Taking A Stand

Running head: MORAL DILEMMA AND ITS IMPLICATIONS 1

Analysis of Moral Dilemma and its Ethical, Moral and Legal Implications

Student’s Name

Institution Affiliation

Date

MORAL DILEMMA AND ITS IMPLICATIONS 2

Analysis of Moral Dilemma and its Ethical, Moral, and Legal Implications

Conceptual framework

The primary objective of this paper is to identify and describe a moral dilemma that

may occur in the nursing profession and then make an analysis of moral, ethical and legal

implications that are in this situation. Nurses are always facing moral paradoxes in their job

such as not fully disclosing information to patients or taking part in the removal of an

unwanted pregnancy. Most nurses, therefore, have a moral burden of choosing between doing

the right thing and fulfilling their obligations as nurses.

Many studies are conducted on the best ways to handle moral dilemmas in healthcare.

One of the most common approaches that many scholars have suggested is the use of the

principle-based approach. This method utilizes the vital principles of morality: beneficence,

justice, non-maleficence, and autonomy (Edwards, 2009). The other concept considered is

consequentialism which holds that the end justifies the means. In other words right or wrong

is based on the consequences of a particular action.

However, these approaches have their disadvantages and limitations. The

consequentialism approach has the weakness that the patient-nurse relationship is

interpersonal and a person cannot make a clear judgment on which consequences are good

(Carlson, 2013). On the other hand, the principle-based approach has the disadvantage that

when there is a collision between two of the major principles, it is difficult to make a choice

on which one to use.

Moreover, the decision-making process is an internal one, and the two approaches do

not consider the emotional and interpersonal elements that come along with it. However,

healthcare regulations require that nurses and healthcare professionals handle moral issues

rationally keeping emotions aside. The principle-based approach contains five steps of

MORAL DILEMMA AND ITS IMPLICATIONS 3

addressing a moral dilemma situation. First is to identify the relevant facts. Second is to

establish the ethical issues involved. Thirdly, find out whether there is a violation of the

primary moral principles. The fourth step is to analyze if internal procedures exist for

mitigating the problem and finally come up with alternative courses of action.

The moral dilemma issue

As a nursing professional, I may come across this scenario during my work. I have an

elderly patient in my care diagnosed with cancer. They made a diagnosis a few years back,

and the patient declined to receive any form of treatment from the hospital. Now few years

down the line his cancer has progressed to other parts of his body, and the doctor has given

him a few weeks to live. As his nurse, this patient approaches me and confesses that he is

going to commit suicide and asks me not to reveal his secret. What do I do as a professional?

Analysis of the moral, ethical and legal implications of the moral dilemma

Step 1: Identify relevant facts

In this situation, I am faced with an ethical dilemma since the patient at his end-stage

cancer has confessed his intentions to commit suicide. According to Beauchamp & Walters

(1999), a moral dilemma exists where a person has to decide between two mutually exclusive

decisions. While Chally & Loric (1998) said that where you have two mutually exclusive,

morally correct actions amoral dilemma arises.

Step2: Ethical issues involved

In this case, I have two options that are both morally right. One is to keep the promise

and respect the patient’s decision and autonomy. This action may, however, may cause the

patient’s death through suicide without any treatment. The second option is to tell my

colleagues, and this will prevent the suicide but violate the patient’s wishes and autonomy.

MORAL DILEMMA AND ITS IMPLICATIONS 4

Step 3: Identify whether there was a violation of the primary moral principles

There exists a relationship between ethical dilemmas and principles. Johnston (2009)

argued that it is possible that logical incompatibility between two principles can cause a

moral paradox and choosing one of them will infringe the other. In this specific case, two

principles are evident, beneficence and autonomy. Beneficence states that you should

promote others welfare and autonomy means respecting others decisions. The two of them

are equally applicable to the situation but applying one leads to the violation of the other.

The conflict between the two principles is the cause of the dilemma that as a nurse

should tell other colleagues about my patient’s suicide intentions without his consent. But

then again the principle of non-maleficence comes into play. This law states that do not cause

intentional harm but applying it will violate the autonomy principle while supporting

beneficence.

Now, as a nurse, I have an obligation to my patient to take all the necessary steps in

promoting their health and welfare, which means that I have to look which of the main

principles applying to my case will best improve the patients' health and well-being.

Choosing beneficence, in this case, will be the most logical and best course of action to take.

Regulation in the Ageing Disability and Home Care states that nurses should take all

steps to ensuring the health and safety of their patients. And again as said earlier on,

healthcare demands that professionals exercise rationality in their decision making and put

emotions aside. Apart from the principle-based approach, utilitarianism is usable since it

promotes performing an action for the better good and in this case, it is the patient's health.

Step 4: Identify whether mitigating internal procedures exist.

If I decide to tell my colleagues of his impending suicide, I will violate his rights of

confidentiality and autonomy. But at the same time remaining quiet will be seen as assisting

MORAL DILEMMA AND ITS IMPLICATIONS 5

in the patient’s death. According to Sneesby (2009, p 456), the moral principle of autonomy

is not upheld by law with regards to assisted suicide and euthanasia because people do not

have a right to be aided in their death whenever they choose. As such the patient's autonomy,

in this case, is not allowed by standard law since it is prohibited. Further, I should follow my

hospital’s suicide and self-harm protocol very carefully to ensure my patient's safety.

Step 5: Provide alternative courses of action

In this case, the best option would be to inform other colleagues of my patient’s

intended suicide. This choice will make my colleagues get involved and restrain the patient

so that he does not kill himself. However taking this course of action may escalate the

situation further because the patient will feel betrayed and have some resentment. It is,

therefore, necessary to initially offer some psychological comfort to the patient to stabilize

their mood. Another possible course of action would be to initiate conversations with my

patient and find out the leading cause of my patient’s suicidal tendencies.

Leadership style

Lewin (1944) identified three primary forms of leadership: democratic, autocratic,

laissez-faire. Authoritarian is one in which the makes all the decisions are without involving

the employees. Democratic on the hand lets employees participate in the decision-making

process. Laissez-faire is a delegate type of leadership where employees have complete

control.

In this context, I would appear to be applying an autocratic style of leadership if I

decide to inform my colleagues about my patient's suicidal intentions without his consent.

This form has its advantage. By telling my colleagues of my patient’s suicide intentions, it

may lead to the saving of his life since they will act quickly to ensure that the patient does not

MORAL DILEMMA AND ITS IMPLICATIONS 6

harm himself. On the hand, the patient may resent me for going against his wishes and

confidentiality which may escalate the situation even further.

MORAL DILEMMA AND ITS IMPLICATIONS 7

References

Beauchamp, T. L., & Walters, L. (1999). Ethical theory and bioethics. Contemporary issues

in bioethics, 1-32.

Carlson, E. (2013). Consequentialism reconsidered (Vol. 20). Springer Science & Business

Media.

Chally, P. S., & Loriz, L. (1998). Ethics in the Trenches: Decision Making in Practice--a

Practical Model for Resolving the Types of Ethical Dilemmas You Face Daily.

Edwards, S. D. (2009). Nursing ethics: a principle-based approach. Palgrave Macmillan.

Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences.

Lewin, K. (1944). A research approach to leadership problems. The Journal of Educational

Sociology, 17(7), 392-398.

Sneesby, L. (2009). The human face behind an ethical dilemma: Reflecting on attempted

suicide and outcomes of a case study. International journal of palliative

nursing, 15(9).

Place new order. It's free, fast and safe

Paper type

Deadline

Page count

550 words

Total price: $ 15.00

Our customers say

Jeff Curtis

USA, Student

"I'm fully satisfied with the essay I've just received. When I read it, I felt like it was exactly what I wanted to say, but couldn’t find the necessary words. Thank you!"

Ian McGregor

UK, Student

"I don’t know what I would do without your assistance! With your help, I met my deadline just in time and the work was very professional. I will be back in several days with another assignment!"

Shannon Williams

Canada, Student

"It was the perfect experience! I enjoyed working with my writer, he delivered my work on time and followed all the guidelines about the referencing and contents."

Place new order. It's free, fast and safe

Our customers say

Jeff Curtis

Ian McGregor

Shannon Williams