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It is known that nurses are called to increasingly deliver care to patients experiencing pain. In Taiwan, nurses are the major providers of care to patients in critical care units. However, in a critical care unit, it is a nurse’s duty to undertake invasive procedures including intubation and insertion of catheters and other tubes to relieve the suffering of the patient. This paper analyses the nurses’ perceptions of moral responsibility for quality assurance and patient care in the context of the “malpractice paradox” in Taiwan. The study involved data collection from 616 nurses working in critical care units in two medical centres in the Eastern and Central regions of Taiwan. The study employed a qualitative method. The findings revealed that the nurses were more likely to perceive themselves as moral agents in their daily work than the patients. The nurses demonstrated greater confidence in their abilities to give accurate and effective care as a means of attaining continuing education and professional development as well as moral support and social accountability. The nurses responded positively to events that validated their beliefs and provided them with a sense of belonging. The nurses were more aware of and vigilant about the potential adverse effects of improper nursing practice. However, they also struggled to know what constitutes “improper” nursing practice, and were conflicted when two important variables, the professional nurse role and patient trust, collided. The findings suggested that the nurses’ experience of malpractice creates stress that leads to poor job satisfaction and low morale. The findings also suggest that although ethical supervision and monitoring have been implemented, it is inadequate to prevent and control malpractice. The findings also suggest that it is important for the nursing profession to explore the factors that have contributed to the phenomena of malpractice in order to explore the “malpractice paradox”. Health care providers must be committed to continuous professional education and career development to protect
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