Australia, like New Zealand, is a nation comprised of many cultures. Kanitsaki describes culture as “a particular people’s beliefs, value orientations and value systems, which give meaning, logic, worth and significance to their existence and experience in relation to both the universe and other human beings” (Kanitsaki, 1994, p.95).

Such cultural diversity gives rise to vastly different ethical thoughts and actions. As ethical behaviour and sound moral decision making are integral to professional nursing practice, a lack of knowledge and understanding of the different cultural ways of others can sometimes make it very difficult for nurses to provide culturally appropriate, therapeutically effective and ethically just care (Johnstone, 2004). This creates the possibility of undesirable moral consequences, when a patient’s wellbeing, and perhaps even their life choices, may be placed at risk.

This case study looks at ethical considerations and moral judgments of a somewhat unique situation when Zoe, aged 46, educated, with a young family, supportive husband and otherwise good health, made an informed decision to discontinue dialysis. Her decision caused confusion and conflicting emotions amongst her caregivers. Her outcome is, however, surprising.

From every patient there are lessons to be learnt. For the nursing profession, this case study and these ethical considerations, give us knowledge for the future.