|
Ethical Dilemmas:
choosing between two rights
| Course Number |
LWE710
1772 |
| Objectives |
At the end of this course, you will 1) define
dilemmas, 2) select the relevant values, principles and personal
issues in the dilemmas, and 3) propose solutions to ethical dilemma
cases. |
| Credit Hours and Fee |
3.0 CE Credit Hours with a fee of $24.00 |
| Instructor |
Rudolf Klimes, PhD (Indiana University), MPH
(Johns Hopkins University);
Adjunct Professor at Folsom Lake College, Folsom CA. |
Welcome
to this
3-contact-hour Continuing Education course with instant online processing and
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click here.
"What is usually the right thing to do?" Consider
the following four opinions.
"We cannot afford that much help."............"The
more we give, the more we get"
"People should forgive people"
...............................................
"We can never forgive the Nazis"
To deal with ethical dilemmas, you need to find the answers to these
questions:
1. How do you define a dilemma?
2. What values are at stake in the dilemma?
3. What principles are at stake in the dilemma?
4. What personal issues are at stake in the dilemma?
5. How will you solve the given 10 dilemmas?
Accreditation:
Nurses,
Dental Health Workers, Massage,
Pharmacy Workers,
Cardiovascular
1.
How do you define a dilemma?
Since a dilemma deals with two possible rights, these two right choices
must be clearly stated. Then the dilemma can move to a solution, where one of
the rights is preferred over the other one.
Determine the
two sides of the dilemma. (__v. __) Write
the dilemma as "a. one view" versus "b. another view."
Analyzing dilemmas: Ethical dilemmas are
termed in the form of _____v. ______, such as Equality of workers v.
Integrity of organization. Many dilemmas are also written as dealing with
:
1.1 Primacy of the interests of one party over the other (client or group)
1.2 Distribution in one way or other (merit or equal share)
1.3 Obligation of one to another (duty, custom, legal obligation)
1.4 Responsibility to client, colleague, profession, employer, society etc.
Some cases may be also deal with
* Permanency v. physical safety
* Best interest of client v. obligation to do no harm, etc (or v. rights of
others, benefits)
* Quality of life v. prolonging of life
* Client self-determination v. obligation to prevent harm
* Right to confidentiality v. autonomy
* Effectiveness of service v. client privacy
2.
What values are at stake?
Explore the
relevant values in the authorities literature of the case. Individuals
may validate their
basic ethical values from such sources as laws, social science research, and the
Bible.
Some of the issues concerning values are:
2.1 The right or wrong of an action.
2.2 The acceptance, reputation or embarrassment of an action.
2.3 Qualification and disqualification of a person, with reasons.
2.4 Virtues such as integrity, love, forgiveness, respect, purity, trust,
sanctity of life.
3.
What principles are at stake?
Select
the relevant principles that apply to the case and explain the reasoning process
that you used to arrive at a tentative solution. Some of the terms presented in
the dilemma definitions in Section 1. also suggest principles that may be at
stake.
Some
relevant principle may be:
3.1 Protection of life etc.
3.2 Conflict avoidance
3.3 Greatest good of group, etc.
3.4 Truth telling
3.5 Acceptance of Biblical command
3.6 Accountability
4.
What personal issues are at stake?
Consider
what personal issues of people or populations may effect the outcome of the case
to such an extend that a particular ethical position is required. Reconsider
your tentative solution in light of the personal issues involved and suggest a
final solution.
In
some cases, the loyalty for one group takes precedence over the loyalty to
another group. Some groups include the:
4.1 victim
4.2 family
4.3 employer
4.4 profession
4.5 community
5. How will you deal with these 10 cases?
Use
each of the above four steps to analyze the following cases, describe your
reasoning, and reach a solution. For an example of using a case worksheet, see
www.learnwell.org/reality.htm.
Case
Worksheet. 1. Definition: a._________________ v. b.__________________________
2.
Values for a_________________________________ b____________________________
3.
Principles for a______________________________ b____________________________
4.
Personal issues for a________________________ b_____________________________
5.
Reasoning and solution:____________________________________________ circle
a b
4.0
Two orphans:
Two
sisters, Ann (age 6) and Bev (14), who live in foster care must leave the place.
They have very different problems, Ann is physically handicapped, Bev is
mentally handicapped. Should the sisters be placed together or separately? (Case
1.2)
4.1
Wanting to die:
Mrs. Klimov (age 33) wants to stop her difficult cancer treatment and wants to
die. She has a ten-year old son, who can be taken care of by her mother. Her
mother says she is too young to die and considers it suicide. She was named her
daughter's Advance Directive (medical decision maker) and refuses to let her
daughter stop the treatment. (Case 1.3)
4.2
Adoption: Mary
(age 15) was adapted 12 years ago and now wants to know who her birth-parents
are. The records are sealed. Her adopted parents do not want her to meet her extremely
poor birth-parents for they feel that it will upset her too much and that she
may want to leave them. (Case 1.7)
4.3
Computer Records: To
be more efficient, Pastor Jones places his confidential home visitation records
on his officer computer. That will make record-keeping easier and he could visit
more homes. While at present he is the only one with access to that computer, it
would be easy for anyone to access the information when he is not in the office,
that is usually unlocked. It could compromise the records. (Case 3.2)
4.4
Cultural Differences: Mr.
Kim has immigrated from Korea some 3 years ago and joins the Washington Writer's
Society. He speaks and writes very good English but has many problems adopting
to the rules of the Society, which seem very strange to him. All his practices
are acceptable in Korea, but not in Washington. The Society is considering if it
can keep Mr. Kim as member because his presence disrupts the Society. (Case 3.3)
4.5
Organizational Mission: Joe,
age 25, comes to a social worker at JKM, an organization that serves and
supports homosexuals. He requests help in becoming heterosexual. JKM does not
have a program for that and does not advocate sexual-orientation changes. (Case
3.4)
4.6
Suicide: Bill,
age 45, has been abused as a child and has recently lost his wife. He is very
depressed and visits his only friend, a male nurse. He threatens suicide. His
friend things that he will get over it and tries to motivate him to living. He
could also commit him to a clinic for treatment. Next day Bill commits
suicide. (Case 4.1)
4.7
Family:
Henry, age 95, is keen of mind but feeble, lives alone and wants to stay living
alone. He sometimes falls, but has not injured himself seriously. His daughter
is concerned and wants him to come live with her. He refuses to move. (Case 4.4)
4.8
Rape Report: Jane,
age 16, was raped by a neighbor and comes to tell her teacher she trusts. She
asks the teacher not to tell anyone about that. The teacher feels that reporting
it to the police and the investigation may be worse than the rape itself.
Reporting may also place Jane's life in danger. (Case 4.9)
4.9 Tasha's
Baby: Tasha,
age 23, is single and 3 month pregnant. She uses drugs that endanger her fetus.
Her mother tries to persuade her to give up drugs. She refuses. She also refuses
to go see a doctor for she feels that the doctor will make her feel bad about
her drug-use. (Case 5.3)
The above cases were adapted from Juliet Cassuto Rothman's From the Front
Lines: Case Studies in Social Work Ethics, Allyn and Bacon, 1997.
Further
Reading
ERIC_NO: ED413544, A Practitioner's Guide to Ethical Decision Making. by Forester-Miller, Holly; Davis, Thomas E., 1995
ABSTRACT: Counselors must make sound ethical decisions but, often, determining the
appropriate course to take when confronted with a difficult ethical
dilemma can be a challenge. This guide assists counselors in
ethical decision making; it is presented as a supplement, and is to be used in
conjunction with, the American Counseling Association (ACA) Code of Ethics and
Standards of Practice. This practitioner's guide addresses principles that are
globally valuable in ethical decision making and provides a model for
professionals to utilize in their practice. It opens with a review of the five
moral principles that are viewed by many as the cornerstone of ethical
guidelines: autonomy, nonmaleficence, beneficence, justice, and fidelity. These
principles provide an absolute against which counselors can explore an ethical
dilemma, thereby gaining a better understanding of conflicting
issues. A sequential, seven-step, ethical, decision-making model is presented
next and comprises the following: (1) identify the problem; (2) apply the ACA
Code of Ethics; (3) determine the nature and dimensions of the dilemma; (4)
generate potential courses of action; (5) consider the potential consequences of
all options and then determine a course of action; (6) evaluate the selected
course of action; (7) implement this action.
www.eric.ed.gov
ERIC_NO: ED334468, Resolving Ethical Dilemmas in the Workplace: A New
Focus for Career Development. ERIC Digest No. 112., by Lankard, Bettina A., 1991
ABSTRACT: The diverse, multicultural population that constitutes today's work force faces ethical
dilemmas on the job that bring pressures to protect their own or
their company's interests, at the risk of losing their personal integrity.
Employers and vocational and career development personnel are recognizing the
need for decision-making and problem-solving skills that will facilitate
negotiation and conflict resolution in the workplace. Conflicts arise between
two or more personally held values, between personal values and those of another
person or the organization, between principles and the need to achieve a desired
outcome, and between two or more persons or groups to whom one has an
obligation. The resolution of conflicts requires interpersonal and negotiation
skills; the application of "employability skills" such as honesty,
cooperation, and integrity; and the participation of all stakeholders in a
situation. Ethics training should help employees (1) recognize which decisions
involve ethics; (2) understand the values of all stakeholders; and (3) weigh the
potential impact of various options on those values. As part of a career
development curriculum, discussions and analyses of case studies, use of ethics
committees and resource people, and training in critical thinking, conflict
resolution, communication, group processes, and mediation skills can prepare
students for the ethical dilemmas they may face in
the workplace. www.cdc.gov/od/ethics .
Organ Transplantation: Ethical Dilemmas and
Policy Choices
Since the first human kidney was transplanted in 1954, the nation has engaged
in searching public discussions about the ethics of organ transplantation: about
the human significance of removing organs from both living and cadaveric donors;
about the criteria for determining when death occurs and thus when the
decedent's organs might be taken; about whose wishes should ultimately decide
whether organs are used or not used; and about the ethics of different organ
procurement and allocation laws.
The current organ policy is shaped largely by two important laws: The first
is the Uniform Anatomical Gift Act of 1968, adopted in all fifty states, which
granted individuals the right to decide before death whether they wished to
donate their organs; the second is the Organ Transplantation Act of 1984, which
aimed to encourage organ donation by establishing an organized organ matching
and procurement network, while outlawing the buying and selling of human organs
or the direct compensation of organ donors and their families. Taken together,
these laws sought to reap the medical benefits of organ transplantation and to
encourage individuals to become organ donors, while preserving certain ethical
limits against treating the body as property and the newly dead as simply
natural resources. It also sought to ensure, as much as possible given other
inequities in the health-care system, that organs are allocated in an equitable
way.
Whether this policy has been a great success or terrible failure – both
medically and ethically – is a complex question. Many lives have been saved that
would not have been otherwise, and yet waiting lists for organs continue to
increase. Many individuals have given of themselves (literally) to save the life
of another, and yet the unequivocal protection of those who are not-yet-dead
(but would be useful if they were) has been called into question. The human body
(dead or alive) has not been reduced to mere property, and yet the desperation
of watching thousands of individuals die every year while waiting for organs has
prompted a renewed debate about whether monetary incentives should be used in an
effort to increase organ supply.
In the 107th Congress (2001 – 2002), a number of bills aimed at promoting
organ donation and increasing organ supply were proposed. Some bills would have
provided formal recognition of donors with commemorative medals. Other bills
offered tax credits to individuals who donate organs (or credits to their
surviving families) or reimbursement of the costs incurred by living donors.2
In addition, numerous books and articles have been written claiming that the
current organ procurement system has been a failure, resulting in "prolonged
suffering, declining health, and rising death rates,"3
and that the time has come to explore a market-based system to solve the organ
supply problem. A new group – called LifeSharers – is attempting to develop a
private network of organ giving and receiving, so that members have first
priority on the organs of other members. And while the medical community
generally supports the guiding principle of the current policy – that organ
donation should be an act of giving, without monetary incentives of any kind –
the American Society of Transplant Surgeons has endorsed the idea of a pilot
program that would partially reimburse surviving families for the funeral
expenses of individuals who allow their organs to be taken after death.
Source:
http://www.bioethics.gov/background/org_transplant.html
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Ethics
Resources
http://scholar.lib.vt.edu/ejournals/SPT/v8n1/devon.html
www.gutenberg.org/etext/15487
www.law.manchester.ac.uk/research/centres/csep/
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