Ethical Dilemmas in Healthcare Service
Singer et al (2001) suggest that recently the research base of clinical ethics has strengthened appreciably. This can be attributed to a variety of ethical challenges with which modern health care providers face on a permanent basis. An effective approach to these challenges improves patient outcomes and increases the prestige of the national health (Parker, 2007). In order to demonstrate the significance of ethics in nursing practice, the present paper approaches two situations that involve addressing ethical dilemmas. These situations are considered in terms of ethical leadership, a kind of leadership that involves “moral courage” (Edmondson, 2010).
When comparing between ethical and unethical approach to particular situations, the paper concludes that ethical leadership is an integral element of modern health care practice.
Situation 1: Health Care Provider to Patient Staffing Ratio
While working as a physician in a hematology department in Sheikh Khalifa Medical City in Abu Dhabi, I often face with a situation when there is an insufficient number of health care experts to ensure quality and timely treatment of all patients. The introduction of obligatory health care provider to patient staffing ratio could resolve the problem, but it is related to addressing a difficult ethical dilemma. As a health care provider, I do not see a solution in which interests of all stakeholders involved in the treatment process are met. Mandatory health care provider to patient staffing ratio involves that health care institutions have adequate number of experts to provide treatment to all patients (American Nurses Association, 2015). The mandatory staffing ration has been ambiguously assessed by experts. A fairly large group of experts believe that mandatory staffing ratios are necessary since there is a direct relationship between the amount of time spent on a patient and his or her outcomes (Thompson et al., 1979; Thompson & Diers, 1991). I agree with this view, since the more time I can spend studying the history of the disease and communicating with patient, the more accurate is the diagnoses and the better are patient outcomes. At the same time, many experts suggest that mandatory health care provider to patient staffing ratio is ineffective, as under insufficient funding providers are forced to assume non-relevant responsibilities (Mitchell, 2007) and tend to leave the profession (Welton, 2007). When facing with this problem, a health care leader is expected to establish a balance between the interests of the involved stakeholders.
Evidently, prioritizing interests of one of the parties is unethical, and it is seen when approaching the dilemma in terms of utilitarianism. The ethical theory suggests that seeking the greatest good for the greatest number of people is ethical. However, in the context of a single hospital, it is difficult to define “the greatest number of people”, especially if taking into account the trend towards increasing the number of health care providers. In turn, approaching the same situation in terms of deontology suggests completely opposite results. According to the deontological theory, adhering to duty is moral, regardless of the potential outcome. Since …