Three ethical dilemmas
978-1-4419-6518-9_15pmcid: pmc3086476nihmsid: nihms283553ethical dilemmas in oncofertility: an exploration of three clinical scenariosclarisa r. Oncofertility is currently gaining significant attention from professionals in many related fields and is undergoing considerable scrutiny in part because of the many compelling ethical dilemmas it raises. To illustrate some of the dilemmas providers face, and make suggestions for clinical care, this chapter presents three clinical scenarios encountered in medical practice. An increased awareness of the complex problems involved should help prepare clinicians for some of the challenges posed by this rapidly expanding the three cases presented here are based on real-life situations, they have been modified to protect the identity of the patients involved. The cases raise the diverse, and sometimes overlapping, problems that surface in the clinical environment, highlighting different ethical dilemmas faced by physicians. The question is what can physicians do under these circumstances to satisfy the requirements of their ethical responsibility? Can they escape the pitfalls of the dilemmas and find ethically satisfactory courses of action?
Presenting each of the three cases, we discuss them and highlight the dilemmas they pose. Two of these, deontology and consequentialism, fail to resolve the dilemmas, but a third, namely virtue ethics, appears promising. The ethical dilemma for physicians facing such clinical situations lies in whether they should respect the cultural norms of parents and allow them to decide what information to disclose to their teenage children or to enforce full disclosure. They are given three options in case of death of each parent: donation to research, donation to another couple, or destruction. In this case, rather than make a decision, the husband abandoned the situations in which the partners are uncomfortable with the three options mentioned and prefer to keep the embryos in storage, even though they are not willing to pay for the cost, is it ethical to discard the embryos? In michelle’s case, had the physician known that she would become critically ill after the procedure, thus delaying potentially life-saving treatment, then it would have been ethically justifiable to deny her fertility preservation options. From the many available, we have chosen three to illustrate how they attempt to escape the dilemmas considered here.
To the deontological strategy, in order for actions to be ethically sound, they must be made on the basis of principles that are worthy in themselves, apart from any consideration of the consequences that those actions may have. And if the physician knows that the procedure the patient wishes to have is likely to cause her harm, then the physician must choose between the two principles, thus still facing an ethical second problem is that it makes no intuitive sense to argue that the ethical value of an action relies fundamentally on a matter of principle and has nothing or little to do with its consequences. This strategy argues that the ethical value of actions should be measured exclusively by their consequences. If fertility treatment in a cancer patient has better results than no treatment, then the decision to treat the patient is ethically sound. But if its consequences are worse than no treatment, then the decision to proceed with the treatment is ethically unsound. For case 1, if respecting the culture of the parents, and not informing the patient of the consequences of her treatment, results in harm to the patient, namely, permanent future infertility, then the decision is ethically unsound. How can a physician determine and choose the ethically sound decision before he or she knows what will actually happen to the patient?
For this reason, it makes no sense to base ethical responsibility on factors that lie outside the information accessible to a second problem with consequentialism is that it is quite impossible to measure all the consequences of any action. How can a physician be expected to act ethically, if the ethical value of the action is contingent on such an innumerable, and mostly unavailable, number of consequences of the actions? Short, consequentialism does not help physicians resolve the dilemmas posed by the three cases we have examined. According to this point of view, the key element in the resolution of ethical dilemmas such as the ones physicians face in the three cases presented here, is the physicians themselves. In fact, this approach puts a heavy burden on them to accept and exercise their responsibilities with utmost care, based on sound position is called virtue ethics because it bases ethical behavior on what a person with the proper training and education would do, which in this context refers to the physician. To repeat, this approach does not absolve physicians from responsibility, but rather it recognizes their authority and gives them the freedom to act according to their best judgment and without cal strategiesapart from the theoretical strategies discussed above, there are some practical steps that help physicians deal with the dilemmas they face in the practice of oncofertility. Case highlights how the ethical dilemmas faced by physicians taking care of adolescents with cancer are largely the result of communication barriers between physicians, the patients’ parents/guardians, and the patients themselves.
Removing such barriers through enhanced physician awareness and comprehensive communication is an effective way for physicians to tackle the dilemmas in this situation [5]. Clear instructions on disposition in case of abandonment can help to prevent the ethical dilemma of embryo and gamete disposition. These steps do not always absolve physicians from the dilemmas posed by case 2, but they do ameliorate the situation and help physicians fulfill their ethical responsibilities. When physicians are undecided about how to proceed, it may be helpful to seek advice from an ethics sionthe theoretical approach and practical steps suggested in the three cases we have discussed should help physicians deal with some of the ethical difficulties they face in making decisions about patients in the field of oncofertility. As demonstrated in the three cases we have presented, physicians have to make decisions to the best of their ability, even though these choices may not be acceptable to all parties involved or completely beneficial for all. In short, the ethical dilemmas do not disappear completely and it is the duty of the physician to weigh the risks, benefits, and wishes of patients and families to guide them to the best course of action. Ultimately, a better understanding of the complex ethical, social, and medical issues in oncofertility is needed.
Workers are routinely confronted with ethical dilemmas in practice, and social work programs infuse their courses with professional ethics and values to help students prepare for this eventuality. The council on social work education (2008) requires that students learn how to “apply social work ethical principles to guide practice, engage in ethical decision making, recognize and manage personal values in a way that allows professional values to guide practice, and tolerate ambiguity in resolving ethical conflicts” (epas 2. Work students become familiar with the code of ethics, learn one of the various models on ethical decision making (congress, 1999; dolgoff, loewenberg, & harrington, 2009; reamer, 1995) and, at some point in their education, are typically required to write a paper on an ethical dilemma. Correctly identifying an ethical dilemma is the first step in resolving is an ethical dilemma? Are three conditions that must be present for a situation to be considered an ethical dilemma. Situations that are uncomfortable but that don’t require a choice, are not ethical dilemmas. Therefore, because there is no choice in the matter, there is no ethical violation or breach of confidentiality when a student discusses a case with the supervisor.
The second condition for ethical dilemma is that there must be different courses of action to choose from. Third, in an ethical dilemma, no matter what course of action is taken, some ethical principle is compromised. In other words, there is no perfect determining what constitutes an ethical dilemma, it is necessary to make a distinction between ethics, values, morals, and laws and policies. There is considerably less recognition of the supremacy of agency policy in the code, and ethical standard 3. States that we must not allow agency policies to interfere with our ethical practice of social is also essential that the distinction be made between personal and professional ethics and values (congress, 1999; wilshere, 1997). Conflicts between personal and professional values should not be considered ethical dilemmas for a number of reasons. Because values involve feelings and are personal, the rational process used for resolving ethical dilemmas cannot be applied to values conflicts.
Therefore, although they can be difficult and uncomfortable, conflicts involving personal values should not be considered ethical types of “absolute” or “pure” ethical dilemma only occurs when two (or more) ethical standards apply to a situation but are in conflict with each other. Although this problem is outside of the clinician’s general competence, the limited options for treatment, coupled with the client`s discomfort in being too far from home, would likely mean the client might not receive any services if the clinician declined on the basis of a lack of competence (ethical standard 1. Denying to see the patient then would be potentially in conflict with our commitment to promote the well-being of clients (ethical standard 1. Although these are not absolute ethical dilemmas, we can think of them as “approximate” dilemmas. However, because the nasw code of ethics acknowledges our obligation to follow legal requirements and to intervene to protect the vulnerable, technically, there is no absolute ethical dilemma present. Breaking the situation down and identifying the ethics, morals, values, legal issues, and policies involved as well as distinguishing between personal and professional dimensions can help with the decision-making process in approximate dilemmas. Table 1 (at beginning of this article) is an illustration of how these factors might be writing an ethical dilemma paper or when attempting to resolve an ethical dilemma in practice, social workers should determine if it is an absolute or approximate dilemma; distinguish between personal and professional dimensions; and identify the ethical, moral, legal, and values considerations in the situation.
After conducting this preliminary analysis, an ethical decision-making model can then be appropriately f, r. Is ethical dilemma really, really so grateful for this article and am surely contented with the information provided thereby anticipating for more. It is best that you consult with your supervisor and attorney about the specific than 2 years sional ethics vs the best care of your sional life versus family lifeanother example of an ethical dilemma involves professional ethics versus the best care of your child: alan works in the claims department of a major hospital. It is also available in the pdf version of the grobman, publisher/ than 3 years is an ethical dilemma ful, thank you. 2004 jan;14(1):l dilemmas in research on internet r s1, haans d, skinner information1teennet project, department of public health sciences, university of toronto, ontario, ctthere has been a rapid growth in the number of articles using internet data sources to illuminate health behavior. However, little has been written about the ethical considerations of online research, especially studies involving data from internet discussion boards. In this article, the authors examine how a youth-focused research program negotiated ethical practices in the creation of its comprehensive health site and online message board.
They address three situations in which ethical predicaments arose: (a) enrolling research participants, (b) protecting participants from risk or harm, and (c) linking public and private data. Drawing on the ethical principles of autonomy, nonmaleficence, justice, and beneficence, the authors present practical guidelines for resolving ethical dilemmas in research on internet : 14725180 doi: 10. Commentshow to join pubmed commonshow to cite this comment:Ncbi > literature > ng business ethicsmay 2001, volume 5, issue 2,Pp 195–212 | cite asencouraging classroom discussion of ethical dilemmas in research management: three vignettesauthorsauthors and affiliationsdavid a. Ctwhile many measures address, say, marketing ethics, little attention has been paid to ethical dilemmas and decision-making in the more general field of ethics in research management. This paper presents results from the development of a multidimensional measure of ethical dilemmas in research management. The investigator developed three vignettes representing ethical dilemmas that could be realistically found in three phases of most business research (the planning, execution, and termination phases). Results from 216 management majors validate the three vignettes and support this approach in stimulating heated class l dilemmas management research vignettes previewunable to display preview.
Smith: 1995, 'effects of ethics instruction on the ethical perceptions of college business students', journal of education for business. Dutton: 1991, 'context, values and moral dilemmas: comparing the choices of business and law school students', journal of business ethics. Robin: 1988, 'some initial steps toward improving the measurement of ethical evaluations ofmarketing activities', journal of business ethics. Y of managementthe university of this article as:Kluwer academic ts and alised in to check ted access to the full e local sales tax if about institutional use cookies to improve your experience with our ng business ethicsmay 2001, volume 5, issue 2,Pp 195–212 | cite asencouraging classroom discussion of ethical dilemmas in research management: three vignettesauthorsauthors and affiliationsdavid a.