EthicsGame Reflective Journal
TheCase of the Troubled Teen
Theethical dilemma in this case is as a result of a minor mother, RachelBanks, 16 years old, who was admitted with early stage labor. Theunwed mother was brought to the hospital by her parents, who made adecision to limit her medication and medical assistance offered tothe teen mother due to personal reasons. However, there is no doubtthat situation is getting worse and could result in irreversiblemedical complications. Joseph Banks, the brother of the sixteen yearsold mother is upset by her parents and the hospital for punishing hissister. According to Joseph, the parents are punishing Rachel forgetting pregnant before marriage. The hospital has provided aguideline to the workers on how they are expected to resolve ethicaldilemmas. As the supervising nurse, I have a responsibility ofsupervising a team of nurses and therefore I have a major duty in thecase. Although fetal distress is not critical, Rachel is yet to beseen by a physician. The case may be complicated by the fact that theunit is short staffed and the physician on duty has another emergencycase. The financial shortfalls have resulted into limitations onon-call physicians. Therefore, there are several competing values andobligations in the case (Ethicsgame).
Thefirst step in the decision-making process is being attentive. Thisinvolves carefully attending to and understanding the context of thecase. After analyzing the context of the ethical dilemma, the nextstep is being intelligent. The first part of being intelligent isidentification and exploration of the values in the tension. Thisinvolves looking at the evidence and evaluating the facts in thecase. This include analyzing the extent of Rachel case, understandingthe emotional states of the parents, the accuracy of Joseph’saccount, organizational guidelines, and administrative directions. At this stage, it is also important to consider all the stakeholdersin the case. Identification of the primary stakeholders and how thefinal decision will affect them is the most important step inresolving the ethical dilemma. The third step is being reasonable. Being reasonable involves identification of my duties to thestakeholders, acting with courage to select the most appropriateaction, determining the impact of the action on the stakeholders, andidentifying and fulfilling the ethical desires. The fourth step isbeing responsible with result lens. This involves acting with courageto determine the impacts of the decision on the stakeholders andmaking the final decision on the case. The final step, beingreflective involves communication the final decision and evaluationof the decision (Hein, 2015, Ethicsgame).
Thefirst lens considered in making the decision is rights andresponsibilities lens. This involves the use of reason to determinethe right decision. The decision is determined by the duties andobligations in the particular case. This ethical principle answersthe question what is my duty is the situation. The second ethicalprinciple considered in the decision-making process is the resultslens. It focuses on the ethical desires or the outcomes of thedecisions (Ethicsgame).
Bothresult lens and responsibility and rights lens influenced the finaldecision in the case. The effects of the decision on the ethicaldesires of all the primary stakeholders were considered. However, dueto variation in ethical maturity, being reasonable was necessary. Theresponsibilities of the nurse and the parents also influenced thefinal decision, which constitutes the responsibility and right lens(Ethicsgame).
Ethicaldilemmas usually occur in all workplaces. The most important ethicaldilemmas relate to conflicts between the ethical desires of one partyand the responsibility or duties of an individual. The ethicaldesires may also conflict with administrative directions ororganizational policies resulting into an ethical dilemma (Davis,2010).
TheCase of Policies and Politics
Inthis case, Alain Trottier has been admitted to the ICU whileunconscious but there is no definitive diagnosis for his condition.His domestic partner, Yves has been denied entry into the ICU byCarlotta during the previous shift. According to the policy of thehospital, domestic partners are to be treated as married couples,especially when medical consent is required. The MD of the facility,Breanne Nichols identifies Yves as the partner to the patient.However, according to Carlotta, the day shift supervisor, Yves hasnot provided any document to prove his identity as the patient’spartner. The ethical dilemma is whether Yves should be allowed tovisit the patient or have the same right as straight couples inmedical decisions (Ethicsgame).
Thefirst step in the decision-making process is being attentive. Thisinvolves attending to the context of the case in order to understandthe issues involved. The second step is being intelligent. Itinvolves exploring the values in tension which can be done throughevaluation of the facts in the case and the emotional states of thestakeholders. This will facilitate the identification of competingvalues. After exploring the values in tension, the next step isidentifying the stakeholders, both primary and secondarystakeholders. The third step is being reasonable with therelationship lens and reputation lens. Relationship lens involvesidentification of the rights and liberties that are related to thecase. This is followed by determining the stakeholder who is more orleast advantaged. For example, the least advantaged stakeholders inthe case are the patient and his partner. Reputation lens involvesidentification of professional virtues and aligning personal valueswith the professional values. The fourth step is being responsiblewith the relationship lens and reputation lens. This answers thequestion of which option supports the rights and liberties of primarystakeholders. It also answers the question of which decision meetsthe requirements of core professional and personal values. Beingresponsible with the lens will play an important role in the finalchoice. The fifth step is being reflective. It involves communicatingthe final decision to the stakeholders and evaluation of the decision(Benjamin & Curtis, 2010, Ethicsgame).
Thereare two lenses that were used in the decision-making process. Thefirst lens is relationship lens. This is concerned with the rights ofpartners and family members in relation to the health of anunconscious member of the family. The second lens is the reputationlens. It is concerned with the professional virtues and personalvalues that have an influence on the decision (Ethicsgame).
Boththe relationship lens and the reputation lens influence the finaldecision. The rights of family members, especially domestic partnersto make a decision on behalf an unconscious family member influencedthe decision. The reputation lens which focuses on the professionalvirtues and personal values also influenced the decision(Ethicsgame).
Thereare several concepts in workplaces that relate to this case. Theymainly involve ethical dilemma where rights and freedoms of otherindividuals conflict with personal values and professional virtues.For example, a client can make a decision that is against personalvalues or professional ethics. Balancing between professional orpersonal ethics and individual rights result in an ethical dilemma(Davis, 2010).
Benjamin,M. & Curtis, J. (2010). Ethicsin nursing: cases, principles, and reasoning. Oxford,New York: Oxford University Press.
Davis,A. (2010). Ethicaldilemmas & nursing practice.Boston: Pearson.
Ethicsgame.TheCase of the Troubled Teen.
Ethicsgame.TheCase of Policies and Politics.
Hein,I. (2015). Why is it hard to make progress in assessing children’sdecision-making competence? BMCMed Ethics.10(16):1.