Advocacy paper: the bioethical decision making model applied

The model is the paper's structure, and the instruction is explicit: *address each section of the model in your paper*. That is a spine, not a suggestion, and it means the marker can find each step by name or note its absence. Use the model's own language for your headings — define the dilemma, identify the medical facts, identify the non-medical facts, separate facts from assumptions, identify the decision makers, review the ethical principles, define alternatives, follow up — and the paper becomes checkable rather than merely readable. Four to five pages across roughly eight substantive sections is half a page each, which is enough for a real analysis and not enough for a literature review, so resist the urge to explain the model before applying it. Labelling the sections with the model's own vocabulary also makes it obvious to you, while drafting, which step is still empty.

Read the numbered list carefully, because the copy you have been given is imperfect and pretending otherwise causes trouble. The steps run one to six, then jump to eight — there is no step seven — and step six ends with an orphan fragment reading *all of the answers*, which is the tail of a sentence that did not survive. Steps two and three are also one idea rather than two, since the third is a reminder that diagnosis and prognosis count as medical facts. Cover every step that is actually present, treat the separation of facts from assumptions thoroughly since that is where the break occurs, and if the missing step matters to your grade, ask rather than invent one. A paper that silently renumbers to eleven has fabricated a requirement. Noting the gap in a sentence is safer than either ignoring it or filling it, and it shows the marker that the list was read rather than skimmed.

The ethical principles step is selective and most papers treat it as a checklist. The brief names six — beneficence, nonmaleficence, veracity, fidelity, autonomy and justice — and then asks you to *review which ones and why they apply to this particular case*. Naming all six and defining each is the wrong answer: it demonstrates recall rather than judgement. Choose the two or three that are actually in tension in your scenario and argue them against each other. In an incomplete informed consent case, veracity and autonomy pull one way while a clinician's beneficence pulls the other, and the whole ethical difficulty lives in that conflict. A principle that is not in tension with another one does not need a paragraph. The same applies to the alternatives step, where the benefits and burdens are only interesting if the two options genuinely favour different principles.

The clinical situation can be actual or hypothetical, and hypothetical is usually the better choice for a reason the brief does not spell out: a real case brings confidentiality obligations with it, and an anonymised real case often loses the detail the model needs. What the model demands is unusually specific — non-medical facts including culture, religion, economics, the existence of an advance directive and verbal preferences the patient expressed, plus external influences including organisational policy, state law, practice acts and codes of ethics. Build the scenario with those slots already in mind. A case that does not specify whether an advance directive exists cannot answer step four, and inventing one halfway through the paper is visible. Writing the scenario last, after listing what each step will demand of it, is faster than writing it first and patching it afterwards.

Two requirements sit outside the model and are separately marked. The conclusion is not a summary: the brief asks you to *conclude with a discussion of nursing advocacy in the clinical setting and the nurse's role as a patient advocate*, which is a general argument about the role rather than a recap of your case. That is where your outside sources earn their place, because the advocacy literature defines the role in terms your case can be measured against. And the sourcing rule is narrow: one to two scholarly sources *other than your text*, with the text also cited — so the assigned reading has to appear, and two well-used articles beat six listed ones. Placing the advocacy sources in the conclusion rather than scattering them through the case analysis also keeps the case in your own voice, which the first step asks for.