Mary is 86 years old and resides in a nursing home.  She is alert but forgetful, and unsteady on her feet.  She has a history of falls and the nurses are becoming increasingly concerned that she may injure herself seriously one day.  They believe that she could easily fall and break her hip and may never walk again.  The nurses have been asking Mary to call for help when she wants to walk but she has not been doing this.  They have also organised a walking frame for her which she is reluctant to use. They have now suggested to Mary that when she sits down she wears a belt which is tied to her chair. The nurses hope this will  remind her not to get up without asking some-one to walk with her and will also prevent her from getting up unaided.  Mary objects.  She is unwilling to give up her ability to move about the nursing home as she chooses.  In desperation a nurse tells Mary that she must use the belt as it is a new rule of the nursing home (this is not the case).  Mary reluctantly agrees to wear the belt because she is scared of the consequences of breaking the rules.  The nurses are very relieved.

 Q. Imagine you are an enrolled nurse looking after Mary.  How would have you resolved this ethical dilemma? Use Kerrige's model for ethical decision making to help you resolve the dilemma (Kerrige, Lowe & Stewart 2011).