Solving Ethical Dilemmas – Medical Ethics Example

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"Solving Ethical Dilemmas" is a great example of a paper on medical ethics. The discussion involves an understanding of the necessary steps that can be taken in solving any sort of ethical dilemmas that might arise in any situation. The dilemma which has been viewed in this discussion was related to Mr. Brown who was suffering from the problem of third-degree heart block along with syncopal episodes, weakness as well as fatigue for around 21 days. The cardiologist felt the need of performing surgery to set pacemaker in Mr.

Brown’ s respiratory system. However, Mr. Brown did not want a pacemaker in his chest. In this context, the ethical principles which are involved along with identifying alternatives and developing a suitable action plan for solving the ethical problem relating to this case have been depicted. Steps To Take When Solving Ethical Dilemmas A 70 years aged patient, Ed Brown was admitted to the hospital suffering from the problem of third-degree heart block along with syncopal episodes, weakness as well as fatigue for around 21 days. In consultation with a cardiologist, it was observed that Mr.

Brown required a stable pacemaker that was conveyed to the patient and thus approval was obtained thereof. However, while being taken to the holding area, Mr. Brown changed his mind deciphering his strong reluctance to undergo the operation. He communicated with the nurse regarding his wish. The information was then conveyed immediately to the physician. After attending the patient in the holding area, the physician then suggested Mr. Brown discuss the entire procedure.   The examples referred to above depict one of the common phenomena witnessed in medical treatments where patients often change their decisions just prior to the surgery due to anxiety or uneasiness or emotional dilemma.

The key players engaged with the case can be identified as the patient, Mr. Brown, the nurse, and the physician or surgeon. Apparently, Mr. Brown’ s wish was to regain his health while the interests of the nurse and the physician were to render adequate health assistance to the patient and ultimately cure the problems with which he was admitted to the hospital. From an in-depth perspective, the wish of the nurse was to assist the patient in order to serve him with appropriate healthcare without hampering his interests.   In this context, a strong influence of emotional strength can be witnessed which in turn motivated Mr.

Brown to reject undertaking the medical treatment with the pacemaker surgery just before he was being taken to the holding area. The emotional interests of the patient in this context can be identified as his willingness to have no other injuries on his body because of surgery. It can also be affirmed that as Mr. Brown was already 70 years old, he might have preferred to die with dignity without taking the support of a machine to live a longer life.

This gave rise to the dilemma for medical practitioners to secure their medical obligations to preserve the emotional interests of Mr. Brown. Dilemma With regard to the case study, it has been viewed that the main dilemma was that the cardiologist desired to perform the surgery to set pacemaker in Mr. Brown’ s respiratory system so as to satisfy his professional obligations to secure the patient’ s health and preserve life.

In a similar context, the nurse also desired to preserve Mr. Brown’ s life serving him with adequate medical assistance but simultaneously ensuring that his emotional interests were not hurt. On the other hand, the reluctance deciphered by Mr. Brown a few minutes prior to the surgery before being placed in the holding area can be assumed to be his anxiety of undergoing such a major operation or his emotional interest to face death with dignity. Hence, even though the moral concerns of all these key players can be identified as just and appropriate, the clash between the patient’ s emotional interests and practitioners’ professional interests gave rise to the conflict.

According to the case study, it can be stated that in such circumstances, in case the surgery is performed and even in case it is not undertaken, the rights of the patient are being compromised. It is the patient whose rights are to be highly valued. In relation to the case study, the willingness of the patient about placing a pacemaker in his chest was essential and he should be guided with every benefit as well as disadvantages that might arise from the procedure. The ethical principles which include the Principle of Distributive Justice and Double Effect can be involved in the case study.

In this regard, the Principle of Distributive Justice states that every individual is entitled to receive equal access to basic healthcare. In doing so, the requirements of the individuals should be highly valued. Conversely, the Principle of Double Effect suggests a reasonable procedure of analysis for any conflicting situations for the purpose of delivering morally sound services to every individual (Ascension Health, 2012). Personal Values The aspect of ethical decision-making is fundamentally described as a procedure that can be employed as well as refined in addressing any sort of dilemmas.

The procedure of decision-making in solving ethical dilemmas generally involves adhering to the values of beneficence and autonomy. The principle of beneficence implies avoiding evil and delivering good to an individual. In contrast, the principle of autonomy refers to supporting various choices of an individual for the greater good (The American Nurses Association, Inc, 2012).   In order to solve the ethical dilemma identified in the case scenario, when Mr.

Brown deciphered his unwillingness to insert a pacemaker in his chest, the nurse should have discussed the problem with the cardiologist providing a little more time for the patient to re-think his decision. It was quite necessary for the nurse to consult with the cardiologist regarding the dilemma in order to barricade any harm to the patient and thereby his life. Furthermore, the practitioners should have properly communicated with Mr. Brown making him understand the importance of the surgery.

They should also have intended to understand the emotional status of the patient which could have assisted them to deal with the situation in an appropriate way. Alternatives Apart from freely discussing the problem with the physician, in order to solve the ethical dilemma, the nurse could have also reported the issue to the family members of the patient, identifying them to have a direct interest in the health of Mr. Brown. This would have ultimately facilitated the development of an appropriate and just decided to deal with the entire conflicting situation.

However, it should also be mentioned that a written consent paper should have also been signed by Mr. Brown in order to avoid such conflicting situations which is quite common in medical history where patients are observed to become reluctant to accept the treatment facilities owing to their emotional weariness or anxiety. Plan of Action Every patient possesses the right to compose their own individual choices regarding their personal or medical care. Moreover, the patients also bear the right to make any personal decisions regarding their healthcare including the denial of treatment (The American Nurses Association, Inc, 2012).

Similarly, Mr. Brown who was admitted after suffering from a third-degree heart block must also be entitled to the right takeoff taking any decision regarding his healthcare. In order to determine patient care from an ethical viewpoint, a nurse should bear the understanding of various moral theories such as beneficence and autonomy among others. From the perspective of physical consequence, the nurse can perform the action plan of identifying similar ethical problems prior to their happening as well as collecting relevant data in order to solve the issue in an efficient way securing the interests of all the key players in the conflict situation.

In relation to psychological consequences, the nurse should recognize the person who possesses the power to control the situation of the problem, such as the family members, the physician, or any other member having a strong influence on the entire procedure. Additionally, with a social concern, the nurse should make use of various applicable interdisciplinary resources such as the ethics committee and consultants among others to deal with such situations. Furthermore, from a spiritual perspective, the nurse should choose a morally justified option from the alternatives which include reporting the problem to the family members of Mr.

Brown or informing the problem to the superiors. Concerning the most probable short-term consequences, the nurse should prioritize as well as act upon or implement the selected option after conveying the entire plan to the concerned parties including the patient if felt necessary. Finally, to control the long-term consequences of the dilemma, the nurse should evaluate the chosen option in comparison to the alternatives taking into account both the positive and the negatives mitigating the chance of giving rise to any other ethical concerns (Nysna, n.d. ).


Ascension Health. (2012). Key ethical principles. Retrieved from

Nysna. (n.d.). Role of the registered professional nurse in ethical decision-making. Retrieved from

The American Nurses Association, Inc. (2012). Ethics: the power of one. Retrieved from

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