Moral Dilemma

The Nature of Moral Dilemmas

In the modern era, professional accountability and litigation in healthcare organizations are increasing at a very good pace. This means that it has become very common for nurses to encounter situations in which they face legal and ethical conflicts at the time of providing care to patients. Further, nurses can be termed as one of the most important members of healthcare organizations. The rationale behind this is that they are the ones who come into direct contact with the patients. During situations of moral conflicts, it becomes almost impossible to react effectively. Moral dilemmas are defined as an argument or conflict that results in an opponent between two or more choices or alternatives.

It can be stated that sometimes nurses are not able to determine the difference between right and wrong because of their personal convictions and professional duties. This can be understood by the example that there is a nurse who has been asked to terminate a pregnancy by a healthcare organization. Such situations result in conflict between professional duties and the personal convictions of a nurse. It can be expressed that in such a situation moral dilemmas play a very crucial role to the nurse in terms of how she/he is required to react. As per the view of Cohen and Erickson (2006), the job and role played by a nurse can be considered one of the most crucial ones in a healthcare organization. This is because, when dealing with patients, nurses are required to act according to situations and instructions provided by their employees.

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This means that they need to completely neglect their norms and values. The results of this are that the quality of care provided by nurses is affected in a negative sense. Along with this, it also leads to an increase in the level of frustration, anger, and sadness among them. Nowadays, the operations and activities of healthcare have become very complex because of enhancements in medical technology. Further, laws and legislation related to nursing practices have also become very complex. In such situations, moral dilemmas are important as they result in providing support and guidelines to nurses in terms of how they can carry out their practices and duties in the best possible manner. However, it has been argued that irrespective of location and the nature of the organization, nurses face moral dilemmas that have a direct impact on nurses as well as on their patients. People are not able to determine what is right and what is wrong, and this results in creating a high level of confusion. Sometimes, nurses need to deal with highly critical situations where they are required to demonstrate their effectiveness and quality of care.

They need to make sure that they can save the lives of people by making the best utilization of the available resources. Moral dilemmas are also linked with situations when nurses are required to make choices between control and freedom. This can be justified by an example when a nurse encounters a situation in which the patient is required to consume a lot of fruits and juices to overcome weakness but he refuses to do the same. Now the dilemma here is that the nurse is not able to decide whether he/she should provide freedom to the patient or take control over the same. It can also be expressed that the nurse also gets confused about defining whether he/she has the authority or right to force the patient or not. Kain (2007) has explained that as per the nature of moral dilemmas, people or individuals are required to make choices between two or more available alternatives.

Another example of a moral dilemma is that without signing or providing any kind of acceptance, nurses are bound to confidentiality because of their profession. Furthermore, it can be stated that irrespective of whatever the situation is, the profession of nurse does not allow him/her to disclose confidential information or the existing condition of clients (patients) to people who are not associated with the same. The concept of moral dilemmas revolves around a situation where sometimes nurses do not do their professional obligations at the time of providing care services. On the other hand, the dilemmas are also associated with situations in which their moral belief allows them to provide care to patients by breaking all obligations.

Evaluate the Strengths and Limitations of a Range of Moral Theories

In the current scenario, there is a set of different moral theories that can be used by people or employees in healthcare organizations to carry out their practices. The main purpose behind the use of morale theories is to enhance the thinking of individuals and provide assistance to their decision-making process. In the context of healthcare, consequentialism, deontology, moral subjectivism, utilitarianism, etc. are some key moral theories. However, it can be stated that before carrying out the practical application of any theory, one is required to become aware of its key strengths and limitations. The moral theory of consequentialism emphasizes the fact that it is the consequences or outcomes of an act based on which a moral response can be determined.

One of the key strengths of consequentialism moral theory is that it can be universally applied to every healthcare organization. The rationale behind this is that every decision has its own set of measurable consequences, which can be easily evaluated. Another strength of this moral theory is that it is very systematic, and this allows people to make the most effective decisions regarding the selection of choices available. However, it can be argued that one of the major drawbacks or limitations of this theory is that it can consume lots of time, and its application in terms of practicality can be very complicated. Sometimes employees in healthcare organizations are required to make very quick decisions to save the lives of their respective patients. Therefore, in such situations, consequentialism moral theory cannot be used as it is very time-consuming.

Another morale theory linked with healthcare is deontology, which emphasizes the fact that employees or individuals are required to make decisions and carry out their activities based on their professional obligations and duties. This theory provides more value and preferences to the intention of people at the time of making decision instead of focusing upon outcomes of the decision made. The key strength of this theory is that it concentrates on carrying out professional duties and obligations in the best possible manner. This directly results in enhancing the quality of care services that are provided to patients. Another strength of this theory is that people can obtain the desired outcomes of their decisions because their intentions are good. In terms of limitation, it can be stated that this theory encourages people to tell the truth irrespective of whatever the situation is.

In simpler terms, practitioners using this theory are morally obligated to tell the truth in every situation and this is not practically possible in all circumstances. On the other hand, moral subjectivism is another theory linked with morality that is used by workers and professionals in healthcare.

The theory explains that the right and wrong of a decision completely depends on their feelings related to wrong and right. It can be expressed that the key strength of this theory is that it depicts a very close relationship between the feelings of individuals and their morality. This results in making the most effective decisions and getting favorable outcomes. Along with this, moral subjectivism's strength is that it makes individuals clear about the things or topics upon which they are arguing. However, it can be argued that its limitation is that it is not necessary that what people feel is always good. Other than this, virtue ethics is another effective theory that can be linked with morality.

According to this theory, good and effective decisions are made only by good individuals. Therefore, to become moral, it is required for people to seek and implement the ways through which they can improve themselves. The major strength of this theory is that it focuses on the examination of moral agents, and this is not carried out in any other morality theory. Another strength of the ethics theory is that it gives value to human emotions, which is not provided by any other theory of morality. In terms of limitations, it can be expressed that virtue ethics theory only focuses on individualism, and this means that the solution to moral dilemmas at a large level is not possible with the use of this theory. Along with this, the theory does not consider relativist dilemmas; this is another major limitation of virtue ethics theory.

Influence of One's Moral Values and Beliefs on Healthcare Practice

In the last few years, medical practice has started to place more emphasis on the beliefs and values of an individual. The rationale behind this is that quality of care and healthcare practices are directly influenced by the values and beliefs of an individual. It can be stated that the belief of a person plays a very important role in determining the cause and treatment of illness. Along with this, values and beliefs also support making decisions regarding the person who needs to be involved in the entire process of care. In the present scenario, the practices of nursing are being affected by the rise in ethical and moral dilemmas. It can be expressed that these dilemmas arise in situations where the values and beliefs of individuals restrict their ability to do the right thing.

Every nurse has some sort of commitment towards their patients, which needs to be accomplished in the best possible manner. Therefore, healthcare organizations are required to emphasize providing morale and courage to nurses. As per the view of Holmstrom and Hoglund (2007), at the time of carrying out their practices, nurses often encounter situations when they witness the difference between their core values developed during learning and the practical applicability of the same. This difference resulted in affecting the overall practices that have been carried out by a particular healthcare organization or practitioner.

Furthermore, workplace resistance or constraints are considered the biggest factor that hinders nurses from applying core values in their working practice. To cope with such situations, the practitioners are available with three main options, which are innovation, rejection, or acceptance. On the other side of this, it can be expressed that at the time of doing their work, sometimes nurses are also required to develop relationships with people they do not like to treat a patient. Thus, they are bound to provide healthcare services whether their values and beliefs allow them or not.

Range and Rotherham (2010) have asserted that every person has their own set of beliefs and values, which can be completely different from another individual. The services provided by a person are directly affected by their core values and beliefs (Range and Rotherham, 2010). However, it has been argued that when the beliefs of individuals are not agreed upon by other people working in healthcare, situations of conflict or disagreement arise. Every nurse is responsible for acting morally when providing care practices. Along with this, their beliefs and values should be capable enough to carry out the difference between what is right and what is wrong. The practices of nursing are determined by different types of acts and guidelines that need to be taken care of. Furthermore, nurses are also required to get familiar with all major documents related to the code of conduct, acts, and procedures. This supports them in finding answers to the practices that are completely wrong according to their values and beliefs.

It can also be stated that every professional healthcare worker is required to make sure that their values and beliefs do not contradict their respective roles and responsibilities. This means that they are required to treat every care seeker with equality, irrespective of their color, religion, or any other factor. Furthermore, carrying out discrimination among patients based on their demographic or any other factor will be against the code of practice and conduct. Nurses are also required to take care of the fact that no preference should be provided to the service user based on their personal beliefs and values.

Critically Analyze the Value of Moral Decision-Making Tools about Their Practical Application.

As per the view of ethical decision-making, it is the process in which the most suitable alternative is selected among all available alternatives. Furthermore, the decision-making is completely based on moral principles. It can be stated that moral decision-making consists of three major components, which are competency, commitment, and consciousness. Moral decision-making is very valuable in terms of providing the best care to patients and enhancing the quality of services. Along with this, moral decisions are also considered ethical decisions. McClendon and Buckner have explained that the process of moral decision cannot be carried out based on a particular set of rules.

Further, analysis of the situation and consideration of moral values are the two most important tools that are used for making moral decisions (McClendon and Buckner). This means that first people are required to analyze the situation and become aware of all its key elements. People need to make sure that they collect all the relevant facts and information that are associated with the situation. On the other side of this, individuals are also required to be aware of their core principles and values based on which decisions will be drawn. According to the viewpoint of Esterhuizen (2006), moral sensitivity is the most crucial element that is required to make moral decisions. Sometimes people also make the most effective and moral decisions based on their intuition.

Another important tool that is required to be used at the time of moral decision-making is the experience of people. The rationale behind this is that experience helps a person to analyze effectively and integrate moral values into the same. Moral decision usually consists of issues or conflicts between two or more beliefs and values. Other than this, all dimensions relating to morality are required to be taken into consideration. It can be argued that making moral decisions is not an easy task and healthcare practitioners are required to be very careful regarding the same. Therefore, they are required to consider the intention of the parties, the nature of the act, and all circumstances linked with the same. Individuals also need to carry out inquiries and investigations of all the moral norms, which can affect the entire process of decision-making. However, it can be argued that before making a decision, people should perceive favorable consequences or outcomes of the same. The value of moral decision-making can be witnessed by the fact that at the time of carrying out their practices, all healthcare professionals and nurses encounter a variety of moral issues and challenges.

Moral decision-making has become important because the majority of problems or issues faced by healthcare are linked with ethical dilemmas. It can also be stated that the profession of nursing is characterized by the fact that they are required to take care of the welfare and well-being of people or patients in the best possible manner. The process of moral decision-making consists of different stages that need to be taken care of by people. In the first stage, healthcare practitioners are required to gather relevant facts, data, and information.

One of the most important things that needs to be taken care of at the time of evaluating those facts is to be neutral. It can also be stated that individuals in healthcare can't collect all the facts. On the other hand, people are required to carry out the prediction of the future based on all facts collected. This prediction is made in the second stage of moral decision-making. The stage is very crucial because it supports the increasing possibility of getting desired outcomes. In the third stage, people are required to identify and carry out assessments of their intuitions. At last, people make moral decisions and select the best alternative among all the available ones.

Conclusion

From the above study, it can be concluded that moral dilemmas arise in situations when individuals get confused between the selection of one option from all the different options. Furthermore, moral dilemmas usually arise in terms of conflict or argument. It can be inferred that at the time of carrying out their respective duties, nurses often face situations where they are not able to decide whether they should follow obligations or should break them. From the above study, it can also be concluded that there are a range of moral theories available for healthcare organizations, and effective theories can be adopted by carrying out assessments of their strengths and limitations.

References

• Armstrong, A. E. (2006). Towards a strong virtue ethics for nursing practice.Nursing Philosophy.
• Austin, W. and Mekechuk, J. (2009). An overview of moral distress and the pediatric intensive care team. Nursing Ethics.
• Cohen, J. S. and Erickson, J. M. (2006). Ethical dilemmas and moral distress in oncology nursing practice. Clinical journal of oncology nursing.
• Esterhuizen, P. (2006). Is the professional code still the cornerstone of clinical nursing practice? Journal of advanced nursing.
• Goethals, S., Gastmans, C. and de Casterlé, B. D. (2010). Nurses' ethical reasoning and behavior: a literature review. International Journal of Nursing Studies.

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