Strict adherence to performance measures can force nurses to make difficult decisions.
Douglas P. Olsen is a nurse ethicist at the National Center for Ethics in Health Care, Veterans Health Administration, Washington, DC, and an associate professor at the Uniformed Services University of the Health Sciences, Bethesda, MD. The views he expresses here are his alone and should not be construed as representing those of the National Center for Ethics in Health Care or the Veterans Health Administration. Contact author: firstname.lastname@example.org. The author has disclosed no potential conflicts of interest, financial or otherwise.