ETHICAL DECISION MAKING IN HEALTHCARE 1
Ethical decision making in healthcare
According to Perkins et al (2014), ethics discussions are oftenchallenging, as people come out approaching issues from differentperspectives. As such, ethical discussions elicit different feelings,which make the topic unique in profession. In the field ofhealthcare, nurses and other practitioners are often faced withethical dilemmas on a daily basis. It becomes quite difficult for theprofessionals to keep things in perspective, given that they are anumber of options for solving various issues. Additionally, in ahealthcare facility, the values and beliefs of an individual are atmany times in conflict with those their peers and the patients. Assuch, Bond et al (2013) assert that it is important for the nurses tounderstand the values and ethics of the others, as a means of solvingconflicts. Regardless, many situations continue to raise ethicalconcerns in the face of disagreement and conflict of interest. Thispaper explains the characteristics of an ethical dilemma, anddifferentiates this from other situations resulting in disagreementbetween conflicting preferences, needs and expectations.
One of the outstanding characteristics of an ethical dilemma is thatit often causes an individual to question the most appropriateactions to take. Unlike other situations, which may lead todisagreement between people, ethical dilemmas often boil down to oneindividual. As such, an ethical dilemma elicits thoughts on how theindividual should react to something in a way that they believe isright or wrong. There is no argument between individuals whendeliberating on the route of action, unlike other situations wherebythere is an argument with one or more people. Moreover, an ethicaldilemma compels an individual to make a choice that directly reflectsa moral dilemma. In healthcare, the nurses are made to take an oathwhereby they promise to conduct themselves in a manner that benefitstheir patients (British Medical Association, 2012). As such, when itcomes to dealing with the patients in complicated situations, thenurses have the moral responsibility to make a decision, whichreflects adherence to the oath they took, and by doing so,characterizing a moral dilemma in healthcare. Additionally, moraldilemmas are characterized by the need to make a decision based onjustice issues, for instance, where there is lack of enough resources(Sittig & Singh, 2011). This differentiates ethical dilemmas fromother situation that lead to disagreement in needs and preferences,given that it is up to the nurse to make a decision withoutconsulting their peers. Unlike ethical dilemmas, power and authoritymay influence decisions made in the other situations.
Another distinguishing feature of ethical dilemmas is that they areunforeseen and unpredictable. According to Hoagwood, Jensen &Fisher (2014), most ethical dilemmas are because of the professionalfinding themselves in situations which they had not prepared for. Forinstance, a nurse may have find having to make a decision betweenletting a patient use the phone to call their children, where on theother hand, they are not supposed to be doing this. In such asituation, the nurse does not have an option to contact their peers,as this would make them feel bad about the patients. As well, ethicaldilemmas are multifaceted. By this, it means that ethical dilemmasare often characterized by clash between different ethical values andriles standards or norms in healthcare. In healthcare, drawing uponone’s values to make decisions may turn out to be disastrous, giventhat there is a rigid framework for course of action. There are anumber of other situations, which may lead to disagreement, forinstance, the type of procedure to be used to take care of a patientin a certain condition. However, when personal values and ethicsfactor in, the nurses find themselves having to make a personaldecision based on what they feel, and not what the system demands.
Ethical dilemmas are also characterized by elements such asgenerosity and authenticity (Holm & Severinsson, 2013). Allnurses in the field of healthcare must have these characteristics inorder to conduct themselves ethically. When it comes to interpersonalrelationship, there can be a number of opinions forwarded by thepeers, which may be mixed, analyze and compared to arrive at adecision. However, an ethical dilemma involves a personal debatewithin the individual, whereby the nurses have to maintain autonomyand be able to make a self-inspired decision. Ethical dilemmas, inthis perspective, are quite challenging when the nurse has to involvethe patient in making a decision. According to Holm & Severinsson(2013), there are many cases where the patient’s decisions andactions are often harmful. This is made worse when the patient isinfluenced by his or her own beliefs and values. For instance, apatient may deny the nurse permission to use certain drugs orremedies on them, which according to their own beliefs, are wrong. Inthis case, the nurse finds himself or herself in a situation wherethey have to debate whether to do what is procedurally right, thatis, administering the drugs and remedies, or doing what is morallyright, that is, respecting the wishes of the patient.
Another outstanding characteristic of ethical dilemmas in healthcareis aspect of self-care. Medicine is one of the most criticalprofessions when it comes to the safety of the practitioner (Hoagwoodet al., 2014). In this field, the practitioners have to be carefulnot to harm themselves, even as they ensure that they do not harmthose whom they are entrusted to take care of. The same elicitsdifferent feelings when two or more people are in disagreement. Inthis setting, despite the differences in opinion, the warring partiesoften agree on taking a mutually beneficial action, whereby thepatient and the care-givers are kept out of harm’s way. However,making an independent solution, when it boils down to taking asolitary action, may present a major ethical dilemma to anindividual. According to the British Medical Association (2012), thedilemma is balancing contrasting issues, which are taking care of thepatient’s wellbeing and taking care of one’s safety. As such, thenurse has to make an ethical decision on what is right, betweentaking care of the patient and ensuring their personal safety. Inhealthcare, this kind of dilemma is most evident when dealing withhighly contagious patients.
It has been demonstrated that ethical dilemma is quite different fromother situations that may lead to disagreement between individuals.In healthcare, there are certain distinguishing features, which makeethical dilemmas quite different from these situations. One of thedistinguishing features of ethical dilemmas is that they all boildown to making individual decisions. Secondly, ethical dilemmas areunique in a way that the solutions are independent, while thesolution of other disagreements is often mutual and dependent.Ethical dilemmas are also characteristically unpredictable. Finally,solutions to ethical dilemmas are guided by values and personalbeliefs, while other dilemmas are guided by rules and guidelines.
Discussion to answers
The first post offers insight into the meaning of ethical decision byhighlighting the traits of ethical dilemmas. It is imperative to notethat the post highlight the appropriate interventionist approaches totake in an ethical dilemma thus, provide explanations as to thediscussion. In addition, the student provides pieces of literature toprovide the meaning of ethical dilemmas and in so doing give anall-round answer to the discussion. By asserting that an ethicaldilemma does not require a wrong or right answer, but rather aconstructive solution, the discussion highlights one of the mostimportant characteristic of ethical dilemma.
The discussion provides an example of an ethical dilemma. In thiscase, doctors have to come up with the best solution in scenariowhere they have diagnosed a patient with cancer for the secondperiod. Such a scenario calls for a cultivation of an appropriatesolution that will not only make the patient feel cared for but alsoappreciated. In addition, by highlighting the decisions that thedoctors will have to consider, the student shows an understanding ofan ethical dilemma.
In this case, the student highlights the difficulties in solvingadvanced directives especially in cases where laws come into play. Inaddition, the discussion offers an insight into the part played byfamilies even in cases of estranged family members. Although a replyto another post, this post tries to provide an answer to the level ofinvolvement family members and friends should take in trying tomaintain and respect the rights of patients. However, state laws mayintervene or provide a hindrance to a common ground in suchscenarios, for example, as highlighted in this case.
In this case, the discussion also deals with the rights of a patient.In addition, it discusses the level of involvement a family membershould reach in interfering with the rights of a patient. As thediscussion highlights, it is imperative for family members to respectthe rights of their sick members as well as take the most viable andethically inclined solution, rather than seeking a solution based ontheir beliefs. In fact, the discussion provides that respecting therights of the patients is the most ethically inclined solution totake.
Bond, C. S., Ahmed, O. H., Hind,M., Thomas, B., & Hewitt-Taylor, J. (2013). The conceptual andpractical ethical dilemmas of using health discussion board posts asresearch data. Journalof medical Internet research, 15(6).
British Medical Association.(2012). Medicalethics today: The BMA`s handbook of ethics and law.John Wiley & Sons.
Hoagwood, K., Jensen, P. S., & Fisher, C. B. (2014). Ethicalissues in mental health research with children and adolescents.Routledge.
Holm, A. L., & Severinsson, E.(2013). Reflections on the ethical dilemmas involved in promotingself-management. NursingEthics, 32(1): 24-53.
Perkins, D. V., Hudson, B. L.,Gray, D. M., & Stewart, M. (2014). Decisions and justificationsby community mental health providers about hypothetical ethicaldilemmas. PsychiatricServices.
Sittig, D. F., & Singh, H.(2011). Legal, ethical, and financial dilemmas in electronic healthrecord adoption and use. Pediatrics, 127(4),45-87.