A Case Presentation on Ethical Dilemmas

BY 1. Ritesh Ranjan 2. Amit Kumar 3. Rajnish 4. Nadeem Tahir 5. Davesh Somaya 6. Parikshit Bhujbal 7. Tukaram 8. Hitesh Patharawe 9. Ajit Nalawade 10.Neeraj Vasani

Definition..
A situation in which an individual feels compelled to make a choice between two or more actions that he or she can reasonably and morally justify, or when evidence or an arguments are inconclusive, is called an ethical dilemma (Beauchamp&Childress,2001;McConnell,2002). One action must be chosen because performing both actions would be impossible. Ethical dilemmas, also known as a moral dilemmas, are situations in which there are two choices to be made, neither of which resolves the situation in an ethically acceptable fashion. In such cases, societal and personal ethical guidelines can provide no satisfactory outcome for the chooser

Salient Features of ethical dilemmas

Uncertain outcomes Multiple choice and alternatives Mixed consequences Direct/Indirect involvement

Approaches of resolving ED
Utilitarian Greatest benefits for largest number of people Universalism Rule based Good intentions always result in good outcomes ultimately Care based approach with those who are in official relationship Virtue Ethics While performing any action he/she should develop virtues

Methods to resolve ED...

1. Define the problem and recognize the moral issues. 2. Determine who will be affected by the decisions and your role 3. Collect information on how the problem occurred 4. Isolate illegal issues and separate right v/s wrong 5. Make the tough choice a) Truth v/s Loyalty b) Individual v/s community c) Short term v/s long term d) Justice v/s mercy

Methods to resolve ED Continued

6 Approach: a) Care basedb) Rule basedc) End basedd) Virtue based7 Find out if there are any other ways out 8 Decide and act 9 Review of the decision

Types of dilemmas
Dilemmas of Beneficence-dilemma that involve deciding what is good as opposed to what its harmful. Dilemmas of autonomy- those that involve deciding what course of action maximize the patient's right of self determination.

Dilemmas of justice- dilemmas that involve dividing limited health care resources fairly

Continued
Dilemmas of fidelity- those that are involve honoring promises Dilemmas of nonmaleficence- dilemmas that involve the avoidance of harm Dilemmas of confidentiality- those that involve respecting privileged information Dilemmas of veracity- dilemmas that involve telling or concealing the truth

The Case Raghunath v/s Satyadas..

Story
Raghunath, running a small shop in a small town, is contented with earning his frugal living. He is religious in outlook and compassionate towards others. One afternoon, when it is raining, an old man, poor vendor of herbs named Satyadas comes to his shop. He is running high temperature. Raghunath provides him food and shelter. In the morning, the visitor is again provided hospitality.

Continued..
He then leaves for another destination leaving behind (may be inadvertently) a pouch containing six gold coins and a ring studded with gems. Raghunath waits for him for several months to return and then on the persuasion of his wife Jamuna, he sells the contents of the pouch one by one, sets up a bigger shop and builds a comfortable house for himself to live in. He starts life with dignity in the society. One fine day, suddenly, Satyadas makes his appearance.

Continued.
Raghunath is shocked. He is not as hospitable as before. On the contrary, he thinks as if a devil has turned up and wishes that he would leave at the earliest. As Satyadas is about to leave, conscientious Raghunath asks; "did you leave behind something here when you visited last time?" Satyadas says: "I don't know. But God knows everything. The story ends here leaving Raghunath with a deep sense of guilt and remorse. Where did he go wrong?

The Interpretation of the Story

1. The sense of guilt on the part of Raghunath 2. Satyadas, Raghunath, and Yamuna are all three purely imaginary characters created by the author to portray the three Conflicting aspects of a single mind: morality, guilt, and greed.

Underlying Theme..
We have to believe in many things. All issues in life have two sides. Every idea has its opposite. We are supposed to choose. Clear choice is not always possible. It is not this 'or that. It is this 'and' that. Life is based on compromises. Our knowledge may assure us what is right and what is wrong, but we can do only what we understand to be good based on a good compromise. We call it wisdom. All this is based on beliefs only.

The Ethical Dilemma for Raghunath

The story sees the transformation of Raghunath from an honest humble man to a greedy dishonest man The main dilemma he faced was: The dilemma of being of being responsible to Satyadas member of the larger society The dilemma of being honest of respecting the property of Satyadas and guarding it until it was returned The dilemma of accepting his mistake when Satyadas returns