Caring as Coercion: Exploring the Nurse's Role in Mandated Treatment.

When nurses work in environments that have overlapping medical, legal, institutional, social, and therapeutic priorities, nursing care can become an effective tool in advancing the competing goals of these multiple systems. During the provision of patient care, nurses manage the tensions inherent in the competing priorities of these different systems, and skillful nursing can have the effect of rendering these tensions invisible. This puts nurses in an ethically complex position, where on one hand, their humanizing empathy has the potential to improve the delivery and effect of mandated care yet, on the other hand, their skillfulness can render invisible the weaknesses in medicolegal structures. In this article, we present a composite case study as a vehicle to illustrate the way this dilemma manifests in day-to-day nursing interactions and explore the potential of microethics to inform the everyday decisions of nurses delivering care-as-coercion.