The Concept of Ethical DilemmasThe Concept of Ethical Dilemmas

Presented by: Presented by: Pauline Ansine BSN RNPauline Ansine BSN RN

What is Ethics?What is Ethics?

The code of conduct or behavior The code of conduct or behavior governing an individual or a group (as governing an individual or a group (as the members of the profession).the members of the profession).

The complex of ideas, beliefs or The complex of ideas, beliefs or standards that characterizes or standards that characterizes or pervades a group, community or pervades a group, community or people.people.

The Merriam WebstersThesaurusThe Merriam WebstersThesaurus

What is a Dilemma?What is a Dilemma?

A difficult problem seemingly incapable of A difficult problem seemingly incapable of a satisfactory solution.a satisfactory solution.

A situation involving choice between A situation involving choice between equally unsatisfactory alternatives.equally unsatisfactory alternatives.

Aroskar et alAroskar et al

Perplexing situation.Perplexing situation.

Merriam Webster DictionaryMerriam Webster Dictionary

Definitions 0f Ethical Definitions 0f Ethical DilemmasDilemmas

EthiEthical dilemmas are situations involving cal dilemmas are situations involving conflicting morals claims, and give rise in conflicting morals claims, and give rise in such questions as : such questions as :

– What ought I to do? What ought I to do?

– What harm and benefit result from this What harm and benefit result from this decision or actions? decision or actions?

– What is good (virtue) or what is duty (right)?What is good (virtue) or what is duty (right)?

Aroskar et alAroskar et al

Ethical Dilemmas in BusinessEthical Dilemmas in Business

Informational and emotional deception in Informational and emotional deception in negotiation.negotiation.

Managers’ moral reasoning.Managers’ moral reasoning.

Data miningData mining

Gender differencesGender differences

Managerial and technical workManagerial and technical work

Information technologyInformation technology

Ethical Dilemmas in Social Ethical Dilemmas in Social WorkWork

Ethical dilemma occurs when social Ethical dilemma occurs when social workers must choose between two workers must choose between two contradictory ethical principles or contradictory ethical principles or directives.directives.

Conflict may arise between patients, Conflict may arise between patients, families, agency staffs, and government families, agency staffs, and government regulations.regulations.

Tensions may arise in homecare.Tensions may arise in homecare.

National Association of Social Workers National Association of Social Workers

Social Workers dilemmaSocial Workers dilemma

Social workers reported that the most Social workers reported that the most common issues were patient competence common issues were patient competence and confusion because of the lack of and confusion because of the lack of advance directives.advance directives.

Three possible areas of Three possible areas of decision making have decision making have been Identified:been Identified:

1.1. Using all possible means to Using all possible means to keep the patients alive keep the patients alive (ordinary & extraordinary (ordinary & extraordinary means).means).

2. Surgeons experience ethical 2. Surgeons experience ethical dilemmas in deciding the dilemmas in deciding the right treatment in different right treatment in different situations.situations.

3.Taking some “positive” steps 3.Taking some “positive” steps to hasten individual’s death.to hasten individual’s death.

Ethical Dilemmas Ethical Dilemmas Physicians FacedPhysicians Faced

Pope Pius XII Pope Pius XII statement in 1957statement in 1957

– “– “One is held to use One is held to use only ordinary means only ordinary means according to according to circumstances of circumstances of persons, places, times persons, places, times and culture – means and culture – means that do not involve that do not involve any grave burden to any grave burden to oneself or another.”oneself or another.”

Ethical Dilemmas Ethical Dilemmas in Nursingin Nursing The challenge of The challenge of

decision making .decision making .

The sanctity of life vs the The sanctity of life vs the quality of life.quality of life.

Informed consentInformed consent

Truth-telling – the Truth-telling – the question “am I going to question “am I going to die? This raises die? This raises important issues about important issues about truth telling.truth telling.

Situation on Truth TellingSituation on Truth TellingA Patient’s Right to Know the TruthA Patient’s Right to Know the Truth

Carolyn , age 21, is dying of leukemia. She Carolyn , age 21, is dying of leukemia. She wants to know what is happening to her. wants to know what is happening to her. However, her devoted mother believes in However, her devoted mother believes in shielding Carolyn from this prognosis. Nurse A shielding Carolyn from this prognosis. Nurse A believes client, who repeatedly ask about her believes client, who repeatedly ask about her worsening signs and symptoms, has a right to worsening signs and symptoms, has a right to know the truth. Carolyn’s mother , a wealthy, know the truth. Carolyn’s mother , a wealthy, influential woman, threatens to sue the hospital influential woman, threatens to sue the hospital if her daughter finds out that she is dying.if her daughter finds out that she is dying.

Situation cont.Situation cont.

Nurse A wishes to support the patient’s Nurse A wishes to support the patient’s right to know the truth. Nurse B wishes to right to know the truth. Nurse B wishes to acquiesce to the mothers wishes.acquiesce to the mothers wishes.

As a professional nurse, what would you As a professional nurse, what would you do in this situation??do in this situation??

Nursing Students’ Experiences

Resolution of the conflict. Rational for resolution.

Conflict about the right thing to do.

Unethical attitudes and behaviors of practicing nurses and doctors.

ReferencesReferences

Aroskar; M.A., Davis, A., Drought, T., Liaschenko, J.(1997). Ethical dilemmas Aroskar; M.A., Davis, A., Drought, T., Liaschenko, J.(1997). Ethical dilemmas and nursing practice. 4and nursing practice. 4thth.ed. Appleton & Lange Stamford, Connecticut. .ed. Appleton & Lange Stamford, Connecticut.

Bandman b., Bandman, E. (2002). Nursing ethics through the life span. 4Bandman b., Bandman, E. (2002). Nursing ethics through the life span. 4 thth ed. ed. Prentice Hall, New Jersey.Prentice Hall, New Jersey.

Barry, B., Fulmar, I., Long, D. (2009). Lying and smiling: Informational and Barry, B., Fulmar, I., Long, D. (2009). Lying and smiling: Informational and emotional deception in negotiation. emotional deception in negotiation. Journal of business ethicsJournal of business ethics. 88:691-709 . 88:691-709 DOI 10.1007/s10551-008-9975-x.DOI 10.1007/s10551-008-9975-x.

Cameron, M., Hyeroun, A., Schaffer, M. (2001). Nursing students’ experience Cameron, M., Hyeroun, A., Schaffer, M. (2001). Nursing students’ experience of ethical problems and use of ethical decision-making models. of ethical problems and use of ethical decision-making models. Nursing Nursing ethics. 8 (5).ethics. 8 (5).

Calluzzo, V., Cante. (2004). Ethics in information technology and software use. Calluzzo, V., Cante. (2004). Ethics in information technology and software use. Journal of business Journal of business ethics. 51: 301-312, Kluwer academic publishers.ethics. 51: 301-312, Kluwer academic publishers.

Crow n, D,. Franke, D,, Franke., G., spake, D. (1997). Gender differences in Crow n, D,. Franke, D,, Franke., G., spake, D. (1997). Gender differences in ethical perceptions of business practices: A social role theory. ethical perceptions of business practices: A social role theory. Journal of Journal of applied psychology.. Vol. 62. no 6, 920934.applied psychology.. Vol. 62. no 6, 920934.

ReferencesReferences

Danna, A., Oscar, G. (2002). All that glitters is not gold: Digging deep beneath Danna, A., Oscar, G. (2002). All that glitters is not gold: Digging deep beneath the surface of data mining. the surface of data mining. Journal of business ethicsJournal of business ethics. 40: 373-386. Kluwer . 40: 373-386. Kluwer academic publisher.academic publisher.

Monga, M. (2007). Managers’ moral reasoning: Evidence from large Indian Monga, M. (2007). Managers’ moral reasoning: Evidence from large Indian manufacturing organization. manufacturing organization. Journal of business ethicsJournal of business ethics. 71:179-194 DOI . 71:179-194 DOI 10.1007/s10551-006-9133-2.10.1007/s10551-006-9133-2.

Erdil, F., Korkmaz, F. (2009). Ethical problems observed by student nurse. Erdil, F., Korkmaz, F. (2009). Ethical problems observed by student nurse. Nursing ethicsNursing ethics. 16 (5).. 16 (5).

Egan, M., Kadushin, G. (2001). Ethical dilemmas in homecare: A social work Egan, M., Kadushin, G. (2001). Ethical dilemmas in homecare: A social work perspective. perspective. National association of social workersNational association of social workers. 26 (3).. 26 (3).

Hunt, G. (1994). Ethical issues in nursing. London and New York. Rutledge.Hunt, G. (1994). Ethical issues in nursing. London and New York. Rutledge.

Nordam, A., Torjuul, K., Venke, S. (2005). Action ethical dilemmas in surgery: Nordam, A., Torjuul, K., Venke, S. (2005). Action ethical dilemmas in surgery: an interview study of practicing surgeonsan interview study of practicing surgeons. BMC Medical ethics. 6: 7 doi: . BMC Medical ethics. 6: 7 doi: 10. 1186/1472-1472-6939-6-7.10. 1186/1472-1472-6939-6-7.

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