Introduction to Moral Dilemma
In the present scenario, morale dilemmas plays very important role in growth and development of an individual. In simpler terms, it is defined as a situation in which individuals makes morally right decision and it results in wrong outcomes. On the other side, it can be stated that sometimes people makes decision which are morally wrong and it produces the most favorable outcomes. Furthermore, it can be better understood by example of Shipwreck in which the captain of ship experienced a situation where he was required to make decision regrading whether he should throw weak passenger or should let the all the people drown. The present research depicts the nature of morale dilemmas along with the strengths and limitations of different moral theories.
The nature of morale dilemmas
In the modern era, professional accountability and litigation's in health-care organizations are increasing with a very good pace. This means that it has become very common for nurses to encounter a situations in which they face legal and ethical conflicts at the time of providing care to patients. Further, Nurse can be termed as the one of the most important member of health-care organizations. The rationale behind this is that they are the one which comes in direct contact with the patients. During situations of morale conflicts, it becomes almost impossible to react in effective manner. Morale dilemmas are the defined as an argument or conflict which results in 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 example that there is a nurse who has been asked to terminate pregnancy by health care organization. Such situations result in conflict between professional duties and person convictions of a nurse. It can be expressed that in such situation morale dilemmas plays a very crucial role in providing guidance to 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 nurse can be considered as one of the most crucial one in health-care organization. This is because at the time of dealing with patients, nurse are required to act according to situations and instructions provided by their employer.
This means that they need to completely neglect their personal norms and values. The results of this is that quality of care provided by nurse is affected in negative sense. Along with this, it also leads to increase in the level of frustration, anger and sadness among them. Nowadays, the operations and activities of health-care has become very complex because of enhancement in technology of medical. Further, laws and legislation's related to nursing practices has also become very complex. In such situations, morale 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, has argued that irrespective of location and nature of organization, nurses face morale dilemmas which has a direct of impact on nurse as well as to their patients. People are not able to determine what is right and what is wrong and this results in creating high level of confusion. Sometimes, nurses needs 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 life of people by making the best utilization of the available resources. Morale 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 encounter a situation in which the patient is required to consume a lot of fruits and juices in order to overcome weakness but he refused to do the same. Now the dilemma here is that the nurse is not able to decide whether he/she should provide freedom to patient or to take control over the same. It can be also expressed that the nurse also get confused to defining whether he/she has authority or right to force the patient or not. Kain, (2007) has explained that as per the nature of morale dilemmas, people or individuals are required to make choices between two or more available alternatives.
Another example of morale dilemmas is that without signing or providing any kind of acceptances, nurses are bound with confidentiality because of their profession. Furthermore, it can be stated that irrespective of whatever the situation is, the profession of nurse do not allow him/ her to disclose confidential information or the existing condition of clients (patients) to person which are not associated with the same. The concept of morale dilemmas revolve around the situation where sometimes nurses do not go beyond their professional obligations at the time of providing care services. On the other hand, the dilemmas are also associated with situations in which their morale 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 are set of different morale theories which can be used by people or employees in health-care organization in order to carry out their practices. The main purpose behind the use of morale theories is to enhance thinking of individuals and provide assistance to their decision making process. In context of health-care, 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 their key strengths and limitations. The morale theory of consequentialism lays emphasis on the fact that it is the consequences or outcomes of an act on the basis of which morale response can be determined.
One of the key strengths of consequentialism morale theory is that it can be universally applied to each and every health-care 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 morale theory is that it is very systematic in nature and this allows people to make most effective decision regrading the selection of choices available. However, it can be argued that one of the major drawback or limitation 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 health-care organization are required to make very quick decisions in order to save life of their respective patients. Therefore, in such situations, Consequentialism morale theory cannot be used as it is very time consuming.
Another morale theory linked with healthcare is Deontology which lays emphasis on the fact that employees or individuals are required to make decisions and carry out their activities on the basis of 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 concentrate on carrying out professional duties and obligations in the best possible manner. This directly results in enhancing the quality of care services which are provided to patients. Another strength of this theory is that people are able to obtain desired outcomes of their decisions because their intention is 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 which is used by workers and professionals in healthcare.
The theory explains that right and wrong of decision completely depends on their feeling 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 feeling of individuals and their morality. This results in taking most effective decisions and getting favourable outcomes. Along with this, moral subjectivism strength is that it makes individuals clear about the things or topic upon which they are arguing. However, it can be argued that its limitation is that it is not necessary that what people feels is always good. Other than this, virtue ethics is another effective theory which can be linked with morality.
According to this theory, good and effective decisions are made only by individuals which are good in nature. Therefore, in order to become moral it is required by people to seek and implement the ways through which they can improve themselves. The major strength of this theory is that it focuses on examination of moral agent and this is not carried out in any other morality theory. Another strength of Virtue 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 large level is not possible with the use of this theory. Along with this, the theory do not take relativist dilemmas into consideration and this is another major limitation of Virtue Ethics theory.
Influence of one’s moral values and beliefs on healthcare practice
In last few years, the medical practise has started to give more emphasis on belief 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 belief of a person plays very important role in determining the cause and treatment of illness. Along with this, values and beliefs also supports in making decisions regrading the persons which needs to be involved in the entire process of care. In the present scenario, the practises of nursing are getting affected by the rise in ethical and morale dilemmas. It can be expressed that these dilemmas arises in situation where values and beliefs of individuals restrict their ability of doing right things.
Each and 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 lay emphasis on providing morale courage to nurses. As per the view of Holmström and Höglund, (2007) at the time of carrying out their practices nurses often encounter situations when they witness difference between their core value develop during learning and practical applicability of the same. This difference resulted in effecting the overall practises which has been carried out by a particular healthcare organization or practitioner.
Furthermore, workplace resistance or constraints is considered as the biggest factor which hinder nurses to apply core values in their working practise. In order to cope up 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 relationship with people they do not like in order to treat a patient. Thus, they are bound to provide healthcare services whether their values and beliefs allows them or not.
Range and Rotherham (2010) has asserted that each and every person has its own set of beliefs and values which can be completely differ form another individuals. The services provided by a person are directly affected by their core values and beliefs (Range, and Rotherham, 2010. However, has argued that when the belief of individuals are not agreed by other people working in healthcare, situations of conflicts or disagreement arises. Each and every nurse is responsible to act morally at the time of providing care practises. Along with this, their belief and value should be capable enough to carry out difference between what is right and what is wrong. The practises of nursing are determined by different type of Acts and guidelines which needs to be take care of. Furthermore, nurses are also required to get familiar with all major documents related to code of out, acts and procedures. This supports them to find answer of the practises which are completely wrong according to their values and beliefs.
It can be also stated that each and every professional health care worker is required to make sure that their values and beliefs do not contradict with their respective roles and responsibilities. This means that they are required to treat each and every care seeker with equality irrespective of their colour, religion or any other factor. Furthermore, carrying out discrimination among patients on the basis of their demographic or any other factor will be against code of practise and conduct. Nurse are also required to take care of the fact that no prefer should be provided to the service user on the basis of thier personal belief and values.
Critically analyse the value of moral decision-making tools in relation to their practical application
As per the view of ethical decision making is the process in which the best and most suitable alternative is selected among all available alternative. 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 the best care to patient and enhancing quality of services. Along with this, moral decision are also considered as ethical decision. McClendon and Buckner, has explained that the process of morale decision cannot be carried out on the basis of particular or specific set of rules.
Further, analysis of situation and consideration of morale values are the two most important tools which are used for making moral decision (McClendon and Buckner. This means that first people are required to analysis the situations and become aware of all its key elements. People needs to make sure that they collect all the relevant facts and information which are associated with situation. On the other side of this, individuals are also required to aware about their core principles and values on the basis of which decisions will be drawn. According to the view point of Esterhuizen, (2006) moral sensitivity is the most crucial element which is required in order to make morale decisions. Sometimes people also make the most effective and morale decision on the basis of their intuition.
Another important tool which 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 person to analyse situations in effective manner and integrate moral values in the same. Moral decision usually consists of issues or conflicts between two or more belief and values. Other than this, all dimensions regrading morality are required to be taken into consideration. It can be argued that making moral decision is not an easy task and healthcare practitioner are required to be very careful regrading the same. Therefore, they are required to considered intention of parties, nature of act and all circumstances linked with the same. Individuals also need to carry out inquiry and investigation of all the moral norms which can affect entire process of decision making. However, it can be argued that before making decision, people should perceive favourable 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 practises, all healthcare professional and nurses encounters a variety of moral issues and challenges.
Moral decision making has become important because majority of problem or issues faced by healthcare are linked with ethical dilemmas. It can be also stated that the profession of nursing is characterised by the fact that they are required to take care of welfare and well-being of people or patients in the best possible manner. The process of moral decision making consists of different stages which needs to be take care of by people. In the first stage, healthcare practitioner are required to gather relevant facts, data and information.
One of the most important thing which needs to be taken care of at the time of evaluating those facts is to be neutral. It can be also stated that it is not possible for individual's in healthcare to collect all the facts. On the other hand, people are required to carry out the prediction of future on the basis of all facts collected. This prediction is done in the second stage of moral decision making. The stage is very crucial because its supports inn increasing possibility of getting desired outcomes. In the third stage people are required to identify and carry out assessment of their intuitions. At last people make moral decision and select the best alternative among all the available ones.
From the above study, it can be concluded that moral dilemmas arises in situation when individuals gets confused between selection of one option from all different options. Furthermore, moral dilemmas are usually arises in terms of conflict or argument. It can be inferred that at the time of carrying out their respective duties, nurses often faces situation where they are not able to decide whether they should follow obligations or should break them. From the above study, it can be also concluded that there are range of moral theories available for healthcare organization and effective theory can be adopted by carrying out assessment of their strengths and limitations.
- 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 paediatric 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 behaviour: a literature review. International Journal of Nursing Studies.