Study Session 8 Ethical Dilemmas in Health Service Delivery

In Study Session 7 of this Module you learnt about some of the basic concepts and principles of healthcare ethics that you will meet in your work with individuals, groups and communities. In this study session you are going to learn more about some of the ethical dilemmas that you may well face in your day-to-day activities while providing healthcare services as a Health Extension Practitioner.

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This study session will also help you to identify some of the common ethical conflicts that may arise in your day-to-day practice and hopefully learn how to resolve them. You will be able to learn additional useful ethical theories and a specific method of decision making that should help you resolve ethical problems that arise in your work.

Learning Outcomes for Study Session 8

When you have studied this session, you should be able to:

8.1  Define and use correctly all of the key words printed in bold. (SAQ 8.1)

8.2  Identify the ethical dilemmas that exist in a case study presented to you. (SAQs 8.2, 8.3 and 8.4)

8.3  Describe two theories that can help you resolve ethical dilemmas that may arise in your health work. (SAQ 8.3)

8.4  Understand a decision making process that may be able to help you to resolve ethical conflicts. (SAQ 8.4)

8.1  Ethical dilemmas and conflicts

In the previous study session you learnt about some of the core ethical concepts. You will remember that these are autonomy, beneficence, nonmaleficence and justice. In this section you will study more about ethical dilemmas, sometimes called ethical conflicts.

Ethical dilemmas arise when a difficult problem cannot be solved in a way that will satisfy everyone who is involved. The same dilemma might occur when a situation arises that involves a choice between equally unsatisfactory alternatives.

In ethical conflicts, the decision maker is confronted with more than one course of action that respects personal, professional and societal morality, but by deciding on one course of action the other course is harmed in some way. For example, as a Health Extension Practitioner you may face confidentiality conflicts. You are morally and legally obliged to keep patient information confidential; at the same time, you may be required to disclose sensitive information because breaking the rules of confidentiality would benefit the family or the wider community. You will be able to understand the subject better when you go through each of the following common ethical issues listed in Box 8.1. For each of these issues you will be presented with a case study to think about.

8.2  Practitioner–client relationship

In the previous study session you learnt about the core ethical concepts of autonomy, beneficence, nonmaleficence and justice. These basic principles should always form the basis for your working relationships. In addition to the above principles there are issues like confidentiality, privacy and trust that you also have to think about at all times.

The following case study will help you to explore some ethical conflicts and ways it might be possible to resolve these conflicts.