Healthcare, like any other profession, requires the individuals to uphold high levels of integrity, ethics, and respect for the law. The moral, legal and ethical implications of practice are all back to the value of providing the best care for the patients. The leadership and management of a healthcare organization, therefore, require that the moral values and ethics become the guiding principles for all the individuals working within the healthcare organization. Health care is all about integrity and holding high ethical values for the organization. The nursing profession through the American Nurses Association and the Academy of Nurse Practitioners have provided the ethical and moral requirements of the nurses within the profession. Ethics require that nurses respect their patients, maintain dignity and protect their rights. Patients depend on the honesty of the nurses and their adherence to the ethical as well as legal standards. Patients’ entrust their dignity to nurses, so nurses must guard their privacy, listen to their concerns and consider their wishes concerning the care they want to receive. Therefore, the moral values, as well as ethics, need to remain the guiding principles for all the healthcare professionals. This paper examines the ethical, moral and legal dilemma that leaders may experience and then provide a legal implication for the role of a leader in ensuring ethical decision making.
Ethical, Moral and Legal Dilemma
Working with patients, nurses in many occasions deal with difficult situations that require rational thinking and ethical decision making. In everyday activities, nurses are faced with a variety of ethical issues forcing them to reconcile their values with their professional nursing obligations ( Epstein & Turner, 2015 ). In many occasions, nurses find themselves unable to make the most ethical decisions when faced with ethical dilemmas and increase their risks of being involved in the disciplinary charges for malpractice litigations. Nurses are therefore required to be familiar with the Code of Ethics developed by the American Nurses Association ( SHAPIRA ‐ LISHCHINSKY, 2014 ). Adhering to these standards as well as the application of the leadership skills can help in making decisions that are considered ethical.
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The ethical dilemma that in have faced in the workplace is the disclosing the medical condition of the patient. In this ethical dilemma case, the family of the patient asked that I do not disclose the medical condition and diagnosis to the patient for fear of getting shocked. Therefore, I had to decide between telling the truth to the patient or remaining deceptive as requested by the family members. The nurse has a right to know, and at the same time, the family of the patient requires that their request be respected. At the same time, a nurse has a role in protecting the patient from any harm, and as considered, if the family is right that telling the patient the truth could worsen the condition, then the nurse had to protect the patient from such harm. The nurse has an obligation to the patient and the ethical principle of nonmaleficence and fidelity. Similarly, the nurse has an obligation to prevent any harm to the patient and also to remain faithful to the family of the patient. The dilemma is, therefore, to decide on whether to tell the patient the truth because the patient has the right to know or to remain deceptive and protect the patient from any harm that could arise as a result of shock as claimed by the family. In this case, each of the two options has consequences, and therefore the need to logically think and apply the ethical principles as well as the required code of the nursing profession.
Analysis of the Ethical Implication
The role of a leader is to ensure that moral decisions are made in a way that promotes positive outcome to the patients. While faced with an ethical dilemma, it is the responsibility of an individual to apply the professional code of conduct as well as ethical and moral standards to provide a decision that maximizes the outcome of the patient. In this situation, my role is to apply the leadership skills for decision making as well as the moral values to make an ethical decision that will have a positive outcome. While resolving this ethical dilemma, I will use the deontology theory of ethical decision. This theory states that people should adhere to their obligations and duties when engaged in making the ethical decision ( Silva et al., 2018 ). As a moral agent, I am obliged to make decisions that will have a positive outcome for the patients. Based on the deontology theory, I will follow what my obligations and duties are under the professional code of conduct. Adhering to the deontology theory while making ethical decisions require a person to stick to the line of duty and adhere to the ethical and legal framework stipulated by profession.
The nurse has an ethical and legal obligation to the patient. The ethical principles that act as the guidelines while resolving this ethical dilemma are the nonmaleficence and fidelity. Nonmaleficence is concerned with the obligation of the nurse to not harm the patient, and must, therefore, weigh the risks and benefits ( Demirtas, 2015). Fidelity, on the other hand, is concerned with the need to remain loyal and faithful to the patient and being honest and truthful. Revealing the true medical condition to the patient could violate the nonmaleficence principle because it could cause harm to the patient. Also, remaining deceptive can violate the fidelity principle and the obligation of the nurse to remain truthful and honest. It is therefore based on weighing the benefits and the risks for each decision. However, the professional code of nursing states that nurses have an obligation to the patients to know their health condition and remain truthful. Based on the deontology theory, a moral decision is one that sticks to the duties and obligation as required by the law and the profession. Therefore, the ethical decision to make in this case would be to remain truthful and tell the truth to the patient because they have a right to know their medical condition.
Leadership Style
Effective leadership skills, qualities, and leadership type play a key role in finding a solution to the ethical dilemmas in the workplace. The leadership style that a person possesses, and the overall beliefs as a leader help in determining the ethical decision that a leader makes. Leaders who believe in upholding the rule of law are more likely to make decisions that are within the legal framework. Similarly, those leaders who believe in integrity and honesty not only as a professional value but also as personal values are more likely to operate within the ethical and moral framework.
After the assessment on my leadership style, I have found that my temperament type is an idealist. Idealist leaders are high energy leaders who believe in attaining a positive potential for everyone around them. These are leaders with the desire to learn and grow and want everyone around them also to learn. The idealist leaders are usually calm with a strong desire to improve everything around them including the people they meet. The desire and enthusiasm to bring people and new ideas together can create a long term relationship as well as connections ( Pagan, 2014 ). Because of creativity and passion, idealist leaders can make great achievements for a meaningful purpose. Through the demonstration of effective communication skills, empathetic and optimistic, idealists can be constructive and lead to positive growth in the organization.
Other than the above strengths of idealists, various weaknesses come with this style of leadership and which can act as a barrier to ethical decision making. First, idealists are good at sympathizing with both sides of an issue and feel reluctant to commit to one either side, a situation that can lead to indecisiveness. The ethical dilemma mentioned requires a leader to have good decision-making skills. They must be able to weigh both sides and make a decision that is best of the two. However, the sympathizing nature of the idealists and inability to commit to either side of an issue leads to lack of decision and thus a barrier to ethical decision making. My leadership temperament, therefore, acts as a barrier to my ability to make decisions that put one in a dilemma situation.
Conclusion
Ethical, moral and legal standards are essential for providing the best patients care for the community and all the individuals. Maintaining ethical and moral values are the basic principles for enhancing the effectiveness of health care operations. Nurses in their daily work experience situations that subject them to an ethical dilemma and require them to make ethical decisions. As a result, developing ethical leadership skills and qualities is essential in improving individual decision-making skills. Failing to make ethical decisions can result in legal litigations and lawsuits which can affect the profession of an individual.
References
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. OJIN: The Online Journal of Issues in Nursing , 20 (2), 1-10.
SHAPIRA ‐ LISHCHINSKY, O. R. L. Y. (2014). Simulations in nursing practice: toward authentic leadership. Journal of Nursing Management , 22 (1), 60-69.
Silva, T. N. D., Freire, M. E. M., Vasconcelos, M. F. D., Silva Junior, S. V. D., Silva, W. J. D. C., Araújo, P. D. S., & Eloy, A. V. A. (2018). Deontological aspects of the nursing profession: understanding the code of ethics. Revista brasileira de enfermagem , 71 (1), 3-10.
Demirtas, O. (2015). Ethical leadership influence at organizations: Evidence from the field. Journal of Business Ethics , 126 (2), 273-284.
Pagan, L. S. (2014). Nursing Ethics In Everyday Practice. Care Management Journals , 15 (2), 97.
