What If the Power of the Family Is Missing?

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.