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Decision-Making and Nurse Case Management: A Philosophical Perspective

Fraser, Kimberly D. MA, RN; Strang, Vicki PhD, RN


Decision-making related to resource allocation in home care case management practice is addressed from the unique perspective of nursing. The case management process stipulates the adherence to both client-centered and system-centered goals. Issues that emerge from this process include the ethical dilemma of deciding the equitable and fair distribution of resources related to the provision of appropriate levels of service; economic factors as they relate to limited financial resources; and the variance among case managers in their decision-making. Moderate realism, as compared to critical and feminist theory, provides a philosophical perspective that allows a practical interpretation of these issues.

From the Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

The authors thank Dr Marion Allen, professor, Faculty of Nursing, University of Alberta for her thoughtful critical review as we finalized the manuscript.

Corresponding author: Kimberly D. Fraser, MA, RN, 127 Charlton Crescent, Sherwood Park, Alberta, Canada T8H 1S3 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.