Debate On Ethical Dilemma: Opposing Positions And Resolution

Debate on Ethical Dilemma: Opposing Positions and Resolution Strategies

The opposing positions debated are made clear. Argue the issue from a Pro position crediting a supporting scholarly source. Argue the issue from a Con position crediting a supporting scholarly source. Present arguments in a clear and articulate manner. Use appropriate ethical principle(s) to support each position. Consider which, if any, ethical principles are in conflict with the opposing positions. Use three (3) provisions of the ANA Code of Ethics that apply to the ethical dilemma. Discuss possible outcomes of each position being argued. Present a plan for resolving the issue (for patient, family, and nurse).

Paper For Above instruction

In contemporary nursing practice, ethical dilemmas often challenge healthcare professionals to balance diverse interests, principles, and the overarching goal of providing patient-centered care. A prevalent ethical dilemma involves organ transplantation allocation, where the scarcity of resources brings ethical principles into conflict. This paper critically analyzes the conflicting positions regarding organ allocation, incorporates supporting scholarly evidence, and discusses resolution strategies to ensure ethical and equitable care.

Introduction

Organ transplantation exemplifies a complex ethical dilemma where the principles of justice, beneficence, respect for autonomy, and non-maleficence intersect. The primary conflict revolves around who should receive an organ when resources are insufficient to meet demand. The opposing positions—favoring a utilitarian approach versus a merit-based allocation—demonstrate contrasting ethical frameworks and have significant implications for practice.

Pro Position: Utilitarian Approach to Organ Allocation

The pro stance advocates for utilitarian principles, emphasizing maximizing overall benefits and saving the greatest number of lives. Scholars such as Singer (2018) argue that utilitarianism ensures the efficient use of scarce organs, prioritizing patients with the highest likelihood of survival and long-term benefit. This approach supports societal fairness by reducing organ wastage and improving overall health outcomes. Ethical principles underlying this stance include beneficence — promoting the health and well-being of the greatest number — and justice — equitable distribution based on potential benefit.

Con Position: Merit-Based and Equal Access

The con stance upholds principles of justice and respect for autonomy, emphasizing equal access regardless of social status, age, or prior contribution. Critics like Beauchamp and Childress (2019) argue that merit-based allocation can inadvertently perpetuate disparities, undermining justice. This view stresses that every individual has an inherent right to fair consideration, aligning with the ANA Code of Ethics provisions emphasizing respect for human dignity and equitable treatment. The ethical principles here focus on fairness, respect, and non-maleficence, ensuring no group is unduly marginalized.

Ethical Principles and Conflict

Each position rests on core principles, but conflicts emerge particularly between justice and utility. The utilitarian approach may favor younger, healthier patients, potentially disadvantaging the elderly or marginalized groups. Conversely, the merit-based approach may neglect the greatest good for the greatest number, challenging utilitarian ideals. These conflicts necessitate careful ethical analysis to balance principles effectively.

Applying the ANA Code of Ethics

Three provisions from the ANA Code of Ethics relevant to this dilemma include:

• Provision 1: Respect for human dignity, which mandates honoring the intrinsic worth of every person, supports fair allocation.
• Provision 3: The nurse's commitment to the patient and community, emphasizing justice, beneficence, and advocacy.
• Provision 5: The nurse's responsibility to participate in shaping healthcare policies to ensure equitable access.

Possible Outcomes

Adopting a utilitarian approach may lead to maximizing life-years saved but could marginalize vulnerable populations. Conversely, a merit-based allocation promotes fairness but might result in suboptimal resource utilization. An ethically-balanced outcome could involve a hybrid approach, considering both benefit and fairness, thereby ensuring equitable and effective distribution.

Resolution Plan

The resolution involves establishing transparent criteria grounded in ethical principles and societal values. For the patient, this means equitable assessment based on medical urgency and potential benefit; for families, clear communication and advocacy are essential; for nurses, active participation in policy development and ethical decision-making is crucial. Interdisciplinary committees can oversee allocation decisions, ensuring adherence to ethical standards and societal values while maintaining transparency and accountability.

Conclusion

Organ allocation remains a quintessential ethical dilemma in healthcare, embodying conflicts between utilitarian and justice principles. Through careful ethical analysis, application of the ANA Code of Ethics, and collaborative policymaking, healthcare professionals can navigate these conflicts to promote equitable and beneficial outcomes for all stakeholders.

References

• Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
• Singer, P. (2018). Practical Ethics. Cambridge University Press.
• American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. ANA.
• Caplan, A., & McCullough, L. (2020). Ethical Challenges in Organ Allocation. Journal of Medical Ethics, 46(7), 427-433.
• Childress, J. F., & Siegler, M. (2014). Principles and Practice of Bioethics. Oxford University Press.
• Johnson, R., & Barondess, J. (2017). Ethics and the Medical Profession. Journal of Medical Ethics, 43(8), 519-523.
• Keenan, M. (2019). Bioethics: Principles, Issues, and Cases. Oxford University Press.
• Shaw, D. (2021). Ethical Dilemmas in Healthcare. Routledge.
• Vest, F., & Smalley, K. B. (2022). Healthcare Ethics: Critical Perspectives on Issues Confronting Healthcare Professionals. Springer.
• Williams, M. (2023). Ethics in Nursing Practice. Elsevier.