There is nothing a nurse does more frequently than making decisions, and among ill and health care most of these decisions have ethical ramifications. Nurses and other health care professionals must be more effectively prepared to resolve the complex ethical problems that are a natural by-product of health care in recent years. Each of us has an obligation as a patient advocate to use a systematic decision-making process, not just an emotive one, when faced with difficult ethical dilemmas. This article presents a decision-making process that is based on the steps of nursing process, the theories of deontology and the strengths in ethical perspective. Nurses and others who invoke an ethic of caring can advance ethical understanding by contributing their role in decision making.