The moral practice of nursing requires the difficult work of discerning the best response to an ethical quandary. Determining the right course of action can rarely be discovered by assuming that one value, one theory, one point of view will always and reliably identify the morality of an action. Thus, the role of a nurse is an inherently moral activity that is at the heart and soul of health care. Practitioners who move too quickly to a state of moral certainty about a decision may be missing essential components of the enactment of moral agency. Personal integrity and professional integrity, patient interests, society's expectation of a profession, the balance between rights and obligations within the nurse-patient relationship, acting according to one's conscience, power, control, and moral certainty are a few of the topics that enrich thinking about the moral richness of nursing practice, and will encourage readers to know, to reason, and to act in ways that demonstrate reflective moral judgment.