Ethical dilemma

Class,

This week we will learn about situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?(Ethical dilemma essay example)

In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

To Prepare(Ethical dilemma essay example)

CASE STUDY 1

The parents of a 16-year-old male is seen for his required physical examination before starting sports. His parents are opposed to him receiving any vaccines.

CASE STUDY 2

A 33-year-old woman with advanced stage breast cancer has been admitted to the emergency room with cardiac arrest. She is not married and her boyfriend accompanies her in the ambulance.(Ethical dilemma essay example)

Select one scenario from above, and reflect on the material presented throughout this course.(Ethical dilemma essay example)

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?(Ethical dilemma essay example)

Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.(Ethical dilemma essay example)

The Lab Assignment

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.(Ethical dilemma essay example)

Ethical dilemma essay example-solution

Ethical Theory

The word ‘ethics’ is derived from the Greek word, ‘ethos,’ which is an equivalent of the word ‘character,’ which is a virtue of people with reliable and acceptable behavior (Gordon, 2013). According to Rich (2013, p.4), ethics is a systematic approach to understanding, analysing, and distinguishing matters or right or wrong, good and bad, and admirable and deplorable as they relate to the well-being of and the relationships among sentient beings.” From this definition, ethical theory refers to formal statements outlining moral actions when faced with an ethical dilemma. For instance, it is wrong to lie even if it will make somebody sad. Thus, ethical theories are formal statements about what we ought to do when faced with a moral dilemma—for example, choosing between lying or making someone sad from the truth or killing one person to save ten others.(Ethical dilemma essay example)

In trying to choose between two conflicting actions, it becomes clear that the centrality of ethical issues is whether to focus on the nature of the actions or their consequences. Often, the word ethics is used interchangeably with morality. Morality is derived from the Greek word ‘mores,’ which refers to the rules guiding conduct in a society or a group of people (Gordon, 2013).  When thinking of them as distinct concepts, one can consider morality as a set of beliefs in choosing right and wrong. On the other hand, ethics can be looked at as the method for justifying the beliefs and the rules which guide one in applying them.

Metaethics

Metaethics is a subdivision of analytical philosophy that explores the founding frameworks of acceptable societal values, their status, properties, and construction of words (Kirchin, 2012). Metaethics is, therefore, considered an abstract way of philosophical thinking on morality. Metaethical concepts respond to ethical questions by examining the semantics and ontology of moral discourses and properties, the significance therein anthropological disparity on moral practices and values, the psychology of morality, and the epistemology of human knowledge of moral values (Kirchin, 2012). The significance of metaethics lies in its inquiry of whether moral judgments are subjective or objective.(Ethical dilemma essay example)

Ethical Thinking

A more straightforward approach to deciding the ethical validity of an action is to look at its consequences. According to Reiss (2010), the validity and conclusion of ethical issues are based on three measures; (a) whether the moral arguments are convincing and supported by reasoning, (b) whether the ethical scrutiny is done within the confides of supported ethical framework, or (c) whether there is an agreement around the validity of the moral judgement. We are often faced with moral issues, and ethical thinking is critical in making the right decisions. For instance, one may ask, what is the metaethical interpretation of the permissibility of abortion? Is abortion right or wrong? The public discourse on the right to life is a significant public debate due to its attacks on an ethical domain.(Ethical dilemma essay example)

According to Wilkens (2011), the process of moral judgment is critical when arguing moral facts and determining solutions to issues basing on existing moral principles. In any case, a sound ethical system must begin with a correct understanding of human nature (Clark & Poortenga, 2003). Who are we to judge people and their beliefs? The fact is that judgment is essential in the domain of morality and human life. The ethical theory has shown that through metaethics, a practical and moral judgment, that these principles are the study of right and wrong actions and the concern of goodness.(Ethical dilemma essay example)

For instance, metaethical foundationalism views moral judgments depending on their appeals to other moral beliefs or when self-evident (Fisher, 2014). Metaethical positions may also be divided according to how they envision the frameworks for justifying moral beliefs. In contrast, metaethical coherentism views moral judgments as part of other consistent networks of beliefs (Fisher, 2014). (Ethical dilemma essay example) Equally, metaethical contextualism justifies moral judgments by reference to some relevant epistemological norms and practices (normative contextualism) or existing straightforward beliefs (structural contextualism) (Fisher, 2014). Another account of metaethical decisions is through reference to existing religious beliefs and justifications (religious epistemology) (Fisher, 2014).(Ethical dilemma essay example)

(Ethical dilemma essay example)One way of determining the permissibility of abortion is through moral intuitionism. Intuitionism holds that a valid ethical judgment is self-evidently provided; it is clearly and calmly reflected, and it is not distorted by subjective interests or faulty moral background (Tropman, 2009). Considering the modern legal frameworks, the permissibility of abortion depends on the mother’s or doctor’s provisions. In this sense, clear proof that the mother’s life is at risk would guarantee an abortion without which abortion is not just illegal but immoral.(Ethical dilemma essay example)

However, this moral judgment on abortion would raise concern for compatibility or the conflict between self-interest and morality. It is argued that moral judgments are not factions on reasoning alone and are characterized by an intrinsic inclination of the action itself that reason cannot provide and can only be guaranteed by feelings of approval or disapproval (Cohon, 2004). In this case, moral judgment is considered to serve an individual’s interest in the long run. Consequently, the question of “why should I carry out an abortion?” is answered by the intrinsic moral behavior and extrinsic need for goodwill (benevolence).

Furthermore, the utilitarian approach considers ethical actions to embody a balance of good over evil (Velasquez et al., 2015). Utilitarianism holds the subjective conception of their well-being and rejects the view that certain things are intrinsically right or wrong regardless of their consequences (Reiss, 2010). 19^th Century philosophers Bentham and Mill posited that, “Ethical actions are those that provide the greatest balance of good over evil” (cited in Velasquez et al., 2015, p.1). However, when utilitarian values remain entrenched in society, people tend to do whatever they want at their convenience. In this case, we determine the available actions, their effects and associated harm, and each action’s benefits as outlined in metaethics.(Ethical dilemma essay example)

Christian Worldview

The Cristian position on abortion has received public discourse since the fall of man, as highlighted in the Bible. Christian ethics is concerned with identifying and clarifying principles that assess human behavior in light of Christian teachings and revelation. In The discourse on the reasonability or rationality of belief in God is often proceeded by confrontation from competing religions or the rise of agnosticism or atheism. Moreland & Craig (2017) argued that reasoning is a fallible human way of discovering hidden truths or acquainting themselves with reality and determines how an individual believes rather than what he believes. Consequently, the belief in God is considered irrational due to a lack of evidence, as explained by the concept of evidentialism. Kant argued that all beliefs must be subjected to reasoning and criticism and are considered irrational if found to be unable to survive scrutiny (cited in Ezedike, 2020).(Ethical dilemma essay example)

Typically, Christians’ perception of the ethical propensity of abortion is farfetched from the scriptural inscription in the Bible and other sacred manuscripts. According to Geisler (1989), “there is no moral law without a moral Lawgiver; there is no moral legislation without a moral Legislator.” For instance, Christians’ perspectives on abortion are dependent on God’s commandments. Christians borrow from Exodus 20:13 (NIV) which says, “you shall not murder” (Exodus 20:13 NIV). Since Christians believe that God is the creator of life, man has no moral obligation to terminate life since it is not his property. Taking life through abortion is considered a violation of the commandment and a separation from the moral values associated with humanity and inherent dignity. Further, the provision in Jeremiah 1:5 (NIV), “Before I formed you in the womb I knew you before you were born I set you apart; I appointed you as a prophet to the nations,” has been interpreted by Christians mean life begins before birth, which makes immoral.(Ethical dilemma essay example)

A contrasting worldview of Christian ethics is atheism. Atheism intrinsically holds an opposing view in discourses relating to God as the belief in deities’ nonexistence (Bainbridge, 2005). Atheists hold a nihilistic and existentialist view that the existent of personal God is linked to objective moral standards. In this sense, the right and wrong questions inherently have no meaning, and, thus, any notion of morality is an anthropogenic fantasy. Consequently, belief in God renders human existence baseless and meaningless. Typically, atheists spearhead secularisation in part and weakness in social responsibility that comes with moral questions (Bainbridge, 2005). Atheist argues that Christians have traditionally imposed unfair restrictions on women’s legal and civil rights, specifically abortion rights on many fronts. Following this, the mother’s inherent human dignity would be considered superior to that of the fetus; thus, abortion, in this case, is not immoral whether the life of the mother is not at risk. This is contrary to the Christian values on human dignity.(Ethical dilemma essay example)

Despite the divisive nature of the moral dilemma, there has to be an eventual moral judgment. I agree in part with the moral position of the Christian worldview on abortion. However, I borrow my moral position from moral intuitionism that requires an in-depth thought and reflection on the ethical dilemma.  In this sense, there is a need to contextualize the morality of the actions and their consequences. In this case, the questions that would precede my moral judgment would be “why abort?” and “what does the existing moral practices and norms permit?” In case the reasons for abortion are founded on fatal clinical risks, then abortion is permissible under the guidance of a qualified doctor and using methods that value human dignity. However, when abortion fails moral scrutiny, professional conduct of clinical practice, or societal practices and norm, abortion is not an option.(Ethical dilemma essay example)

References

Bainbridge, W. S. (2005). Atheism. Interdisciplinary Journal of Research on Religion, 1.

Clark, K. J., & Poortenga, A. (2003). The story of ethics: Fulfilling our human nature. Upper Saddle River, NJ:

Cohon, R. (2004). Hume’s moral philosophy.(Ethical dilemma essay example)

Ezedike, E. (2020, January 2). Morality within the limits of practical reason: A critique of Kant’s concept of moral virtue. International Journal of Ethics and Systems, 36(2), 205-216. Retrieved November 16, 2020, from https://doi.org/10.1108/IJOES-11-2018-0171

Fisher, A. (2014). Metaethics: An Introduction. Routledge.

Geisler, N. L. (1989). Christian ethics (pp. 216-217). Baker Book House.

Gordon, J. S. (2013). Modern morality and ancient ethics. Internet Encyclopedia of Philosophy. https://iep.utm.edu/anci-mod/

Kirchin, S. (2012). What Is Metaethics? In Metaethics (pp. 1-20). Palgrave Macmillan, London.

Moreland, J. P., & Craig, W. L. (2017). Philosophical Foundations for a Christian worldview. InterVarsity Press.

Reiss, M. (2010). Ethical thinking. In Ethics in the science and technology classroom (pp. 7-17). Brill Sense.

Rich, K. L. (2013). Introduction to ethics. Nursing ethics: Across the curriculum and into practice, 1.

Tropman, E. (2009). Renewing moral intuitionism. Journal of Moral Philosophy, 6(4), 440-463.

Velasquez, M., Andre, C., Shanks, T., & Meyer, M. J. (2015). Thinking ethically. Issues in Ethics, 7(1), 2-5. https://www.csulb.edu/sites/default/files/groups/dance/2020-2021_docs/reading_resources-touch_and_consent.pdf