Ethical Decision-Making in Complicated Times

The world has gotten pretty complicated. No matter your work or home life, you are likely at least occasionally to encounter an ethical dilemma. Ethics are the moral standards by which we live our lives and are informed by factors such as our family, culture, education, and spiritual beliefs. An ethical dilemma is created when you are confronted with a choice between two or more actions, and any course you take is likely to be in conflict with a personal belief.

How Can I Identify an Ethical Dilemma?

True ethical dilemmas involve choices than can be viewed as “right versus right” depending on your beliefs and values. These dilemmas tend to fall into one of four categories (known as ethical dilemma paradigms):

1. Truth vs. Loyalty: personal honesty and integrity vs. promise-keeping and obligations to others

2. Individual vs. Community: interests of the one or few weighed against those of the more or many

3. Short-Term vs. Long-Term: the immediate needs of the present weighed against those for the future

4. Justice vs. Mercy: fair and equal application of the rules vs. compassion for the individual (going ‘by the book’ vs. making exceptions on a case-by-case basis based on circumstances)

Ethical dilemmas can have very high stakes or comparatively low ones, but in either case they often cause some discomfort as you are deciding what to do. For instance, in a high-stakes situation perhaps you know a friend has committed a crime but did so to protect a more vulnerable person. Do you turn them in, or turn a blind eye because you know they were trying to protect someone else?

In a lower-stakes case, perhaps you are responsible for collecting the money for a gift for a friend or co-worker. Each person is asked to give $20 to the fund. Michelle tells you she gave Jessica her $20 to share with you, but you know Jessica gave you only $20, not $40. You’re aware Jessica has been having financial troubles, and now you’re worried she might have taken Michelle’s $20 for herself. Do you confront her or pretend it didn’t happen because she’s going through a hard time?

Perhaps you can see in these cases that depending on the values you apply, there could be multiple ‘right’ ways to resolve these ethical dilemmas. It can be right to tell the truth, follow the law, and turn someone in who has broken a law or a rule; it also can be right to show mercy to someone who committed a crime to protect a vulnerable person or who broke a community rule to meet an individual need.

How Can I Resolve an Ethical Dilemma?

There are several common principles for resolving ethical dilemmas. The principle you choose to use might depend on the situation and also on your beliefs about what ethical principle is most essential. For example, do you believe that following the rules no matter what is of the highest importance, or do you believe that the consequences of following the rules more often must be carefully weighed?

1. Ends or Consequences 

·        Gives highest consideration to the consequences of your actions.

·        What is the greatest good for the greatest number, the greatest balance of benefits over harms? 

2. Rules or Means

·        Gives highest consideration to rules and duty, assuming that good rules (means) universally lead to good outcomes.

·        How would you want everyone else to act if they were faced with this same situation? 

3. Care or Compassion

·        Empathize with others and consider their needs as in the “Golden Rule.”

·        How would you wish to be treated if you were the person or persons most affected by this decision?

A Framework for Working through an Ethical Dilemma

1. Identify the problem. Is it ethical, legal, clinical, professional, or a combination of these? Seek additional support and advice if you have legal questions.

2. Determine the nature of the dilemma. Which of the ethical dilemma paradigms are involved? What are the implications for resolving your dilemma based on each end of the paradigm?

3. If this is a work situation, consult your professional code of ethics. Also consider consulting a trusted colleague or supervisor.

4. Determine potential courses of action

5. Consider potential consequences for each course of action for all parties involved

6. Evaluate your selected course of action. What ethical principle are you utilizing to determine your course? In addition:

·        Consider justice/fairness - would I treat others in this same situation in the same way?

·        Consider publicity - would I feel good about how I handled this situation if my actions were reported in the press?

·        Consider universality - would I recommend this course of action to another person handling the same situation?

7. Implement your course of action

Why is this Important for Mental Health?

Any ethical dilemma can be uncomfortable to confront, and sometimes moral distress can result. This specific kind of distress is a consequence of the internal conflict that occurs when we know the ethically appropriate action to take in a situation but are unable to act on it. Though well-documented among healthcare workers, moral distress can result for anyone who faces an ethical problem they are unable to resolve because of either internal or external pressures.

The first step in confronting moral distress and coping with it more effectively is developing the ability to identify ethical dilemmas. Because distress can result from ethical dilemmas that remain unresolved, it’s important to recognize when you’re suffering because of an ethical problem and to take the steps needed to resolve it to the best of your ability. Moreover, confronting such dilemmas not only is important for self-care but for effective advocacy for those more vulnerable than ourselves. An ethical problem may be a sign that a system is faulty or broken, and without recognizing the dilemma we can’t work towards meaningful resolution.

By confronting even those dilemmas that are tough and uncomfortable, we might reconnect with parts of ourselves we’ve been silencing. This awareness in turn can make us more effective and energized advocates for others as well as for ourselves.

Want to talk with someone about an ethical dilemma or moral distress? You don’t have to do this alone.

References

American Counseling Association (ACA). (2014). So you have an ethical dilemma?. Retrieved from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.counseling.org/docs/default-source/ethics/ethical-dilemma-posterv5.pdf?sfvrsn=2

Institute for Global Ethics. (2017). Moral courage seminar. Retrieved from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.citadel.edu/root/images/krause_center/leadership_day/ldrs%20311%20mctmscb.pdf

Kidder, R. M. (2009). How good people make tough choices: Resolving the dilemmas of ethical living. New York: Harper.

Municipal Association of South Carolina. (n.d.). Ethical dilemmas and decision-making. Retrieved from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.masc.sc/SiteCollectionDocuments/Land%20Use%20Planning/EthicalDilemmas_DecisionMaking.pdf