ABSTRACT
This chapter will explore how mental health nurses gather facts and values, and how this information can be used as part of the ethical reasoning process. A key part of gathering this information is the assessment process. However, this inform - ation can create ethical conflict, so we will also explore how this conflict can be managed through a good process, something we explored briefly in Chapter 3. Collecting information or evidence has in recent years been heavily influenced by the drive towards clinical effectiveness (Newell and Gournay 2009). This drive within mental health nursing can be traced back to the advent of evidenced-based medicine within psychiatry. Gournay in 1995 was articulating the view that mental health nursing practice should only be based on theories that are testable and have reliability (Gournay 1995). By taking this view Gournay was trying to move mental health nursing away from using nursing models and towards using evidence derived ideally from randomised control trials. Gournay (ibid.) gave an example of how this would work in practice, and has subsequently written a number of papers and resources articulating what evidence-based mental health nursing should look like (Newell and Gournay 2009). Interestingly this approach only indicates the types of evidence the nurse should use, it does not provide examples of how this approach works in unstructured and unplanned situations and where scientific evidence is not available (ibid.).
