Running Head: Conceptual Frameworks 1

Running head: CONCEPTUAL FRAMEWORKS 1
Conceptual Frameworks of Ethical Dilemmas
Michelle Orange
Walden University
6053N, Interprofessional Organizational and System Leadership
August 1, 2018
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CONCEPTUAL FRAMEWORKS 2
Conceptual Frameworks of Ethical Dilemmas
Nursing professionals face many different types of dilemmas and scenarios on a daily basis. One
of the most significant dilemmas nurses face on a daily basis is in regards to ethical dilemmas
and understanding the framework of ethical constructs. Many of us as the question what is ethics
and how does it affect me? Ethics is a standard for right or wrong and what individuals should
do in the positions of rights, obligations, benefits to society, impartiality, and particular qualities.
Marquis and Huston (2017) condense it down to being the moral behavior and values that a
person's actions are guided by according to right and wrong, oneself, and society as a whole.
However, ethics is not just following one's feelings as feelings can frequently veer from what is
truly right or wrong. Nursing management is not a profession that has a well-defined purpose or
regulations. Therefore to make ethical decisions that are appropriate, leaders must have solid
knowledge in regards to ethical principals and frameworks and use an approach that all trial and
error is eliminated [Mar17]. Accomplishing this, leaders must focus on models that are
established decision-making models and utilized the organizational processes to assist in this
decision-making course [Mar17]. The purpose of this paper is to introduce the ethical constructs
of ethics, moral, or legal standards into a conceptual framework, apply it to a dilemma
encountered at work and its implications, analyzing this situations moral, ethical, and legal
implications, and consider the leadership style identified in my self assessment and determine if
it facilitates or creates a barrier to the dilemma.
Conceptual Framework
Nurses face different dilemmas multiple times a day, and some may be the same type of
dilemma just presented in a different situation that calls to be handled differently. Facing these
dilemmas forces nurses to make difficult decisions on a daily basis. These decisions often are
challenging, and results are shown in those that they interrelate with and care for on a daily basis.
Many ethical considerations have serious consequences, but one of the fast growing issues is
patient privacy. Patient privacy is a fast-growing dilemma that frequently presents in the
emergency department setting. The Emergency Nurses Association developed a code of ethics to
include exercising sound judgment in protecting the lives and privacy of our patients and their
families [McE12]. With social media being prevalent in today's world everyone is eager to whip
out the camera and snap a picture and post on a social media forum. Thus, maintaining patient
privacy, especially when they can not speak for themselves, one of the most critical issues.
Ethical dilemmas arise daily, that need to be addressed efficiently and appropriately
without personal values or beliefs interfering in the decision-making process. The ethical
frameworks do not solve the dilemma but serve as a means for the leader to develop a solution to
clearly define any personal values and beliefs [Mar17]. The most common frameworks
identified and utilized are utilitarianism, duty-based reasoning, rights-based reasoning, and
intuitionism.
The utilitarian framework diminishes the needs and wants of the patient but focuses on
the greatest good for the greatest number of people[Mar17]. This framework is one of the most
common approaches utilized in the decision-making process. The utilitarian framework works
well with larger groups of people due to it teaches us to weigh the outcome of our actions
regarding good and bad. In other words, it forces us to look at too and to evaluate the good and
bad outcomes and chooses according to which will produce the greatest good for the greatest
number.
The deontological framework is judges the action of the individual as right or wrong
regardless of the nature of the consequences [Mar17]. The deontological framework is further
broken down into rights-based, duty-based frameworks, an intuitionist. Duty-based reasoning
defines that a decision has to be made to either act or not to act in a dilemma [Mar17]. Whereas,
rights-based reasoning that everyone has fundamental rights that he or she are entitled to without
interference from the outside [Mar17]. The intuitionist framework allows the manager to look at
each issue as separate entities. The intuitionist framework compares the comparative weights of
the goals, duties, and rights individually for every ethical dilemma [Mar17]. The downside of
this framework is that the primary way utilized to obtain the relative weights is intuition and his
or her feelings of what is believed to be precise for that specific dilemma or situation at that
specific time.
Dilemma in the Emergency Department
As the world progresses to mostly an electronic society with emphasis on social media, it
becomes more and more difficult to ensure patient confidentiality. A picture can be taken and
posted in less than thirty seconds and without you being aware it was even done. In the age of
growing technology, social media is at everyone's fingertips. Social media can enable a post to
spread rapidly and beyond an intended audience with one push of a button. With patients that
cannot verbally consent or sign photo consents, it becomes increasingly important to protect their
privacy even in regards to family and close friends.
This particular situation I advocated for a patient was a trauma patient that was severely
injured in a motor vehicle collision in which they were nearly scalped. As family and friends
began to arrive one of the first things they did was pull out their phones and began snapping
pictures of the patient. I quickly intervened and instructed them to delete the photographs and
put their phones away. I ensured that all photographs were deleted and gave them a copy of our
hospital policy in regards to photos and videos. They were angry at first, and I explained to them
that all patients and families have the right to privacy and since the patient could not give
consent to the photos they were indeed violating their right to privacy. At this time, I instructed
them if they wished to stay with the patient their phones would remain put up while in the room
and if they received a call or text they were to leave the room to respond and answer. If they did
not comply, they would not be allowed in the room with the patient.
After this incident, our emergency department posted its official photograph and video
policy in the waiting room for visitors and patients to be informed of upon arrival. Posting our
policy was an effort to curb any future situations and inform our constituents before the initiation
of care and that we take their rights to privacy seriously. When patients are unable to consent for
themselves, it is our duty as health care professionals to advocate for them. Establishing limits
protects the patient and the healthcare providers from any harm or future repercussions
secondary to a breach in patient confidentiality. As healthcare providers, we must remain alert
for any family or patients that are recording their care [Lyo13].
Leadership Style
According to the Keirsey Temperament Sorter, my personality assessment is that of the
guardian. The Keirsey Temperament Sorter states that guardians are given a temperament for
serving and maintaining things running smoothly. Guardians are fun to be with but take their job
duties seriously and are dependable and trustworthy. They are meticulous about schedules and
have an eye for proper procedure. Guardians are cautious about change but realize that change is
needed for the growth of the institution. Guardians are practical and down to earth, believe in
following the rules, cooperating with others, and believe in law and order. The guardian makes
up 40 – 45 percent of the population and does all the crucial and thankless jobs everyone else
takes for granted [Keind].
This temperament assessment is almost an exact description of me. I feel that being a
guardian made me more verbal and adamant in ensuring that all the pictures were deleted in
protecting the patient's privacy. I did not back down from the policy set forth by my organization
nor the rights entitled to my patient and protected their right to privacy. The result was a win-
win situation for all involved.
Conclusion
The challenges in the healthcare realm are challenging and penetrating for providers and
leaders. As nurses and leaders, we have the never-ending obligation to protect our patients and
ourselves against any possible harm. There is not one easy solution to the everyday dilemmas in
the healthcare realm. Therefore, responding to the moral and ethical challenges presented daily,
it is essential for nurses and leaders to know moral conceptions and principles and have
developed specific moral thinking skills. Developing these features assist leaders in successfully
developing a plan of action for any ethical dilemmas that may rise.
References
Keirsey. (n.d.). What is your temperament? Retrieved August 3, 2018, from
https://profile.keirsey.com/#/temperament
Lyons, R., & Reinisch, C. (2013, January - March). The legal and ethical implications of social
media in the emergency department. Advanced Emergency Nursing Journal, 35(1), 53-
56.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing:
theory and application (9th ed.). Philadelphia, PA: Wolters Kluwer.
McElroy, S. (2012, February 2). Ethical considerations in emergency nursing. Retrieved August
1, 2018, from Advance Healthcare Network: http://nursing.advanceweb.com/Ethical-
Considerations-in-Emergency-Nursing/
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Running head: CONCEPTUAL FRAMEWORKS 1

Conceptual Frameworks of Ethical Dilemmas

6053N, Interprofessional Organizational and System Leadership

Conceptual Frameworks of Ethical Dilemmas

of ethics, moral, or legal standards into a conceptual framework, apply it to a dilemma

it facilitates or creates a barrier to the dilemma.

broken down into rights-based, duty-based frameworks, an intuitionist. Duty-based reasoning

Dilemma in the Emergency Department

privacy even in regards to family and close friends.

secondary to a breach in patient confidentiality. As healthcare providers, we must remain alert

According to the Keirsey Temperament Sorter, my personality assessment is that of the

takes for granted [Keind].

win situation for all involved.

Keirsey. (n.d.). What is your temperament? Retrieved August 3, 2018, from

theory and application (9th ed.). Philadelphia, PA: Wolters Kluwer.

1, 2018, from Advance Healthcare Network: http://nursing.advanceweb.com/Ethical-

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