Category: Ethical Dilemma

Throughout nursing professions, nurses face many legal or ethical dilemmas. Every nurse is required to know the ethical and legal aspects of health care. Nurses must understand these codes to practice safely and protect their patients. Although understanding the difference between law and ethics is important for nurses. Ethics respect moral values and actions. Such values include autonomy, utilitarianism, confidentiality, and much more. On the other hand, laws are the rules of conduct that are required. Nurses must comply with these rules or face disciplinary action.

Advance directives are an expression of a patient’s choice and wish for medical care that is based on a person’s values and beliefs. Advance directives also require selecting a proxy, someone who can represent the interests of the patient in making decisions. Discussions about advance care planning can continue in the outpatient setting. At any point during their last year of life, it is common for patients with prolonged chronic disease to seek treatment in outpatient settings. Recognition of the terminal nature or stage of an illness is a stimulus for conversations regarding patient needs and an alternative identification.

Presented with a dilemma, knowing nothing can be done because a patient living will, or advance directive say do not resuscitate. And having a patient die knowing full well that CPR could have revived such a person. However, there is a legal aspect as the family might proceed with a lawsuit against the hospital and have the nurse punished due to lack of action on their loved ones as it is the choice of their deceased to inform them or not. This is allied with the patient legal rights as a person.

Nurses play an advocate role in facilitating conversations with patients, families, and health care team members at the end of life care. Decision-making is a very important, yet complicated process, and it poses various challenges for patients and their families to make up a decision on end-of-life care before a life-threatening crisis occurs. Patients have the right to state their expectations for end-of-life care. And if the patient’s wishes are uncertain, the final decision made will be in the patient’s best interest. The Patient Self-Determination Act (PSDA) encourages contact between health care providers and patients. The right of the patient to voice their end-of-life care decisions autonomously must be protected ethically by the light of the use of advanced treatment options and their prognosis. This right to autonomy has certain limits and is thus faced with an ethical dilemma. There are still difficulties and uncertainty about not resuscitating (DNR) orders, given patient, family, and proxy decision-makers making informed choices. The health care professional should respect the autonomy of the patient while taking into account its limitations and conduct their duties to support the patient without harm.

As everyone is different, so is our belief system. A person may consider classifying a thing as right, which can be seen as a taboo in another’s. Some nurses whose beliefs, values are different from that of the patient most likely would want to be assigned to a patient with similar beliefs. However, as a nurse, if such circumstances occur and go against one belief or values, it is required to report to the charge nurse as he or she will be reassigned to a more comfortable circumstance.

Nurses are required to provide comprehensive and compassionate end-of-life care. This incorporates recognizing when death is close and passing on such information to the families. Nurses and other health care providers have to develop decision-making mechanisms that embody medical conditions, a patient needs an awareness of what may or may not be done clinically. Establishing treatment priorities for this patient at this time might provide a basis for debate on what care should be provided. Sometimes, this process includes cooperation with decision-making professionals, such as ethics boards or palliative care teams. (ANA, 2016).

A good end of life should focus more on what care a nurse can provide than what they forgo. Don’t try to deal with issues yourself. Share your thoughts with your head nurse. Unless the policy of the facility is vague, which will include the ethics committee. Nonetheless, if the policy isn’t clear the manager can notify the physician for assistance. Risk management will also be contacted for medical leadership to assess the condition, and likely resolve the question of medical practice.

The perception of nurses shouldn’t impact end-of-life care as everyone is equal no matter what advance directives say. Just because a patient has DNR on their record, doesn’t mean such person will be treated less by demonstrating less care regarding he or she is about to die and focus the attention of care on those who want to live. Even if such a decision is made by the patient, that should not change or interfere with the comfort and safety of the patient. Every patient has the right to be treated fairly no matter what the status or level of terminally ill the disease is. Nurses are accountable for respecting the patients’ wishes no matter what the circumstances are. If the living will or advance directives say no CPR, nurses should refrain from it, and if it does, do everything possible to save the patient’s life. If such an order is disobeyed, it could lead to termination, license suspension or withdrawal, lawsuits, and so on.

There are numerous moral principles to see while examining DNR orders like beneficence, non-maleficence, autonomy. However, it is difficult to figure out which rule is most significant when they contradict one another. DNR order makes a gray area of when and what number of nurses can intercede with a patient before CPR is necessary. A DNR shows that CPR isn’t to be started but allows all other clinical interventions to happen. Nurses are regularly excluded in the plan of action of a DNR request, which makes advocacy hard. An instance is a nurse who chooses to rescue a patient whose wishes were otherwise, however, were not stated on their end-of-life care. The nurse in this scenario battled a choice between negligence versus non-maleficence. A DNR request doesn’t mean, do not care.

In Texas, the legislature passed a law that regulates inpatient do not resuscitate orders (DNRs) which have gone into effect in hospitals across the state (BCM, 2019). It is intended to protect patient autonomy, but also raises ethical concerns. If a patient can make medical decisions and applies for an inpatient DNR order to be issued, then two competent adults will serve as a witness to the patient’s consent. Including observing requirements, the new regulations also limit who may act as a witness. Any witness cannot be an employee of the attending physician of the patient, or a health care facility employee where the patient seeks medical treatment. If the patient loses ability, the current rules provide for the discontinuation of the patient’s DNR order by a legal guardian (as assigned by the court) or by an agent named in a medical attorney’s document. While at first sight, this provision may not seem problematic, the language of legislation authorizes the doctor to reinstate the request, even if it is against the patient’s wishes, which violates the values of autonomy. Considering that new regulations limit the ability of a legal guardian or an attorney to revoke the DNR order, it remains unclear when and if the DNR order could be revoked by another suitable proxy (e.g., spouse). The new regulations also created several uncertainties for physicians and other related healthcare professionals to practice.

As a coworker or nurse manager, I will assign such patients to a nurse who is more comfortable providing care. Doing this proves teamwork, where everyone’s opinion is valued without being judged. Showing the workplace is meant to be safe, to prevent negligence, malpractice, and many more, as this is against the ethics of nursing if the standard of care is not performed well. By allowing such nurses to state concerns about the situation while respecting confidentiality. After which is identified as a non-discriminating act, but rather values, then such a nurse can be transferred or reassigned to different patients. However, if negligence or malpractice is noticed, such will be reported to the proper hierarchy to intervene before it escalates into a bigger problem.

According to the Oklahoma Nursing practice act, a punishable act means any criminal action allowed by the state’s laws which is imposed by the licensing board against a nurse, including actions against such person license or multistate licensure privileges such as revoking, suspending, probation, limiting and monitoring of licensee’s practice, or other restraint on licensure that can affect a nurse to practice.

In summary, nurses must be advocates for the patients. Without being a part of the decision-making process during ethical dilemmas, they are unable to fulfill their responsibility to advocate. Nurses and others must have the knowledge and communication skills to explain to patients, and more often to families why organ transplantation, chemotherapy, CPR, or an IV cannot help this patient and therefore should not be provided.

Ethics explains the behaviors and regulations that everyone has to follow. Ethics relates to moral concepts such as goodness, crime, truth, error, and responsibility. While privacy is also an individual or group effort to conceal information about himself. In addition, privacy also means something very special and sensitive to some things. Social media is communication through an online website such as Facebook, Instagram, Twitter and so on which is used by individuals or groups to share information, promote business and develop social relationships with one another.

Communication using social media is to use polite language in the form of writing or speech even if it is not communicating in the face. If we’re in a chat do not use totally capital letters because people will assume we are in emotionally angry emotions when typing. Then write using appropriate writing as well as easy to understand.

Social media users are also not allowed to use offensive texts such as abuse or pornographic videos that will bring disgrace to oneself and also religion. For example, an owner of the instafames account is a man who performs a pornographic parody by wearing a barefoot girl and uploads the video in person during Ramadan. This is an offense to the public because of what he has done wrong and he is uploading at the wrong time. As a result, the Instagram account has been closed Instagram because of reports from the public. This is an example that can be attributed because it involves religion.

In addition, in social media, there are also some individuals who distribute pornographic information or pictures on social networks. While in social media such as Instagram, Facebook, or Google, there are also minors who use it. Even though they get a watch from parents. They will also find the page as it opens. This will indirectly cause children to be affected by things that do not fit their age. Additionally, social media users are also not encouraged to post terrorized images with non-adaptive captions or that are intended to encourage the public to imitate the action.

Furthermore, we also can not imitate someone’s copyrighted work by replacing and removing it. Creation is usually a painting, picture, song, or video. For example, the story out of the cinema is recorded quietly and then downloaded on youtube to find popularity while it can destroy the design of the story and spoil the business of others. This is a fine that can be imposed by a court for the offense of plagiarizing the rights of others. The imposed fines are also worthy of what the individual has done.

Therefore, we as people who live in society do not do things arbitrarily because we live in a country where each one needs to respect the other. And in this sophisticated age, it should not be easy for us to believe in the news unless we search for the news whether it is authentic or not because the lies on the market are so vast. We need to follow every set of ethics for everyone’s enjoyment.

During my as a social work student, I got chance to get involved in different aspects of people lives, which include their family relations, financial relations, ill health, drug dependency, homelessness, home modification, a crime such as abuse, and how all these aspects are affecting client’s day to day life. The more social worker involved in these aspects, the more they can do best for them, but there is always a risk of causing harm (Bell. J,2018). While I am doing my placement at FCCVI, I feel much clear about the Social worker role and AASW ethics. I faced an approximate ethical dilemma scenario at Workplace, Benetas residential age care. An approximate ethical dilemma is a complex situation in which there is a conflict between laws, values, and policies (Reamer, Frederic. G,2018). Although my scenario does not belong to FCCVI, I have chosen this scenario as it is similar in respect of work that is dealing with elder people.

Scenario discussion- Steve was an old man who came for few weeks to my workplace. I and other care staff found that he was always in a low mood and anxiety. He always behaved in a fearful manner whenever care staff tried to do meaningful touch to fulfill his care needs. Then one day, he disclosed to me while having a conversation that he is being physically assaulted/ abused by his partner, but he did not want to report it and request me to keep it private and confidential because he was afraid of having backlash from his wife. Because he was a family-oriented man, He thought this matter was private and family specified and don’t want political interference in it.

Why it is an ethical dilemma- I found this scenario as an ethical dilemma because there was a conflict between my Social worker ethics that is respect the client’s consent before disclosing the case to a third and maintain the privacy and confidentiality of information provided by the client. Whereas on the other hand, I was abided by organization policies that are Mandatory reporting of abuse (the age care Act 1997). This provision was made by the government to protect elder people from any kind of abuse. According to this law, any person in the service or during work has the responsibility for making compulsory reports to local police and the Australian Department of Health, and reporting abuse are compulsory to provide a safe and secure environment (agedcare.health.gov.au). I am feeling a conflict situation between legal law and social work ethics. I am facing tension to make decisions as a worker of Benetas, I am legally obligated to make reports of elder abuse to prevent further abuse and provide a safe environment whereas as a social work student I am professionally obligated to respect the client’s choices and privacy.

Possible actions and their risks and benefits- In this scenario, I had the option of two actions, one legal and the other is professional. Usually, legal obligations supersede professional ethics. But on the other hand, I am abided by Social work Ethics which entitles respect to the client’s consent.

The first possible action is to respect privacy and confidentiality and do not report abuse as its client‘s choice to choose to whom he wanted to disclose his matter. According to the AASW Code of Ethics (2010), I need to get consent before disclosing his information even if the information is required for the legal process. As a social work student, I need to take into consideration the client before informing a third party (explaining agency or legal requirements). I need to get the written consent of the client or a legal excuse (e.g. statutory requirement) before using his information. But in my case, the client doesn’t want to disclose any information with the agency and doesn’t need any legal action because of fear of his wife. I tried to explain to him, that legal action is important for your protection and better life with respect and dignity, but he express his choice by choosing not to report as he said it is his family matter and he doesn’t want to involve his family in political matters. If I choose this action, it may affect the client’s trust relationship with me as a professional and he doesn’t trust anyone to share his feeling.

The second possible action- is legal action to report elder abuse to the police or the Department of Health (age care act 1997). Benetas is also following mandatory reports of elder abuse. The aim of this policy is to take immediate action to address the issue and make a secure and safe environment for clients (agecare.health.com.au). I can report but this report is without client consent, no doubt this is for making his life better, free from abuse, but client choice superseded by legal obligations. As consequence, maybe reporting can make his life more complex as he may face family tensions as he mentioned that he is not ready to face counteraction from his wife which can be worse than now. By choosing this action I am violating my professional ethics of respecting client privacy and consent before reporting.

Deontological theory- this theory is based on the morality of action regardless of its consequences. According to this theory, an action is inherently right or wrong, bad or good under series of rules. The rightness of action cannot be judged by its consequences (Reamers 2018). In this Scenario where my professional ethics had a conflict with laws, I feel that sharing the client’s information without his consent is morally wrong. Breaching the privacy and confidentiality of the client is a wrong action, it can break the client’s trust which can mentally affect him, and maybe he won’t be able to express his feeling anymore because this action can hurt his trust. Likewise, in this case, where Steve doesn’t want to get involved in the political sphere and doesn’t want to report his family matter, it’s his choice and he should not be forced to report or get political assistance.

Teleology theory- this theory giving importance to the rightness of consequences. An action is ethically right if it has potential consequences (Reamer 2018). Every action has some consequences, and that action is ethically right which has more positive consequences. Among both actions, reporting abuse may have more positive consequences in which his further life is more safe and secure. The government will take the necessary steps to make his life better. but according to his statement, it can also make his more complex as his preference was not too involved in political interference in his family matter. Moreover, it can lose his trust relationship with me and he doesn’t want to share his feeling with anyone which can affect him psychologically.

Right-based theory- this theory is based on individual fundamental rights, for example- right to life, right to expression, right to choose, right to protection against oppression, unequal treatment. Preference should be given to the rights of a human beings. In my case, there was a clash of right to choose and right to protection against oppression. On one side, I should respect his choice of not disclosing his matter with any agency for legal action whereas, on other hand I should respect his human right that is the right to protection against oppression. This is the actual ethical dilemma I faced, need to choose between two human rights.

Ethical decision-making is an important aspect of social work professions. Ethical behavior comes from the commitment of social workers individual to engage in ethical practice (CASW Code of ethics, 2010). In day-to-day life, social workers faced an ethical dilemma that needs reflection and thinking. An ethical dilemma is a choice between two actions based on conflicting professional values (Linzer,1999). Social workers can use other helpful strategies and resources such as peer consultation, discussion with organization management, review ethical standards, doing research of professional ethics.

Peer discussion -In my case, I also adopted some strategies to support my decision. I discussed this matter with another staff member (Lan), she is also doing Master of Social worker from Deakin University by not disclosing the real identity of the client. I explained all the situations and clashes between client’s fundamental rights, also between my professional ethics and organizational policies. After a brief discussion on ethical complexities, I concluded that I should review code of ethics and do more research on ethical decision -making model which can help me to promote my critical thinking and reflections.

Code of ethics- when I made research on code of ethics, I felt that code of ethics was not clearly solved my dilemma but it helps me to better understand the ethics of privacy and confidentiality of client (AASW code of ethics,2010) and explain about significance of consent of client before taking any action (AASW code of etihics,2010). It is important to obtain informed consent from client before disclosing any information even if this information is required for legal procedures (AASW Code of ethics, 2010, pg. 27).It also states that client have right to choose to whom he/she want to/ don’t want to provide information and in what situation (AASW Code of Ethics,2010,pg.28). It is mandatory for social worker to maintain confidentiality in all cases, should have informed consent before disclosing any information to other party and should also make sure that other party should also maintain client’s privacy (AASW code of ethics,2010). From the above research, I conclude my thoughts that client has right to choose and provide consent before any proceeding.

Discussion with client about dilemma- after considering all the strategies, I thought to have a discussion with my client about my dilemma and I tried to explain him about two possible decisions. I describe to him that how reporting can change his life and provide security. But he again denied for reporting or disclose information to anyone probably because he said reporting can affect his family relations and he don’t want to seek any political interference. So, I thought if he is not ready, I can’t force him to report. I respect his decision but on the other hand I should also take some steps to minimize risk and not compromise my ethical responsibilities. We both agreed for counselling sessions whenever we meet at work (Benetas) so that he can share his feeling and thoughts. I provide him information about contact numbers where he can report abuse against him such as police, organization (Benetas). After this we usually met at my workplace (Benetas), had counselling but after a few months, he got discharge from Benetas and we never met again. I tried to call him, but his family usually respond to phone calls.

Conclusion- after my decision I observed some changes in him, my counselling sessions helps him to share his feeling and he was more relaxed, less frustrated and now he like interact with others. He also enjoyed having conversations with me. He shared his past life with all experience, from this I realize that I got success in building relations with him which is based on trust. I assist him by providing information about support groups and programs in their area for elder abuse. Client enjoyed the time we get to spend together. He stated that counselling session with me helps him to resolve stress in his life.

Stakeholder Analysis

I have experienced and witnessed many ethical dilemmas which have made impacted my own ethical decision-making in life. An ethical dilemma is best defined as a “decision-making problem between two possible moral imperatives”. One dilemma in particular that I would like to share involves my aunt facing a serious ethical decision in her workplace. My aunt is a social worker and a fundamental part of her job is ethical awareness. As we know social workers are supposed to maintain confidentiality regarding intimate details about clients who use their services, but there are exceptions to these guidelines especially when it poses a threat to society or themselves. Another important factor social workers need to acknowledge is their own accountability for their actions towards their clients their colleagues, the professional association, and to the law. A social worker must display integrity by not abusing the relationship of trust with clients while recognizing the boundaries between personal and professional life. As you can imagine social workers face ethical dilemmas on a day-to-day basis when dealing with people’s personal problems. The ethical dilemma which my aunt faced was when she was working with 9-year-old Klaudia, her older Gena who is her present guardian, and her mother, Natalia. Klaudia had been taken away from her mother and placed in the custody of the sister because the mother was abusing drugs and obviously neglecting her motherly duties. After a year, the mother completed rehab and stayed clean while living on her own. Not only was she sober in her own apartment she also had a steady job working as a cashier at Shop Right. My aunt has been working with this family for over 2 years which created a strong relationship within the family. Everything was going great with this family until one of the meet-ups Natalia had with my aunt. Natalia confessed that she made a mistake by taking drugs again the weekend prior. She confessed to my aunt about the situation because they have developed a strong relationship over the years and Natalia needed to confide in my aunt. She admitted she was wrong and promised not to do it again while begging my aunt not to tell the judge. Natalia also stressed the importance of seeing her younger daughter and hopes in getting her back and if she couldn’t see her again, she would use drugs again. My aunt understood that she made a mistake and believed that this has been the only relapse she had. My aunt also believed that she would never put her daughter at any risk or danger by being under the influence of drugs or alcohol during her visits. However, under the code of ethics in her job requirements, she is required to document what Natalia has confessed and to seek supervisory advice, even if it meant Natalia losing her right to see her daughter again. My aunt also had to consider the risk of losing her job if she did not properly document the drug abuse. In conclusion, my aunt knew she had to follow protocol and report Natalia taking drugs. The possibility she could do drugs again while taking care of her daughter was too great of a risk to take. In the end, my aunt believed by reporting Natalia’s drug use was not only morally right but also professionally the right thing to do. Not only did she consider the effects her decision would have on the mother, but also the effects on Klaudia. Although my aunt had a trusting relationship with this family, she felt if she hadn’t reported Natalia, she would be dishonest towards her work as a social worker by violating agency policies and keeping valuable information that could have potentially hurt a little girl. I personally believe my aunt made her decision ethically while keeping the best interests of everyone involved in mind. She may have lost Natalia’s trust on top of losing her as a client, but at least my aunt acted in full accordance with both legal proceedings and agency policies.

There were many different stakeholders affected by this decision. Most importantly, the family was affected in different ways (Natalia, Klaudia, and her older sister Gena). My aunt’s agency and their employees. Other stakeholders that were affected by this outcome are me, my family, and those we had told the story to I truly believe that the decision my aunt made was the “right” outcome. Utilitarianism is that an action is right if it results in the happiness of the greatest number of people in a society or a.

The stakeholders in my Ethical Dilemma are:

• My aunt
• Suzan
• Gena
• Klaudia
• My aunt’s employees
• And my family
• My aunt’s family

Through the lens of utilitarianism, my aunt should have considered all the consequences that her decision would bring. She also has to pick the decision not only that brings the minimum negative consequences but that brings the greatest happiness to the greatest number of people.

Based on my aunt’s decision, I believe that she followed the Utilitarian approach most when making the final decision. Her decision produced the greatest balance of good over harm. I also believe that my aunt represented the rule utilitarianism approach in her decision-making in deciding whether the implementation of an action, as a rule, would be beneficial to society by following her agency policy and rules. She had to deal with consequences while reducing the harm her outcome would have on the family, her job, and her employer representing the utilitarian approach. She had to consider the common conditions that are important to the welfare of everyone in the common good approach. Also, we see that there are other factors besides her own feelings about the situation that was important in the outcome. Another element is how Natalia admitted that she was wrong and promised not to do it again while begging my aunt not to tell the judge. Her decision not to do drugs anymore is very positive and brings enthusiasm to everyone. For Klaudia and Gena as far as safety concerns were, the outcome was great. The mother must feel betrayed but at least she can continue to get help and her health is being cared for. My aunts’ other employees in the agency were affected by this decision as far as being able to trust my aunt and making sure that each employee follows the rules and different policies. All her staff was trained properly, and they would be competent to do their job which would make everything run smoothly. When everyone does their job and works in a team it creates a positive ambiance and also makes work easier. Other stakeholders that were affected by this story are me, my family, and other people who know about this story. It affected me as I now think of the difficult decision my own aunt made when I am faced with an ethical dilemma and how in the end, my decision will ultimately affect many people. My family and other people around us have now understood the importance of ethics whether in the workplace. By using the utilitarian approach, not only were the conditions of the family important but also following the law and considering the welfare of others who may be affected by not reporting the mother’s drug use. In this case, it’s possible that my aunt didn’t want to betray the trust of her client on a personal level and deal with feelings of guilt if Natalia relapses into consistent drug use as a result of her losing the right to see her child. These factors could have prevented my aunt from making the best decision, but she ultimately looked beyond her personal feelings and what was best for just one individual. If my aunt didn’t follow the policy of documenting Natalia’s drug abuse to not feel guilty about it later and to not betray her trust, then she would have portrayed ethical egoism, only acting in her own self-interest. I am a huge supporter of the utilitarian approach when it comes to making ethical decisions, especially this one. I think it’s important to do what’s best for the common good and reduce as much harm as possible when you are put in an ethical dilemma such as mine.

However, in the lens of deontology that would’ve been an erroneous decision to make. This is because according to deontological ethics, my aunt’s obligation as the decision-maker is to follow a series of rules to differentiate right from wrong rather than considering all the consequences and the happiness of all of those who could be affected by her decision. If my aunt was to use deontology ethics to make my decision, she would have to stay loyal to her friendship with Natalia. If my aunt’s decision was based on her own personal self-interest to avoid feeling guilty about the effects on just the mother, she would have represented ethical egoism. If my aunt didn’t follow the policy of documenting Natalia’s drug abuse to not feel guilty about it later and to not betray her trust, then she would have portrayed ethical egoism by acting in her own self-interest. Personally, I believe that if my aunt would have based her decision on ethical egoism, I will consider that as a “wrong” one. I think making a decision based on universal rules is hard because everyone can prioritize and interpret these rules differently. I think, my aunt’s loyalty to Natalia’s friendship could conflict with her loyalty to herself and not being truthful when she is asked about a certain matter. It would also conflict with the fairness of my aunt to other coworkers by being an example for everyone that works for her. It wouldn’t be fair to them to hide what Natalia is doing wrong to keep as a secret.

I think that only utilitarianism ethics was part of my decision. However, I think utilitarianism is reflected more than deontology. In this situation, I don’t believe there was any way my aunt’s organization could prevent the situation. My aunt followed the agency policy and did what she needed to do as far as documenting the information and reporting it to her supervisors. I think the decision she made was mutually beneficial to both her organization and her job position. She has excelled in her organization and has a great reputation within the organization because of this dilemma. She can use this experience as a reminder when faced with other ethical dilemmas she may encounter. She can now not only think of how the decision will benefit the stakeholders involved but also how it may benefit herself, for example, her position in the organization. It was definitely a learning experience for her and her co-workers. Even though it used to be a learning experience for them, it was also one that helped me learn as well which is why I chose this as an example for my analysis. I am a very sympathetic and warm-hearted person so when I am put in an ethical dilemma or situation where my feelings would be affected as well in the outcome, I can use this situation to help guide me and move forward in any ethical dilemmas I may face in the future.

Harry Markham is a chartered financial analysist (CFA) that now works for Investment Consulting Associates (ICA), a firm which offers advice to pension funds, after earning his Master of Finance in 2004. Mr. Markham had an increasing concern over the valuation of public sector pension fund liabilities. Markham felt professionally conflicted as he prepared for a meeting with the board of trustees of a state pension fund. When he himself valued the labilities using the principles of valuation and financial analysis he learned, he would come up with figures twice as large as those that had been reported by the funds. He was not allowed to make adjustments to the official numbers and neither his firm nor clients questioned the figures. The firm did not want to upset and potentially lose the board as a client, so they neglected to inform them that the fund’s liabilities were a much larger figure than being projected by the Government Accounting Standards Board (GASB) rules. Mr. Markham was unsure how he could possibly give proper investment advice based on financials that were utterly deceptive and false. Which leads to the dilemma he now faces as to who his loyalty must primarily lie with: loyalty to his firm, loyalty to his client, the board of trustees and those others that make decisions on investments for public pensions, or loyalty to the pensioners themselves. (John Minaham)

After analyzing and evaluating the situation I have come to the determination that Mr. Markham must ultimately follow the proper procedures set in place to navigate through these situations despite any personal ramifications that may ensue. Markham affirms his compliance with the Code of Ethics and the Standards of Professional Conduct on a yearly basis and should not put himself in a position to have to deceive the institute. A chartered financial analyst (CFA) must not knowingly make any misrepresentations in investment analysis recommendations. (John Minaham) Failure to do so could lead to disciplinary action being taking by the CFA Institute resulting in his membership being revoked, or the right to use the CFA designation being revoked. Actuaries followed the rules established by the Government Accounting Standards Board (GASB) in valuing liabilities, however the results led to an astronomical discount rate proposal that could only be described as wishful thinking. I believe that it is evident that changes need to be made to ensure that valuations reflect realistic expectations on future returns. Many factors need to be taken into account and considered when discounting the cash flow of liabilities, like the current and potential financial climates to ensure pensions can be fulfilled. Consideration should be made when investments could negatively affect other individuals and their livelihood. The critical thinking strategy that I have chosen to utilize is evaluation. Evaluating is the process of assessing, making judgements, determining the value of resources, and making conclusions based on the ideas, facts, or information presented.

My evaluation has led me to believe that Mr. Markham not only has a duty to inform his firm on his responsibility to uphold ethical standards and the integrity of the CFA Institute, he also has a duty to raise the issue at hand with his clients and potentially the pensioners if the board of trustees chose to overlook his findings. He must also report any violations of the Code of Standards even if this means reporting the firm’s actions at large. The 2008 recession was used as an example of what happens when individuals collectively chose to remain silent. This example offers concrete evidence as to what can result when negligence and delinquency is adopted. I recommend that Mr. Markham meet with those in the firm that oversee and are involved with this particular case. He should present his findings and the accurate figures he came up with after he valued the liabilities to the firm. He should then urge his colleagues and superiors to point these inaccuracies out to their clients. If the firm choses to disregard his recommendation he should then move to inform either the clients, pensioners or appropriate authorities on this violation. When individuals do not exercise their duties to uphold ethical standards, especially those in leadership positions, it leads to sectors being discredited, an atmosphere of negligence and misconduct is created, which then trickles into every branch and can ultimately lead to another financial crisis or imprisonment for those who commit misconduct.

References

1. John Minaham, & Reavis, C. (n.d.). Harry Markham’s Loyalty Dilemma. Retrieved Febuary 26, 2020 from MIT Management Sloan School: https://mitsloan.mit.edu/LearningEdge/Leadership/HarryMarkhamA/Pages/Harry-Markham-Loyalty-Dilemma-A.aspx

I am writing this paper over the ethical dilemma of chemical impaired nurses on duty. This subject is an ongoing problem is the nursing profession today that can and has changed a patient’s quality of life, due to mistakes made by a nurse while under the influence. Nurses have access to countless amounts of medications and are trusted to disperse them accordingly. When a nurse violates this code, they are not only taking away from the hospital, but they are compromising their judgment and quality of care, which are two of the main aspects of this job. This has become an epidemic over years, which is why is a topic of discussion for legal and ethical dilemmas. In this paper, I will be covering how a nurse should respond to this dilemma appropriately. Also, how a nurse can recognize the signs and symptoms of a nurse who is chemically impaired.

When dealing with this legal issue, nurses are required to report this in a certain manner to protect their-self and their staff. Tanga (2011) stated the following: Nurses have an ethical duty to protect patients, colleagues, the profession, and community. This ethical responsibility extends to nursing leaders and executives to report an impaired professional and ensure he/she receives the appropriate treatment through BON diversion programs or other professional drug and rehabilitation treatment. Impaired nurses, including nurses who have admitted to unlawful behaviors, should not be allowed to practice and subject patients to potential harm. The NE must safeguard patient safety and provide corrective action in a no punitive manner. (p. 15)

This is not only vital for the patient’s safety, but also necessary for the colleague that is under the influence so they can receive the help and treatment they need. This code provides safety to our patients, while also advocating for our staff.

A nurse that is chemically impaired while working can be compromising patient care in many different aspects. The most commonly thought of might be medication error. Although medication error is a very important topic, that is not the only way one can be compromising care. According to Jouria (2016), “Poor patient care can be described as patient neglect, in which the patient fails to receive the care that should be administered appropriately under the circumstances” (p. 13). This statement confirms that one doesn’t have to make an error to compromise patient care. This is abandonment of a patient, which can be just as lethal as a medication error.

An additional problem with a chemically impaired nurse is how it reflects on the staff and the hospital. Jouria (2016) says “Healthcare workers are often held to a higher standard of expectations than the general population, and this view is not without good reason. Healthcare providers hold considerable responsibility as part of their work. At times, they are involved in life or death situations and their actions may be a deciding factor in whether certain patients live or die” (p. 12). When errors like this are made, it reflects poorly on this hospital by the community. This can potentially hurt the hospital in terms of losing patient business. With that being said, these are a few of many reasons why it is so important to eliminate the use of substances while on the job.

Nurses are trusted to provide the best care possible to all patients. When nurses compromise their judgments, it puts patients and staff in harms way. When a nurse is under the influence of a substance, they are violating the Oklahoma Nursing Practice Act. This is found in section 567.8. Denial, revocation or suspension of license or certification–Administrative penalties, under category B. A nurse under the use of alcohol or drugs while at work has violated the Oklahoma Nursing Practice Act and will get their license revoked (Oklahoma Nursing Practice Act, 2019). Once a license is revoked, there are steps that need to be preformed in order to get the license back and practice nursing again. Oklahoma Nursing Practice Act (2019) states the following: The corrective action may include remedial education, an administrative penalty, or any combination of remedial education and an administrative penalty. The corrective action shall not be considered as disciplinary action. However, the Board may consider a corrective action in an individual’s subsequent violation of the Oklahoma Nursing Practice Act, Board rule or corrective action order. (p. 17)

If a situation like this were to arise with a team member in my work environment, I would have to confront it immediately. If it was a friend of mine this was exhibiting this behavior at work, I would still confront it and hope they would understand that it is coming from a place of trying to protect my friend, and the patients. Before I would report team member, I would know the signs and symptoms of substance abuse. According to Darbro (2011), “Signs and symptoms of a prescription-type substance use disorder can include coming to work on days off and volunteering for overtime. Coming to work while on vacation can suggest the need to divert prescription drugs from clinical supplies” (p. 8). After knowing these signs and symptoms, I would talk to the person under the influence before going to my charge nurse. If I were not to report this situation, I would be doing my staff and my patients a disservice. Darbro (2011) states the following: Many states have mandatory reporting statutes or rules and the nurse manager may face action by the board for failing to report misconduct of subordinates. Regardless of the existence of such requirements there is a moral responsibility to the public to report nurses who pose a threat to patient safety. (p. 72)

Many resources express the importance of knowing the signs of substance abuse before reporting an individual. It is important to do so before filing this complaint, so the nurse has an adequate amount of information and proof before making the accusation. The nurse that is chemically impaired is influenced to file a complaint against their self. If someone filed a complaint against that person before they had a chance to turn their self in on their own, they should still contact the Board of Nursing on their own as soon as they can.

If you receive notice that you are the subject of a complaint, contact the BON immediately. The investigation, from initial complaint until board decision, will be handled in a fair and just manner. Your BON has an established process in place to ensure your rights under the law. A BON representative will describe the details to you and answer any questions you may have. (“State and Territorial Boards or Nursing,” 2018).

This ensures that one is being compliant with the Boards of Nursing and can make the process easier than if one was to deny the allegation. It also shows accountability for ones actions, which is a characteristic all nurses are expected to have. While nurses know the consequences possible to come when working under the influence of substances, they also know the consequences that can arise when not reporting it. With that being said, it is important for patient safety to document this situation, it can also help the nurse potentially avoid additional charges, which can help them have a better chance of regaining their license back.

This dilemma can be an awkward situation for nurses to encounter. Research by Killion and Dempski (2006) says the following: Coworkers of an impaired nurse often struggle with the ethical issue of whether or not to report their suspicions. Reasons cited for not reporting include loyalty, uncertainty, fear of jeopardizing another’s job, fear of being labeled a “whistle blower,” and feelings of inadequacy regarding what to do or say. (p. 119)

Nurses form a bond with their coworkers and may not want to come across as “telling on” a fellow coworker. Although it could be a tough ethical dilemma, it is now a legal matter to report this. Killion and Dempski (2006) says, “The ethical dilemma has been resolved, however, by the legal obligation to report, as mandated by many state reporting laws” (p. 119). This helps ease the uncomfortably of contemplating on whether to report someone, even if it is a friend. It is also important to remember that when reporting a fellow team member, it should be reported to the charge nurse first, and then followed by the Board of Nursing. The nurse manager is the person responsible for taking it into further action.

Another problem among high stress and long hour jobs, like nursing, is overuse of a medication that is prescribed to them. When starting as a new nurse and put on a night schedule, it is liable that they may have some difficulty finding the right sleeping pattern. What if a nurse has a prescription for Adderall, but is taking it to stay awake and focused during a night shift? Where do someone draw the line in an ethical dilemma? McColl (2018) says the following: Stimulants and caffeine can boost performance acutely but do not address the underlying sleep deprivation and thus are not a viable long-term solution. Furthermore, concern over the side effects, addiction and performance degradation with current pharmacologic interventions makes their safe use discouraged (para 13).

This statement reiterates the blurred lines of “safe” versus “misused”. Some nurses may have attention or hyperactive problems that they need medication for. Others may not need it, and may over use it due to fatigue, wanting an extra kick, or many other reason. How can you separate the two? McColl (2018) also states that “Amphetamine abuse is defined as non-medicinal use of amphetamines for euphoria, well being, sharpening of attention and increased levels of energy” (para 10). Nurses can be aware of signs of amphetamine abuse and keep in mind if the nurse in question has a prescription or not. This can help decrease the incidences of misuse of prescription medication in the work place.

This topic over ethical dilemmas has taught me that nurses are held to a rightfully strict standard of code. As stated before, due to the fact that nurses are working with people needing assistance with their health, It is extremely important that nurses are focused and alert, with a clear mind. This is a hard or even impossible to achieve when under the influence of drugs and alcohol. When nurses come to work while under the influence, they are putting patients lives at risk while also putting their job on the line, as well as possibly having a felony charge on their record. Nurses are there to be care takers to patients in need. Its important that each and every nurse keeps that in mind when walking into work everyday, and before taking something that could impair their judgment, and possibly costing someone their life.

References

1. Killion, S. W., & Dempski, K. (2006). Legal and ethical issues (2nd ed.). Sudbury, MA: Jones and Bartlett.
2. MEdIC: Case of the Night Shift Stimulants – Expert Review and Curated Community Commentary. (2019, March 31). Retrieved from https://www.aliem.com/medic-case-night-shift-stimulants-expert-review-commentary/
3. Darbro, N. (2011). Substance use disorder in nursing: a resource manual and guidelines for alternative and disciplinary monitoring programs. Chicago, IL: National Council of State Boards of Nursing.
4. Tanga, H. Y. (2011, March). Nurse Drug Diversion and Nursing Leaders’ Responsibilities. Retrieved from https://nursing.ceconnection.com/files/NurseDrugDiversionandNursingLeadersResponsibilitiesLegalRegulatoryEthicalHumanisticandPracticalConsiderations-1382031396195.pdf
5. Jouria, J. M. (2016, July 10). Recognizing Impairment In The Workplace. Retrieved from https://nursece4less.com/Tests/Materials/N217Materials.pdf

Stakeholder Analysis

I have experienced and witnessed many ethical dilemmas which have made impacted my own ethical decision-making in life. An ethical dilemma is best defined as a “decision-making problem between two possible moral imperatives”. One dilemma in particular that I would like to share involves my aunt facing a serious ethical decision in her workplace. My aunt is a social worker and a fundamental part of her job is ethical awareness. As we know social workers are supposed to maintain confidentiality regarding intimate details about clients who use their services, but there are exceptions to these guidelines especially when it poses a threat to society or themselves. Another important factor social workers need to acknowledge is their own accountability for their actions towards their clients their colleagues, the professional association, and to the law. A social worker must display integrity by not abusing the relationship of trust with clients while recognizing the boundaries between personal and professional life. As you can imagine social workers face ethical dilemmas on a day-to-day basis when dealing with people’s personal problems. The ethical dilemma which my aunt faced was when she was working with 9-year-old Klaudia, her older Gena who is her present guardian, and her mother, Natalia. Klaudia had been taken away from her mother and placed in the custody of the sister because the mother was abusing drugs and obviously neglecting her motherly duties. After a year, the mother completed rehab and stayed clean while living on her own. Not only was she sober in her own apartment she also had a steady job working as a cashier at Shop Right. My aunt has been working with this family for over 2 years which created a strong relationship within the family. Everything was going great with this family until one of the meet-ups Natalia had with my aunt. Natalia confessed that she made a mistake by taking drugs again the weekend prior. She confessed to my aunt about the situation because they have developed a strong relationship over the years and Natalia needed to confide in my aunt. She admitted she was wrong and promised not to do it again while begging my aunt not to tell the judge. Natalia also stressed the importance of seeing her younger daughter and hopes in getting her back and if she couldn’t see her again, she would use drugs again. My aunt understood that she made a mistake and believed that this has been the only relapse she had. My aunt also believed that she would never put her daughter at any risk or danger by being under the influence of drugs or alcohol during her visits. However, under the code of ethics in her job requirements, she is required to document what Natalia has confessed and to seek supervisory advice, even if it meant Natalia losing her right to see her daughter again. My aunt also had to consider the risk of losing her job if she did not properly document the drug abuse. In conclusion, my aunt knew she had to follow protocol and report Natalia taking drugs. The possibility she could do drugs again while taking care of her daughter was too great of a risk to take. In the end, my aunt believed by reporting Natalia’s drug use was not only morally right but also professionally the right thing to do. Not only did she consider the effects her decision would have on the mother, but also the effects on Klaudia. Although my aunt had a trusting relationship with this family, she felt if she hadn’t reported Natalia, she would be dishonest towards her work as a social worker by violating agency policies and keeping valuable information that could have potentially hurt a little girl. I personally believe my aunt made her decision ethically while keeping the best interests of everyone involved in mind. She may have lost Natalia’s trust on top of losing her as a client, but at least my aunt acted in full accordance with both legal proceedings and agency policies.

There were many different stakeholders affected by this decision. Most importantly, the family was affected in different ways (Natalia, Klaudia, and her older sister Gena). My aunt’s agency and their employees. Other stakeholders that were affected by this outcome are me, my family, and those we had told the story to I truly believe that the decision my aunt made was the “right” outcome. Utilitarianism is that an action is right if it results in the happiness of the greatest number of people in a society or a.

The stakeholders in my Ethical Dilemma are:

• My aunt
• Suzan
• Gena
• Klaudia
• My aunt’s employees
• And my family
• My aunt’s family

Through the lens of utilitarianism, my aunt should have considered all the consequences that her decision would bring. She also has to pick the decision not only that brings the minimum negative consequences but that brings the greatest happiness to the greatest number of people.

Based on my aunt’s decision, I believe that she followed the Utilitarian approach most when making the final decision. Her decision produced the greatest balance of good over harm. I also believe that my aunt represented the rule utilitarianism approach in her decision-making in deciding whether the implementation of an action, as a rule, would be beneficial to society by following her agency policy and rules. She had to deal with consequences while reducing the harm her outcome would have on the family, her job, and her employer representing the utilitarian approach. She had to consider the common conditions that are important to the welfare of everyone in the common good approach. Also, we see that there are other factors besides her own feelings about the situation that was important in the outcome. Another element is how Natalia admitted that she was wrong and promised not to do it again while begging my aunt not to tell the judge. Her decision not to do drugs anymore is very positive and brings enthusiasm to everyone. For Klaudia and Gena as far as safety concerns were, the outcome was great. The mother must feel betrayed but at least she can continue to get help and her health is being cared for. My aunts’ other employees in the agency were affected by this decision as far as being able to trust my aunt and making sure that each employee follows the rules and different policies. All her staff was trained properly, and they would be competent to do their job which would make everything run smoothly. When everyone does their job and works in a team it creates a positive ambiance and also makes work easier. Other stakeholders that were affected by this story are me, my family, and other people who know about this story. It affected me as I now think of the difficult decision my own aunt made when I am faced with an ethical dilemma and how in the end, my decision will ultimately affect many people. My family and other people around us have now understood the importance of ethics whether in the workplace. By using the utilitarian approach, not only were the conditions of the family important but also following the law and considering the welfare of others who may be affected by not reporting the mother’s drug use. In this case, it’s possible that my aunt didn’t want to betray the trust of her client on a personal level and deal with feelings of guilt if Natalia relapses into consistent drug use as a result of her losing the right to see her child. These factors could have prevented my aunt from making the best decision, but she ultimately looked beyond her personal feelings and what was best for just one individual. If my aunt didn’t follow the policy of documenting Natalia’s drug abuse to not feel guilty about it later and to not betray her trust, then she would have portrayed ethical egoism, only acting in her own self-interest. I am a huge supporter of the utilitarian approach when it comes to making ethical decisions, especially this one. I think it’s important to do what’s best for the common good and reduce as much harm as possible when you are put in an ethical dilemma such as mine.

However, in the lens of deontology that would’ve been an erroneous decision to make. This is because according to deontological ethics, my aunt’s obligation as the decision-maker is to follow a series of rules to differentiate right from wrong rather than considering all the consequences and the happiness of all of those who could be affected by her decision. If my aunt was to use deontology ethics to make my decision, she would have to stay loyal to her friendship with Natalia. If my aunt’s decision was based on her own personal self-interest to avoid feeling guilty about the effects on just the mother, she would have represented ethical egoism. If my aunt didn’t follow the policy of documenting Natalia’s drug abuse to not feel guilty about it later and to not betray her trust, then she would have portrayed ethical egoism by acting in her own self-interest. Personally, I believe that if my aunt would have based her decision on ethical egoism, I will consider that as a “wrong” one. I think making a decision based on universal rules is hard because everyone can prioritize and interpret these rules differently. I think, my aunt’s loyalty to Natalia’s friendship could conflict with her loyalty to herself and not being truthful when she is asked about a certain matter. It would also conflict with the fairness of my aunt to other coworkers by being an example for everyone that works for her. It wouldn’t be fair to them to hide what Natalia is doing wrong to keep as a secret.

I think that only utilitarianism ethics was part of my decision. However, I think utilitarianism is reflected more than deontology. In this situation, I don’t believe there was any way my aunt’s organization could prevent the situation. My aunt followed the agency policy and did what she needed to do as far as documenting the information and reporting it to her supervisors. I think the decision she made was mutually beneficial to both her organization and her job position. She has excelled in her organization and has a great reputation within the organization because of this dilemma. She can use this experience as a reminder when faced with other ethical dilemmas she may encounter. She can now not only think of how the decision will benefit the stakeholders involved but also how it may benefit herself, for example, her position in the organization. It was definitely a learning experience for her and her co-workers. Even though it used to be a learning experience for them, it was also one that helped me learn as well which is why I chose this as an example for my analysis. I am a very sympathetic and warm-hearted person so when I am put in an ethical dilemma or situation where my feelings would be affected as well in the outcome, I can use this situation to help guide me and move forward in any ethical dilemmas I may face in the future.

Abstract

Throughout our history, legal and illegal drugs have been a topic of discussion and a concern for society as some of the worst drugs ever have made it to the streets of our communities and destroy lives every day. Illegal drugs like meth, cocaine, LSD, and heroin are just some of the major drugs that have left their footprints in communities and put people who use them in danger of losing more than their freedom.

One specific illegal drug, which has differing opinions about its use and danger, is called cannabis sativa, or marijuana. Cannabis is a plant that is very versatile and can grow wild in many of the temperate and tropical areas of the world (Editor, 2013). The main active ingredient in cannabis is THC, delta-9 tetrahydro-cannabinol, from which the user can feel different short-term effects like a feeling of well-being, drowsiness, increased appetite, bloodshot eyes, and anxiety or paranoia (Editor, 2013). Cannabis has been a topic for scrutiny in our society for a very long time but recent changes to laws and legalization have really changed people’s perspective on the drug and its popularity continues to grow.

Legalization of cannabis began to take shape back in 1996 in California, as the state officially made medical marijuana use legal. Now more than twenty years later there are over 29 states that have legalized the drug in some form with states like Colorado and Washington fully legalizing the recreational use of the drug (Trumble, 2017). Most of those states have only legalized the medicinal use of cannabis as it has shown to have many health benefits. Studies have suggested that the medicinal use of cannabis has helped lower the suicide rate in some states for a particular demographic, males age 20 to 39 (Dills, Goffard, & Miron, 2016, p. 11). Cannabis has also been used to treat many other illnesses and is widely recommended to be used for pain which is much safer for a person to use and they would avoid using highly addictive and harmful prescriptions like painkillers and tranquilizers.

On the other hand, cannabis does come with its risks when it comes to legalization and recreational use. Cannabis studies have been mainly focused on the short-term effects of its use and the studies for the long-term effects are still in the infancy stages of their research. There are also concerns on how the legalization of the drug will affect teenagers and if their use will increase.

One of the most difficult obstacles after legalization is how corporations will manage to keep the new promising business ethical in terms of how they operate and promote the drug to the public. Public perception on cannabis has been improving over the years but we are still far from completely accepting its legalization and recreational use. In order for this new industry to gain ethical recognition from the public and become a consumer friendly business, executives must take into consideration the second and often most powerful aspect of human nature, the desire and need to care for others and for ideals and causes that transcend one’s self-interest (Mackey & Sisodia, 2014, p. 16).

Legalization

The legalization of cannabis has had to go through some major obstacles, especially since the drug is still federally illegal. Julie Steiner, a professor who teaches cannabis law and policy at Western New England School of Law, raised a question of social equality when it came to the legalization of cannabis and the programs that should be created to help those communities impacted the most. Ms. Steiner states that marijuana prohibition, as part of the war on drugs, has had a very disproportionate impact on our society by targeting communities with minority populations (Rifkin, 2019). Ms. Steiner’s proposal was that as the new marijuana industry developed, there should be specific preferences given to those who have been the victims of the tough cannabis laws and the impact that it has had on their well-being and criminal record. Records show that arrests and incarcerations in these minority communities far exceeds those in other communities that have much smaller to no minorities in them.

Then there is the debate on how to change and create laws for cannabis that would protect their businesses and stakeholders as legalizing on the state level doesn’t change the fact that cannabis is still illegal on a federal level. There have been numerous circumstances that have affected cannabis businesses and their stakeholders like banks not wanting to work with them because of conflicts of state and federal laws (Quinton & Simpson, 2019). This makes it extremely difficult for people who are starting up cannabis businesses to legally and effectively establish themselves as legitimate entrepreneurs.

Economic Impact and Corporate Social Responsibility

States that have legalized cannabis have been able to take advantage of the drugs popularity and generate huge amounts of revenue through taxation and the selling of cannabis products. Two marijuana analysis and investment firms released a report that stated that the cannabis industry has been steadily growing as cannabis sales grew from $4.6 billion in 2014 to $5.4 billion in 2016 (Hauser, 2016). With this continued growth, funds are considering the ethics of investing in marijuana. If the corporation that investors are looking to work with can relate to the standard of corporate social responsibility, holds that business has a social responsibility to do good things and to make society a better place (Hartman, DesJardins, & MacDonald, 2018, p. 179), then it would be able to ethically justify investing in such an industry.

Cannabis legalization has also created a huge opportunity for job growth in the states that have legalized the drug. According to a research study conducted by hub leafly’s 2019 cannabis jobs count, the cannabis industry employs more than 211,000 full-time workers in the U.S. (Murphy, 2019) with a total of 300,000 if you include indirect jobs associated with the industry. This type of job growth is huge, and it provides communities with job opportunities and self-growth as more jobs become available and unemployment rates continue to sink.

Corporate social responsibility, the ethical responsibilities that a business has to the society in which it operates (Hartman, DesJardins, & MacDonald, 2018, p. 180), needs to be the foundation that new cannabis industries use to build their product and engage with their stakeholders in an ethical and legal manner. When this is done correctly, not only does the business flourish with profit but the communities and the other stakeholders who support the business will be able to reap the rewards of a tightly knit community focused business. Every conscious business has a higher purpose which needs to address the fundamental questions as to why the business exists and why do they need to exist. This purpose is the glue that holds the organization together and no matter its specific intent, the purpose reduces the friction that can come from inside of the organization by pointing everyone in the same direction and moving together in sync (Mackey & Sisodia, 2014, p. 46).

Without this approach, a business could put themselves in jeopardy of losing more than their profits as the business would ultimately fail as their purpose would be focused on the wrong things. Take Enron for example, their purpose was misaligned with what a business should be and they were worried about making profits more than they were concerned for their stakeholders. Enron’s real trouble came when their market-to-market accounting approach failed them miserably and they misled investors into the value of their stocks and business portfolios (Palepu, 2019, p. 5). This is what led to the biggest corporate financial meltdown that we had seen in the modern era and is a prime example of what a lack of corporate responsibility can do to a business when their ethical ideologies are absent from their business practices.

Ethics and Business

With the cannabis industry gaining popularity among voters and more states are looking to legalize the drug in some form during the coming elections, businesses will need to focus on the ethical dimensions of how they are marketing, selling, and promoting the product. To do this, executives will need to stray from the “business first” concepts that seem to have been overwhelmingly accepted by most of the top businesses in this country. Executives will be expected to have a high sense of moral values to avoid any conflicts of interest, can arise when a person’s ethical obligations in her or his professional duties clash with personal interests (Hartman, DesJardins, & MacDonald, 2018, p. 499), that can manipulate their decisions and the way that the business is conducted. This can have a negative impact on not only the business itself, but it can also feed into the negative narrative that many people have about capitalism in general. According to the book Conscious Capitalism, by Raj Sisodia and John Mackey, “Capitalism is portrayed as exploiting workers, cheating consumers, causing inequality by benefiting the rich but not the poor, and destroying the environment” (Mackey & Sisodia, 2014, p. 15). These narratives of businesses in general will likely carry on to the cannabis industry along with all of the other moral questions that much of society has about legalization.

The cannabis industry will need to really establish a solid ethical foundation in order for public perception to improve over time and keep the industry alive. As stated by Marisa Macho, MBA 240 classmate, “Corporations are primary players in our economy, environment, and overall experience of everyday lives. This understanding that there is more to business than just creating returns for shareholders is part of being a conscious leader” (Macho, 2020). Without this leadership, employees can feel disengaged and a diminished sense of moral, like Mr. Bell from class who’s leader wasn’t engaged enough with him and the team by not being available when they needed her (Bell, 2020).

Canopy Growth Corp. is a cannabis company that has taken some initiatives to promote ethical business practices along with other companies in the same field. This alliance was formed to prove to consumers that the cannabis industry can be good corporate citizens. Canopy Growth Corp. has committed to setting a high bar for the industry by accepting and practicing the five page “social responsibility framework” that outlines the guiding principles that include transparency and responsibility, like prohibiting the sales of cannabis products to minors (Editor, Marijuana Industry Sets Environmental, Ethical Goals, 2019). These principles also focus on developing policies to manage greenhouse emissions and using package materials that reduce the consumption of overall raw materials and special focus on using farm practices that reduce environmental harm (Editor, Marijuana Industry Sets Environmental, Ethical Goals, 2019). This fundamental approach provides a foundation for Canopy Growth Corp., and other cannabis businesses in the coalition, to establish on and prove that the cannabis industry will be one of ethical values that serve for the better of our communities and environment. Universally this approach will provide the industry with components from all three major ethical frameworks which are; utilitarianism, ethical tradition that directs us to decide based on overall consequences of our acts; principle-based framework, which directs us to act on moral principles; and virtue ethics, tells us to consider the moral character of individuals and how character traits can influence life (Hartman, DesJardins, & MacDonald, 2018, p. 68).

What more can cannabis industries do to prove that they will operate in an ethical manner? The answer is complicated because there is still a negative stigma attached to the use of cannabis that will follow the drug for as long as we know. The key is for cannabis businesses to have more than one plan on how to successfully build an ethical business, in the words of classmate Brad Hauptmann, “There is an old saying that Plan A is always doomed to fail so expect Plan B to take affect at a moment’s notice” (Hauptmann, 2020). With this in mind, cannabis businesses can have more than one solid plan of execution for providing ethical business practices to the industry and prove to be one of the leading markets that focuses on the community and environment.

Canopy Growth Corp. has embraced a values-based culture, a corporate culture in which conformity to a statement of values and principles is the prevailing model for ethical behaviour (Hartman, DesJardins, & MacDonald, 2018, p. 119), within their business to provide values and ethics to everyone who represents the business and to all of the stakeholders that accompany a large institution like this. This will be detrimental to future growth as college students are now able to take courses in relation to the cannabis industry, thus providing future professionals for the business. The University of Maryland announced in June of 2019 that its School of Pharmacy will offer a master’s degree in medical cannabis, and Cornell University’s School of Integrative Plant Science will also add a new course called, “Cannabis: Biology, Society, and Industry” (Butchireddygari, 2019). Canopy Growth Corp. has developed and accepted a code of business conduct and ethics that is outlined in thirteen different codes which are general, reporting violations, disciplinary matters, integrity of records and compliance with sound accounting practices, protection and proper use of assets, confidentiality, conflict of interest, improper business payments, laws-statutes-regulations and stock exchange policies, amendment-modification-waiver and termination code, public company reporting and other public communication, fair dealing, and administration of the code (Linton, 2018), all of which can be reviewed in great detail on the company’s website. Following all of the fundamental values that Canopy Growth and the other businesses in the alliance have accepted, future cannabis businesses can expect to continue to grow and provide many different opportunities for the future.

Conclusion

After doing research and reading about all the different laws that are being looked at for the legalization of cannabis, it is easy to understand why there has been differing opinions about the matter for so long. It is hard to argue the medical research that has shown cannabis to be a useful medicine for people who suffer from different ailments and still condemn the drug for being too dangerous. Cannabis hasn’t proved to be as dangerous as two of the most consumed legal drugs that we have today, alcohol and tobacco. If the cannabis industry

Cannabis still has a long road to go when it comes to full acceptance and integration into our society. For decades, the drug has been unfairly criticized in society and its outlook is starting to look more promising. It will take strong leadership to adopt and create a culture of corporate social responsibility, the ethical expectations that society has for business (Hartman, DesJardins, & MacDonald, 2018, p. 177), and ethically run the business to the standards that would be no less than that you would expect from a major corporation that cares about its communities.

There will always be concerns when legalizing a drug that has been labelled as dangerous and addictive, but with proper communication and education on the drug and its benefits and risks, people would be able to make a more “informed” decision when thinking about how bad cannabis really is. When legalization takes a foot into new territory, that state will benefit with the revenue that will be generated through taxation and sales of the products not to mention the jobs that this new industry will create. We need to educate ourselves about the differences between drugs like cannabis and other more dangerous drugs like LSD or meth and take the time to understand the many different benefits and opportunities that this drug creates. I didn’t even mention hemp in this essay but hemp is its own juggernaut who could lay waste to the lumber industry if we ever decide to save our trees and start using something that is just as reliable and does less damage to the environment when it is harvested.

Resources

1. Bell, A. (2020). On The Job #1 Discussion. MBA 240.
2. Butchireddygari, L. (2019, July 28). Careers in Marijuana Catch On at Colleges. The Wall Street Journal.
3. Dills, A., Goffard, S., & Miron, J. (2016, September 16). Dose of Reality: The Effect of State Marijuana Legalizations. Cato Institute, p. 11.
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Throughout our careers, we all are presented with ethical dilemmas. Regularly reviewing your own professional ethical standards and values is necessary to maintain a balance in practice. As a student in social work, I am faced with the task of continuously challenging my personal values and principles against interactions with persons whom I work with; this is an exhausting responsibility. Reflecting and resolving ethical dilemmas based on our professional values is essential to maintain accountability as social workers so that we can achieve the best outcomes for people.

My personal ethical standards and values have been developed out of my experiences as a private child carer. Most of the children I looked after were from single mothers dealing with drug and alcohol issues or domestic violence. I spent many hours talking to mothers about their life experiences that have brought them to their current circumstances. Many of the discussions were around safety, rehabilitation, and access to services. Working with children and women of domestic violence, and drug and alcohol abuse led me to situations that challenged me to the very core of my values.

I was given children to care for because the mother’s party had gotten out of hand, babies recovering from the mother’s friend forcing them to inhale marijuana, basic neglect, and other horrors. I have been given children for months on end with no knowledge of when I can return the child to the mother, and no pay to cover the child’s care. Child protection services (for those times) operated under the rule that if the child is being cared for by me, then there is no crime or neglect. My lack of wages is not of concern, and if I returned the child to their mother while the parent was under the influence, I would be arrested and charged with child endangerment. My values and ethical standards in the care of a child, care of a mother, and care of myself were all challenged. I developed regular care and action plans depending on the appointment and initial intake interview.

In student placement, a recent experience in resolving an ethical dilemma has magnified the importance of engaging in relevant processes and practice to achieve equilibrium and prevent complications. This paper aims to explore the ethical issues faced by the use of unconditional positive regard in practice, a vital tool. It also will highlight an ethical dilemma about the AASW Code of Ethics 2010 and how this situation was resolved. I will begin by detailing a case study from practice and discuss the ethical dilemmas that arose from the situation and the process of resolution. The lessons learned from this process about the AASW Code of Ethics 2010 will also be highlighted.

Case Study

For five weeks, I had been counseling Natasha, a 14-year-old female (I was a student in my final year placement). Natasha had stopped attending school because of severe anxiety; the anxiety was clinically diagnosed by her psychologist. During our counseling sessions, Natasha disclosed that her anxiety has been a growing issue since her childhood, and this has had a major impact on her developmental years. This included developing relationships with her peers and being comfortable in the school environment. At the intake stage of our counseling, Natasha formulated her long- and short-term goals, which included positive internal self-talk, returning to school and completing her education, going to TAFE, and working towards a photography career.

The theoretical framework of the solution-focused framework and the strengths perspective were the main foundational applications of the therapeutic approach. By using unconditional positive regard, I was able to encourage Natasha to externalize the problem. This allowed Natasha to be able to explore her strengths and abilities to reach her goals. The use of unconditional positive regard has been vital in building trust with Natasha, so she was willing to be open about discussing her anxiety with me. Unconditional positive regard and reflective listening have also been vital in maintaining my ability to avoid becoming a trigger for Natasha’s anxiety when we have been talking about her issues.

The use of unconditional positive regard has brought with it some ethical dilemmas. While it has been useful in developing trust and openness with Natasha when she was discussing her anxieties with me, Natasha developed an inappropriate emotional attachment to me. I noticed that during our sessions Natasha was open to engaging in her goals, but she constantly required me to positively affirm her actions. I also noticed that Natasha’s motivations towards achieving her goals became more to please me and gain a warm, positive response. When I attempted to withdraw my responses to her achievements, I noticed Natasha became less motivated to move forward, and I even noticed Natasha deliberately failing in areas where she had already overcome, just to draw out my unconditional positive regard response.

Natasha’s care team included her family, school, and a psychologist who were all working on Natasha’s mental health in a collaborative approach. Part of Natasha’s overall care plan was that she would return to school within a set time frame, and pressure was being put on me to move Natasha forward towards this goal. There was some trepidation expressed as to how long Natasha has been absent from school and that she was not engaging adequately in the online classes and tasks that were put in place to assist Natasha’s education while she was absent from school. At the care plan meeting, where Natasha’s progression was the primary focus, it was depicted that anxiety research stipulates Natasha’s return to the source of her anxiety which is the school environment, and it was my role and duty to make this happen. I was then given a time limit of four weeks, which left me feeling uncomfortable with the lack of attention to Natasha’s achievements to date. This is where I reflect on the ethical dilemmas about the AASW Code of Ethics 2010.

Ethical Dilemmas, Resolution and the AASW Code of Ethics 2010

As a student, I felt anxious about the outcomes of the meeting and why this raised issues for me. I was concerned about my adequacies as a professional, but since I was still a student, there should be some guidance if there was an error in my application to the best practice models. I met with my supervisor who instructed me to spend my weekend reflecting on why this raised issues for me. This was the best thing she could do as an instructor.

I did not doubt that Natasha’s care plan was built from professional experience and with Natasha’s recovery as the primary focus. The medical care and corresponding care plan must be followed. My personal values and ethics were applying the solution-focused framework, as well as the ethical standards and values applied by the organization’s best practice model and code of conduct. This meant that I believe that Natasha is the expert in her own life, she has inherent strengths and extensive resources that can be drawn on to solve the problem. It is the client who sets the agenda of therapy, and their goals define the direction their care takes. My question is if the person is in charge of their goals and therapeutic approach, who are we to tell Natasha to return to school in four weeks? The goals in Natasha’s care plan did not always correlate with Natasha’s own personal goals. Reflection upon my views and standards within the context of being a student under supervision and the AASW Code of Ethics 2010 highlighted many values and principles.

Inexperienced Student

It is necessary to first acknowledge my lack of experience as a student in placement. This is an important factor to consider because my skills and abilities in counseling and ethical decision-making practices are still developing. I am being supervised, but if I were on my own, my inexperience put me at greater risk of drifting from ethical standards and the AASW Code of Ethics, which could cause harm to the person.

The comments in Natasha’s care plan meeting had a huge bearing on me as I felt pressured to insist Natasha return to school earlier than she had planned. I doubted my effectiveness in practice, and the achievements that Natasha had obtained during her time with me became veiled in a cloud. I discussed this with my supervisor and she mentored me about taking on responsibility for the issues. This in itself became an ethical dilemma because I had taken on board the responsibility of Natasha achieving her own goals. I had become too involved with the person I was caring for, a mistake regularly made by students, inexperienced workers, and even seasoned social workers. My supervisor reflected to me that as social workers we need to be mindful to not take on the responsibility of resolving a person’s problems. We facilitate self-determination, informed decision-making, and empowerment, but we are not responsible for decisions or when the care plan and clients’ own goals clash. In critically analyzing the AASW Code of Ethics, I will consider the ethical dilemmas and issues and their application to the situation with Natasha.

Person-Centered, Self-Determination, and the Highest Possible Regard

Self-determination focuses on a person’s rights to make his own goals and interventions, in the absence of the impingement of other rights and responsibilities like self-harm or harm to others. It is the equality between the person and the social worker in their relationship that assists and ultimately drives the successful person; this is a core value described in the AASW Code of Ethics. In the interest of the client, a successful care plan is a collaborative approach with other appropriate service providers, including social work, and, where possible, upholds the person’s right to self-determination. Natasha’s self-determination allows her to formulate her own goals and how she can work towards returning to school. If her goals and aims were not upheld, I would run the risk of breaching her trust, and a shift in the equilibrium of the relationship would occur. This situation is more difficult because of Natasha’s age, there is a question about her competence to drive her own goals because of her maturity levels. However, Natasha’s failure to return to school is not necessarily a reflection on her abilities to drive her own therapy, and if I were to take over, this would have a detrimental effect in a person-centered framework, Natasha’s goals take priority, however, this does not stop me from renegotiating a time frame with Natasha with careful use of reflective listening and positive regard.

Informed Choice and Use of Creativity

Informed choice enables a person to self-drive his goals with all of the right information available to them. The client needs a range of alternative choices and a wide range of information made available to them so they can make the correct self-determined choice. For Natasha to make informed choices, she needs to know about other strategies and alternative methods to be able to obtain her goals. The solution-focused framework maintains that the choice must remain with the person, but it is the role of the social worker to educate and inform Natasha about the best option to choose. If I dictated to Natasha that she must be in school in four weeks, this would hinder her informed choice and destroy her self-determination. Based on the 2010 AASW Code of Ethics and the solution-focused framework, the best approach is to go with the person and try to apply an alternative approach to the situation. My supervisor and I formulated an approach that incorporated positive regard, person-centered therapy, and art therapy in the form of creative writing to guide Natasha to a better understanding of her goals.

The use of unconditional positive regard allowed Natasha to feel most comfortable and supported, while at the same time, she felt lifted up in her successful application so far. In the application of art therapy, I sat with Natasha and we wrote our own adventure story where we drove through a labyrinth of scenarios in the journey to obtain Natasha’s goals of going to school, going to TAFE, and becoming a photographer.

Empowerment

Empowerment is the groundwork for the self-determined practice and informed choice, this is summed up by Zastrow: “Social work is done with, not to a client”. The relationship between a person and a social worker is built on support systems for the person to make informed choices about their goals. Overall, the aim is to empower the person to solve their own problems and explore and search for their own information so they can self-advocate. The therapeutic process of Natasha’s case is to focus on her goals and not take control.

Lessons Learned

In considering the ethical dilemmas I have faced as a worker, I learned several lessons from Natasha’s case. Solution-focused theory plays a major role in the values and ethical standards of social work because these disciplines focus on self-determination, and both disciplines complement each other, making them easy to apply. The addition of art therapy as a means to educate Natasha and make sure that she has a complete understanding of her informed choices was a creative idea. I wanted to reach Natasha at her level and inform her that she needs to return to school and have Natasha explore why doing this earlier would be the best move forward.

As a student and moving into practice, I found that the constant parallel reflection of my values and ethics against the AASW Code of Ethics was a valuable and vital tool. It is my responsibility to improve practice by critically reflecting and reanalyzing the situation to allow for new actions, engaging in supervision and education, and other supports that provided me with the ability to self-govern and resolve the ethical dilemmas that arose with Natasha that are not purely based on my own reflective skills.

The use of unconditional positive regard and the ethical dilemmas that arose with it have also been managed through reflecting the ethics and values provided by the AASW Code of Ethics. The AASW Code of Ethics provided a framework that allowed me to challenge conflicts between other professionals caring for Natasha. This also allowed me to ground my values in practice to self-determination and respect while helping her reach her goals.

Conclusion

As a student, my learning curve integrating theory into practice is steep, and the consequences of my errors can be harmful, particularly in ethical practice. This paper reflected upon the case and demonstrated reflection should be done in conjunction with the AASW Code of Ethics. This has shown the structures of the social work code of conduct and how reflection provides practitioners with the ability and skills to learn new tools and initiate core values that may have been overlooked. The use of unconditional positive regard as a vital tool in social work practice has provided its own ethical dilemmas. These issues were resolved with further reflection on my own ethical values against the AASW Code of Ethics. By introducing a creative approach through the use of art therapy and with the aid of my supervisor, I was able to realize my errors and make corrections with little impact on the person.

References

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The fourth industrial revolution

In the twenty first century there has been improvements in technology such as the introduction of artificial intelligence that refers to the process of making technological devices intelligent, in the school context artificial machines (robotics) are equipped and trained to take the role of the teacher with the aim of improving the quality of education to minimize underperformance in different schools. The consequentialist theory determines how moral actions are based on the results that they produce. It is divided into different theories that include Utilitarianism which measures the correctness of an action based on the amount of happiness produced for the majority of the people and how pain can be reduced (The basics of philosophy, 2018-2019). This essay discusses the ethical dilemmas based on Utilitarianism theory that the fourth industrial revolution pose on the future of the South African education system.

How is the Fourth Industrial Revolution used in Education and its advantages?

Wisskirchen et al (2017) describes a “smart factory” as an area that consists of intelligent machines that are responsible for doing all the work that is required and supervised by human beings, a “smart classroom” therefore would be one whereby a robot transfers the knowledge to the learners while the teacher becomes the supervisor. Some of the advantages include improving the quality of education, providing inclusive lessons whereby learners acquire knowledge in a different and interactive manner. Transferring knowledge to the learners both physically and digitally will also equip the learners with the knowledge and skills that will enable them to improve their societies. Another greater advantage that Artificial intelligence has over human intelligence is the ability to make decisions that are well informed, that are not influenced by feelings and make few errors. Marwala (2018) describes the Fourth Industrial as the main “Ingredient” that needs innovation and the ability to shift our thinking to the global scale in order to improve the quality of the education system in South Africa.

Ethical Dilemmas that the Fourth Industrial Revolution pose on the future re-imagination of South Africa education.

According to Molefi (2017) some the negative outcomes of the fourth industrial revolution is that it leads the creation of unprofessional employment with low salaries and does not provide long term decisions. This will also lead to job insecurities compelling most teachers to leave the profession. Artificial intelligence also does not encourage creativity and originality whereby people share knowledge and experience to learn but instead creates a society that prefers what is approved by the majority and this according to the theory of utilitarianism means that only the needs of the majority are regarded as important when making decisions. Molefi (2017) suggests that in order for the quality of the education system to improve in South Africa, they should try to emulate countries with good education systems such Canada that are using technology to improve their education .Unlike Canada, South Africa encounters challenges such as power outage, access to basic needs such as infrastructure which could derail and make the process unsuccessful.

Another challenge that affect most developing countries is accessibility and affordability since these devices are expensive. South Africa for instance has also been experiencing issues of indiscipline and violence in schools, therefore replacing teachers with artificial intelligent machines that cannot interact with the learners socially will lead to the learning environment becoming more unsafe. Marwala (2019) also emphasize that although artificial intelligence might be the solution to improve the quality of education but there is an issue of language barrier because these devices are produced in countries that use English as an official language, they therefore are unable to perform some tasks such as translating to other African languages. This will become a challenge in most South Africa public schools where not all the learners are fluent in English and teachers sometimes use native language to explain in the classroom. Wisskirchen et al (2017) emphasize that artificial intelligence requires sufficient knowledge as well as people who are qualified to use the system. The industrial revolution also will make it irrelevant for learning to take place in the classroom as there are online courses that will enable learners to access the content everywhere they are.

The Utilitarianism theory

The utilitarianism theory focuses on the happiness or the unhappiness that an action produces (The basics of philosophy, 2018-2019). The theory acknowledges the importance of consequences that are produced by actions but many argue that the idea that happiness is the ultimate good can be misleading as people prefer certain things based on their value and not how they feel about them, for instance the fourth industrial revolution was introduced in South Africa to improve the quality of teaching and learning and not because it makes the learners and teachers happy. When making decisions that affect the society the interests of people should be regarded equally as they might have a negative impact on the minority who do not agree with the decision, which will lead to more inequalities in society. Therefore many critics propose that instead of focusing only on happiness, interests and welfare of the majority of the people, actions should also be taken into consideration.

When the focus is only on the happiness of the majority the rights of the minority become violated because the main focus is on producing desirable results regardless of whether the actions produces harm to those who are against them. The theory has also being criticized for not taking into consideration the past, for instance what lessons can be drawn from the past in order to make more informed decisions. The Utilitarianism theory would argue that because children who grow up in the twenty first century have more access to mobile devices and learn quickly how to use them compared to the way they acquire writing skills, it would be beneficial to transfer knowledge to the learners using technological devices. The theory does not acknowledge the inequalities that might be created as some learners come from households that do not have access to technological devices.

As much as the fourth industrial revolution has advantages that might equip learners with knowledge and skills that are relevant for the twenty first century in an interactive manner, there are also ethical dilemmas such as accessibility, affordability, language barriers, job insecurities and challenges of maintaining discipline in the classroom that needs to be considered in order to ensure that indeed it reaches the goal of providing quality education.

Reference List

1. Marwala, T (2018) “Do Student leaders have what it takes to help South Africa?” Available from: https://www.uj.ac.za/newandevents/Pages/Do-student-leaders-have-what-it-takes-to-help-South-Africa,-asks-UJ%E2%80%99s-Prof-Tshilidzi-Marwala.aspx. Accessed on 8-3-2019.
2. Marwala, T., (2019) “Fourth industrial revolution business opportunities in South Africa” Available from: https://www.uj.ac.za/newandevents/Pages/Fourth-industrial-revolution-business-opportunities-in-South-Africa-.aspx. Accessed on 2-3-2019.
3. Marwala, T., (2019) “The fourth industrial revolution and the prospect of human irrelevance” Available from: https://www.uj.ac.za/newandevents/Pages/The-fourth-industrial-revolution-and -the-prospect-of-huamn-irrelevance.aspx. Accessed on 5-3-2019.
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