3.2. Analyse ethical dilemmas

This guide will help you answer 3.2. Analyse ethical dilemmas.

An ethical dilemma happens when someone must make a choice between two or more conflicting moral principles. In a care setting, these decisions can be particularly difficult, as they often affect vulnerable individuals. Analysing ethical dilemmas involves breaking them down to understand their elements and consequences to make an informed decision. Workers need to consider ethical frameworks, organisational policies, and the needs of everyone involved.

The purpose of analysis is to choose the most ethically sound path while minimising harm to individuals and groups. Recognising and addressing these dilemmas is a fundamental part of health and social care.

Recognising Ethical Dilemmas

Before analysing, it is important to identify what qualifies as an ethical dilemma. Key aspects of an ethical dilemma include:

• Moral conflict – When two moral principles clash in a situation, such as preserving confidentiality versus protecting someone’s safety.
• No clear solution – Any choice made will have ethical benefits but might also lead to harm or dissatisfaction.
• Emotional or professional tension – The decision is not only logical but may stir emotional, legal, or organisational consequences for the worker or others involved.

For example, deciding whether to report confidential information when there’s a suspicion of abuse creates a clear moral conflict.

Breaking Down the Context

Understanding the full context is essential. Ethical dilemmas often have layers that need to be unpacked. Consider these key questions while analysing:

• Who is affected by your decision, and in what ways?
• What legal or ethical guidelines apply to this situation?
• Does the service user have the mental capacity to make decisions for themselves?
• Are there any immediate or long-term risks?

Without these details, analysis may overlook vital aspects of the dilemma.

Legal and Ethical Frameworks

Legal and ethical standards often guide decision-making in care settings. Examples of these frameworks include:

• The Care Act 2014 – This focuses on safeguarding adults and caring for their well-being.
• The Children Act 1989 and 2004 – These laws outline how children should be protected and supported.
• The Data Protection Act 2018 and GDPR – Both set rules for confidentiality and the protection of personal data.
• Professional Codes of Conduct – Organisations like the Nursing and Midwifery Council (NMC) issue these to maintain professional responsibility.

Using these frameworks ensures that decisions align with legal and ethical expectations, even in complex situations.

Balancing Moral Principles

Ethical dilemmas often involve conflicting moral principles seen in care work, including:

• Autonomy – Respecting a person’s independence, choices, and rights to make their own decisions.
• Beneficence – Taking positive steps to improve or safeguard another person’s well-being.
• Non-maleficence – Avoiding harm, whether physical, emotional, or psychological.
• Justice – Ensuring fairness and equality in treatment and resource allocation.

Analysing dilemmas requires weighing these principles against each other. In some cases, conflicting principles must be prioritised depending on the specific context.

Steps to Analyse Ethical Dilemmas

The following structured approach can support workers in breaking down and addressing ethical dilemmas effectively:

Step 1 – Define the Dilemma

Start by identifying the core issue. What are the conflicts involved? For example, a dilemma may involve respecting a service user’s choice versus the duty to prevent harm. Be clear about which principles are in conflict and why.

Step 2 – Understand the Facts

Gather all available information about the case. Speak to the individuals involved, review any relevant medical records, and understand the legal implications. Clarify whether mental capacity or other key factors influence the decision.

Step 3 – Identify Possible Actions

List all potential courses of action. Think about both immediate and long-term options and their consequences. Include alternatives that may not immediately feel appealing but offer solutions to balance the conflict.

Step 4 – Assess the Outcomes

Consider the likely outcomes of each possible action. Ask these questions for each:

• Will this solution protect the safety and well-being of the individual involved?
• Does the decision risk breaching confidentiality or other ethical frameworks?
• Is there a way to balance the principles of autonomy, beneficence, non-maleficence, and justice?

Step 5 – Seek Guidance

Discuss the dilemma with your line manager, a senior colleague, or an ethics committee if available. Bringing in another professional’s perspective may help highlight overlooked considerations.

Step 6 – Decide and Act

Choose the solution that best aligns with ethical and legal guidelines while minimising harm. Be ready to explain and justify the decision.

Step 7 – Reflect on the Decision

After acting, take time to reflect on the decision-making process. What went well? What could have been handled better? Continuous reflection ensures learning and improvement for future cases.

Real-World Examples of Ethical Dilemmas

Understanding some examples in a health and social care context can demonstrate how ethical dilemmas arise and how they can be analysed:

Confidentiality vs. Safeguarding

A young person confides in their social worker about self-harming behaviour and asks for this to remain confidential. The worker must decide whether to uphold their confidentiality or share the information to protect their safety.

• Conflicting Principles – Respecting confidentiality versus prioritising safety and well-being.
• Analysis – The worker gathers facts, evaluates the severity of risk, and consults safeguarding policies. A decision may be made to inform the safeguarding team while explaining this to the young person.

Resource Allocation

A care worker in a residential home has two residents requesting immediate help at the same time. Both have urgent care needs, but only one can be attended to.

• Conflicting Principles – Justice in fairly providing care versus beneficence to prioritise the greater need.
• Analysis – The worker evaluates which resident faces greater immediate harm, supports that individual first, and informs another worker to assist the second resident when possible.

Refusal of Treatment

An individual with a serious condition refuses treatment, even though the treatment could prevent life-threatening complications.

• Conflicting Principles – Respecting autonomy versus beneficence by acting in the individual’s best interests.
• Analysis – The professional ensures the individual fully understands the consequences of refusal, considers their capacity to make decisions, and respects their choice if they have capacity.

The Impact of Ethical Analysis

By thoroughly analysing dilemmas, workers build confidence in their decisions. This not only protects service users but also supports professional accountability. Using a systematic approach ensures that workers can explain their choices clearly and responsibly when questioned by colleagues or external bodies.

Ethical dilemmas are challenging, but a structured framework for analysis can make them manageable. By balancing principles, reflecting on outcomes, and consulting with others, workers maintain high standards of care for those they support.