When to Choose between Two Equal Undesirable Alternatives

Introduction

 When an ethical dilemma occurs in the field of medicine, there is a need to find a practical solution. There are different ways to approach a moral dilemma. The first step is determining the situation that causes the dilemma. It is challenging to identify an ethical dimension in a problem. Discussing the dilemma with seniors or colleagues is important although learning to make a reasonable decision in the face of the dilemma is critical. The main factor influencing an ethical dilemma is behavior or attitude. Examples include organizational goals, personal character, and conflict of individual-based values. The purpose of the study below is to identify the way ethics apply to deal with different issues.

The following is a case study of a woman who had an emergency in stomach pains. The physician performs a CT scan and diagnoses her with an abdominal aortic aneurysm, which upon stretching can burst and cause death. The patient is advised to have surgery as soon as possible. She refuses the surgery giving an excuse that she is an erotic dancer and the scar left could affect it. The physicians try to pressure her on the importance, but she refuses. The physicians feel the woman needed assistance but could not make the right choice. The ethical dilemma in the case occurs when the doctor has to decide on the best action to take to help the patient. The caring response, in this case, is making sure the patient receives treatment where the six steps result to the final decision of performing the surgery.

It is advisable to gather all the relevant information from the patient before making a decision. After analyzing the ethical issue in a situation, it is easy to identify the critical aspect of the problem. It involves identifying the questions that need an answer and searching for the relevant principles that should apply. The appropriate source of information is from the patient, the field experts, and also from fellow staff. Its relevance is to ensure that the main issue is addressed. From the gathered information, one can decide whether to perform an act or not. There are various types of information that can help to analyze the patient’s situation in the case. They comprise the number of sources of income, her responsibilities, and status information. Among the questions to ask the patient include: the number of sources of income she has, her duties, how flexible she is to adjust to the change of occupation, availability of anyone to assist her in the responsibilities, and whether she has a spouse.

Different types of ethical problems comprise type A, type B, ethical dilemma, locus of authority, and moral distress. Type A focus on internal and external barriers, and type B deals with truth. Moral distress focus on whether something is wrong as well as negative consequences. Locus of authority asks whether somebody could be influencing the decision, while moral distress deals with personal behavior. Therefore, type A ethical dilemma is more relevant in this case since it involves two aspects of care. The woman is afraid of losing the dance work that helps her in raising income, and the situation is demanding for a surgery. The surgery is a barrier to the work she does as it can burst if stretched and dancing involves a lot of dancing.

Three theories can help in analyzing the situation. They include utilitarianism, deontology, and virtue ethics. To start with, the utilitarianism deals with outcomes such as performing an act that is more beneficial. Then, deontology is based on the duty to help in decision making. The most relevant question to ask in this theory is whether to focus on duties as a guide in making choices. Lastly, virtue ethics focus on the character of an ethical person. Therefore, the approach that fits in the case is utilitarianism. The approach applies when the physician convinces the woman on the importance of the surgery despite losing her job. The benefit of the physician is that she can be able to do other types of work after it heals. However, failure for the surgery will not enable her to work.

Generating a working strategy that ensures that all patients receive assistance is crucial. Hence, it is essential to look for information and brainstorm all the ideas from the answers given by the patient. The characteristics include an ability to generate information fast, put the information in an orderly manner, and offer the participant equal opportunity and find significance in all ideas. The case indicates that the patient has to receive surgery to survive.

The following are three quality alternatives in the case. The first option is the failure to do the surgery upon which the patient dies. The second alternative is performing the operation and losing the work. The third alternative is to leave the patient alone to decide on what she wants. However, it is more appropriate to convince the patient to accept the surgery. The reason is that there are other work opportunities she can get after recovery.

It may be difficult to convince the patient about the advantages of performing the surgery. However, the doctor has to apply the utilitarianism theory to assist her. There are hindrances on deciding to do it such as lack of patient’s agreement and a risk that can occur when the surgery leads to more complications. The steps to ensure the process is successfully done is being positive about the outcomes and convincing the patient on the possibility of getting another job. However, when the information acquired from the patient indicates more harm after the surgery occurs, it may not be necessary to take action.

Self-evaluation is essential in making the right decision and achieving expected results. It offers a possibility to assess the advantages and disadvantages that result from decision making. Nursing, which is my future profession, is more demanding regarding self-evaluation. It is important to review the past evaluation method results and do a self-evaluation. In case there are hardships in making the decision, it is ethically right to do some consultation from my team or more experienced persons.

Conclusion

The case study illustrates the relevant aspects of a decision-making process. There are specific ethics that apply depending on the case study. The first thing when deciding on what ethics apply in a particular case and the way to approach it is gathering all relevant information and analyzing it. The issue of analysis, in this case, was the reason for declining surgery. On ascertaining the information, the idea of the physician to perform the surgery was more applicable. The fifth step is the most difficult in dealing with this case. It is the final decision that comprises making a step where the best ethical choice has to take place. The analysis can be useful in my future nursing career when gathering information and assessing a moral dilemma. 

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