All clinical decisions are ethical decisions in that they are based on some notion of what is good or best in a given situation. Situation-specific knowledge is both essential for effective care and difficult to establish in the detached "professional" relationships between health care providers and their patients. Two exemplars in which the author functioned as a primary nurse for his significant others are used to show that intimate caring relationships can produce a type of clinical knowledge that enhances quality care and ethical nursing practice. "Quality care is nothing more than good care, and ethical care is that which seeks the highest good."
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