goals are foundational to ethical decisions which influence clinical decision making. I have taken it back one step to personal values.

True nursing is both a science and an art. The science is the clinical decision making while the art is the ethical component. A good example is when a patient is facing end of life. Clinically we can hook up machines to extend the life but ethically we need to ask the patient what his/her wishes are. A compitent nurse realizes the two concepts are intertwined, not exclusive, as she or he moves from patient to patient.