3.1. Define the term ‘ethical dilemma’

This guide will help you answer 3.1. Define the term ‘ethical dilemma’.

An ethical dilemma is a situation where a person faces a conflict between two or more moral principles, values, or rules. In such cases, there is no straightforward correct answer, and any decision made may result in violating one ethical principle to uphold another. It challenges an individual to weigh the options and find the best possible outcome, even when that outcome feels morally uncomfortable or imperfect.

The concept of an ethical dilemma is widely discussed in health and social care because workers often face these challenging situations. Deciding how to proceed requires careful thought to balance the well-being of individuals with professional standards and legal responsibilities.

Key Characteristics of Ethical Dilemmas

There are some defining features that make a situation an ethical dilemma. These include:

• Conflicting values or principles – The person must choose between two or more equally significant values that clash.
• No clear solution – There is no single answer that satisfies all involved moral rules or outcomes.
• Potential harm or risk – Any choice carries the possibility of negative consequences for individuals, organisations, or society.
• Emotional stress – Ethical dilemmas create emotional strain, as they often involve high-stakes decisions impacting others.

Examples in Health and Social Care

Ethical dilemmas frequently appear in health and social care roles because professionals work closely with people whose needs, rights, and preferences vary. Below are some common examples:

Autonomy vs. Beneficence

A service user might refuse medical treatment, but a practitioner believes the intervention is necessary to save their life. Autonomy refers to respecting the individual’s right to make decisions about their health. Beneficence involves a duty to act in the person’s best interests. These values may come into conflict.

Confidentiality vs. Safety

A care worker may learn confidential information about a service user’s private life but suspect that sharing this information is necessary to protect them or others from harm. For example, disclosures of potential child abuse must be reported to safeguard the child, even if that breaches privacy.

Resource Allocation

Limited resources in health care settings can present dilemmas when deciding which patients get access to treatments or services. For instance, a care team might face the difficult decision of prioritising one patient’s treatment over another when funding, staff, or supplies are scarce.

Moral Principles Involved

Understanding the ethical principles that inform professional practice is crucial when facing dilemmas in health and social care. These principles guide decision-making and include:

• Autonomy – Respecting the decisions and rights of individuals to make their own choices.
• Beneficence – Acting in ways that promote the well-being of others.
• Non-maleficence – Avoiding harm to others.
• Justice – Treating people fairly and ensuring equal access to care.

Each principle is essential, but sometimes they conflict. Recognising how these principles interact helps workers make informed decisions in challenging situations.

Legal and Organisational Context

Ethical dilemmas in health and social care do not occur in isolation. Professionals must consider the laws, policies, and frameworks that affect their work. Laws like the Health and Safety at Work Act 1974 or the Equality Act 2010 provide legal guidance, while professional codes of practice outline ethical duties. For example, the Nursing and Midwifery Council (NMC) Code emphasises respecting people’s choices but acknowledges situations where decisions might have to consider safety concerns.

When faced with a dilemma, discussing the issue with colleagues or supervisors within an organisational framework can often help identify solutions that minimise harm and maximise fairness.

Steps to Approach Ethical Dilemmas

Resolving an ethical dilemma involves a logical and systematic approach. While no method guarantees a perfect answer, the following steps are widely used:

1. Recognise the dilemma – Clearly define the ethical question and the conflicting values present.
2. Gather information – Obtain all the facts about the situation, including the needs, preferences, and safety concerns of everyone involved.
3. Consult relevant rules – Refer to legal guidelines, professional codes, and organisational policies.
4. Evaluate the options – Identify potential courses of action and consider the likely outcomes of each.
5. Decide and act – Choose the option that minimises negative consequences and aligns with professional ethics as closely as possible.
6. Reflect – After acting, review the decision to assess its impact and learn from the experience.

By following these steps, professionals in health and social care can approach dilemmas thoughtfully and defensibly.

Why Ethical Dilemmas Matter

Ethical dilemmas are not just abstract ideas; they directly affect the care and support that individuals receive. Whether choosing how to allocate time between multiple service users or honouring someone’s right to privacy, these dilemmas shape the quality and fairness of care.

Recognising an ethical dilemma and addressing it openly promotes trust between workers and service users. Conversations about these challenges also contribute to improving policies and procedures, benefiting both individuals and organisations.

Ethical dilemmas will always arise in health and social care settings. By understanding what they are and responding to them ethically, workers can maintain high standards while meeting their professional responsibilities.