Many a time, human beings are torn between making two ethical choices, both of which involve and influence the wellbeing of the other, but either must be sacrificed for the benefit of the other. How do you decide which factor to forgo? This is what ethicists and scholars term the ethical dilemma; the decision-making paradox between two possible moral imperatives, neither of which is unambiguously acceptable or preferable. This complexity, as earlier on stated, arises out of a situational conflict in which obeying one phenomenon would result in the transgressing of the other and is invoked to refute a moral code in its resolution.
The ethical dilemma involves the case of attempted suicide by an aggressive old cancer patient as highlighted by the article written by Lin Jie. The scholar uses Mr. Green, the patient, who confides in one of his nurses the desire to end his life. Green here is not only in his old last days, but he also suffers from an end-stage chronic form of prostate cancer. It would be understandable if such an individual wishes to end his life, and asked the help of another individual. But the individual here happens to be a caregiver who is compelled by medical ethics to disclose such intentions of a patient to the other health care team members. But because the patient confined in the nurse, it would be against their wish and confidentiality to disclose such information without the patient's consent.
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The dilemma, therefore, is whether the nurse should go ahead and communicate this information or uphold the confidentiality (Jie, 2015). The two factors in play in such a dilemma are patient confidentiality and medical ethics. One must be given up to serve the other. in the end, considering the ethical theory, the moral principles and the professional code of ethics, the nurse disclose the information to their colleagues who diagnosed the situation and were able to provide appropriate interventions. But at the end of the day, it is not just some work ethics that should bound a caregiver in taking such a decision, because if anything, the same codes of ethics are broken in other scenarios to affect the desired outcome. The end goal should be to save human life. The nurse made the right decision but should have been more compelled by the categorical imperative to preserve human life.
The categorical imperative, developed by Immanuel Kant as a concept of his moral philosophy in 1978, defines human beings as having the ability to reason out of moral compellation ultimately. This phenomenon argues for actions out of moral motivation; the desire to protect, preserve and promote the life of another person (Paton, 1971). This imperative helps in narrowing down options for any ethical dilemma, especially in such a case that seems to attract neutral responses from the established systems. The problem that will be applied in this case is birth complications that endanger the lives of the unborn child and the mother, so much so that only one of them can be saved. How do you decide who should live and who should pay the price of the other's survival? The causes of such a situation range from health complications of the mother, frequent illnesses, to the factors of the labor, and down to the manner in which the operation was handled.
While some of these conditions can be diagnosed during the early stages of pregnancy, like blood pressure, which may affect the entire period of the pregnancy, or during childbirth, some women may still be adamant in going through the experience albeit medical advice to terminate the pregnancy. Another factor for such a scenario would be hemorrhage noticed during labor or delivery. If noticed during labor and considered a potential threat to the delivery process, there may be considerations to terminate the pregnancy. During delivery, such cases as disorders within the placenta could be of potential threat. A good scenario would amniotic fluid embolism, a condition in which either or both the amniotic fluid and fetal skin float in the womb risking getting into contact with the woman's bloodstream triggering an allergic reaction which could result in her death.
In this case, just like in the previous instances, the medics risk losing both the mother and the unborn child, and a quick decision must be made to save either one of them. This decision does not rely on the healthcare givers; it is up to the concerned family to decide, basing their decision on the doctors' advice. The law, in this case, is neutral. According to Ely (1973), the Roe v. Wade case portrayed that the state is only interested in the life of the fetus once it is viable, where viable in this case is its ability to live independently. And even after viability, the state would not uphold the fetus against the health of the mother. This means, therefore, that neither the American Laws nor professional conducts of the healthcare providers would decide on who lives and who does not because each party demonstrates the same likelihood of survival as of death. To solve this dilemma, the parties involved would best go by Kant's categorical imperative in which it would be only fair to save the life of the individual that according to the situation, stands a higher chance of survival. Whether it is the child or the mother, the imperative advocates or the protection of the one that shows more likelihood of survival, it is about minimizing on the collateral damage.
References
Ely, J. H. (1973). The wages of crying wolf: A comment on Roe v. Wade. The Yale Law Journal , 82 (5), 920-949.
Jie, L. (2015). The patient suicide attempt–An ethical dilemma case study. International Journal of Nursing Sciences , 2 (4), 408-413.
Paton, H. J. (1971). The categorical imperative: A study in Kant's moral philosophy (Vol. 1023). University of Pennsylvania Press.
