ETHICAL DECISION MAKING PROCESS PROFESSIONAL

Some situations result in moral uncertainty, when one cannot accurately define what the moral situation is, or what moral principles apply, but has a strong feeling that something is not right.

Other situations represent moral problems, in which there may be competing moral claims or principles but one claim or principle is clearly dominant. Some are moral dilemmas, situations in which a clear conflict exists between two or more moral principles or competing moral claims, and the nurse must choose the lesser of two evils. Many situations exist in which ethical analysis is needed. Problems arise with this theory when personal and cultural biases influence the choice of the most primary moral principle. The nurse has a duty to act based on the one relevant principle, or the most relevant of several moral principles. In a given situation, one or more moral principles may apply. Another theory in ethics is the deontologic or formalist theory, which argues that moral standards or principles exist independently of the ends or consequences. Additionally, the question must be asked whether good consequences can justify any amoral actions that might be used to achieve them. The theory poses difficulty when one must judge intrinsic values and determine whose good is the greatest. The most well-known form of this theory, utilitarianism, is based on the concept of “the greatest good for the greatest number.” The choice of action is clear under this theory, because the action that maximizes good over bad is the correct one. One classic theory in ethics is teleologic theory or consequentialism, which focuses on the ends or consequences of actions. Because the distinction between the two is slight, they are often used interchangeably. In essence, ethics is the formal, systematic study of moral beliefs, whereas morality is the adherence to informal personal values. The terms ethics and morality are used to describe beliefs about right and wrong and to suggest appropriate guidelines for action.

ETHICAL DECISION MAKING PROCESS PROFESSIONAL

Understanding the role of the professional nurse in ethical decision making will assist nurses in articulating their ethical positions and in developing the skills needed to make ethical decisions. An awareness of underlying philosophical concepts will help the nurse to reason through these dilemmas. The ethical dilemmas a nurse may encounter in the medical surgical arena are numerous and diverse. Ethical issues also surround those practices or policies that seem to allocate health care resources unjustly on the basis of age, race, gender, disability, or social mores. Although many individuals are afforded a better quality of life, others face extended suffering as a result of efforts to prolong life, usually at great expense. Questions have been raised about whether, and under what circumstances, it is appropriate to use such technology. These advances in technology, however, have been a mixed blessing. Technological advances have also contributed to an increase in the average life expectancy. Children and adults who would have died as a result of organ failure are living longer because of organ transplantation. In the early stages of life, premature infants are given a chance for survival by the use of technical support. For example, the prenatal period has been influenced by genetic screening, in vitro fertilization, the harvesting and freezing of embryos, and prenatal surgery. The development of technological support has had an influence on all stages of life. Expensive experimental procedures and medications are available for attempting to preserve life, even when such attempts are likely to fail. Today, sophisticated technology can prolong life well beyond the time when death would have occurred in the past.

Specifically, in health care the focus on ethics has intensified in response to controversial developments, including advances in technology and genetics, as well as diminished health care and financial resources. Consequently, there has been a heightened interest in the field of ethics, in an attempt to gain a better understanding of how these issues influence us. In the complex modern world, we are surrounded by ethical issues in all facets of our lives.

Ethical decision making process