# What If the Power of the Family Is Missing?

## TL;DR

The paper examines ethical issues in healthcare for patients without family support, highlighting risks of inequality and moral distress for nurses.

## Contribution

It introduces care ethics as a framework to address these challenges and promote equity in family-centered care.

## Key findings

- Patients without family face poorer outcomes and ethical concerns in intensive care units.
- Nurses may experience moral distress when advocating for these patients alone.
- Care ethics can help identify measures to counteract inequality in such cases.

## Abstract

This article explores ethical challenges surrounding patients without a family within the framework of family‐centred care (FCC) in intensive care units, exemplified by a case. Families function as powerful social determinants of health, and FCC is built on their existence and presence. Complications and poorer outcomes raise concerns about justice, equity and nurses' moral integrity for patients without strong family involvement. The latter risks disadvantages, while nurses might face moral distress when acting as their sole advocates. Care ethics is offered as a comprehensive tool for analysis and to identify specific measures to counteract inequality.