Author: Mia Struwig – 3353309
There is a constant discrepancy and conflict between moral values and ethical practice in the health service industry/profession. Before discussing the topic any further, it is important to understand the difference between Ethics and Morals. Here is a video that explains these terms:
On my current clinical rotation, I am expected to work in a ward called ‘Gangster Paradise’. Upon hearing this name, I had a pre-set idea of what it would be like and the types of patients I would find there.
I am currently treating a patient that was arrested for attempted murder and has two police men outside his room at all hours of the day and night. I initially thought (prior to this block) that I would not be able to treat a patient that has a criminal record in the same way I would any other patient due to my moral values, upbringing and beliefs and the fact that I believe strongly in always doing everything within the law and in an appropriate/acceptable manner. This comes down to integrity and sincerity. According to Lachman, Sekerka and Bagozzi (2007), moral courage is an esteemed trait displayed by individuals who despite adversity and personal risk, decide to act upon their ethical values to help others during ethical challenges. I would like to consider myself as an individual that strives to do the right thing even when others choose a less ethical behaviour.
However, when I first introduced myself and met the patient for the first time, thoughts about integrity and sincerity were nowhere to be found. I went inside the room, greeted the police men, and got on with what I was supposed to do. At no point did I feel that I was struggling to treat the patient as he was a prisoner.
As morality is constantly played up against ethical principles, the thought about how other therapists would feel about the patient came to mind after having a discussion about a similar topic with a colleague earlier that day. Most people would struggle to be ethical in a situation like this due to their moral beliefs. I, however, struggle with the opposite.
Ethically, we are expected to treat all patients the same regardless of other factors. I find this particularly easy which stirs worry in me. It raises the question, “Are my moral values not appropriate because I feel different about the situation than others?” In addition to that, Kidder (2005) states that the ultimate goal of morally courageous behaviour is to put ethical principles into action and protect ethical values perceived to be at risk, even in situations where the individual has inner conflict between moral and ethical values. However, even though I consider myself a morally courageous individual, I do not experience this inner conflict between moral and ethical values.
I struggle with concept that I might now begin to treat patients as just another folder number instead of a human being as these external factors do not influence the way I feel about treating a particular patient. Does this make me cold? Does this make me less of a physiotherapist? Does this mean I lack empathy and/or sympathy?
The moral concept relates to integrity, sincerity, empathy and sympathy, etc, while the ethical concept is to treat all patients the same and provide the patient with the necessary and needed medical care and attention.
According to society, one is expected to struggle to treat such a patient ethically due to your moral code. In this particular situation, I feel I do not conform as I struggle with the morality side. However, according to Aultman (2008), there are several articles in today’s healthcare literature exploring and addressing the lack of moral courage in healthcare professionals when faced with ethical challenges. This was particularly interesting for me to learn as I thought I was in the minority with regards to how I felt about morals when faced with an ethical challenge.
On the other hand, how do others feel about this? How do the therapists that do feel this inner conflict deal with it? Day (2007) states that demonstrating moral courage in an ethically challenging situation is critical to good professional practice. According to Mitton (2010), a big portion (more than 50%) of healthcare professionals feel morally distressed in ethical situations that do not align with their morals or beliefs. They feel as if they are placed under pressure and experience a big amount of guilt when faced with certain ethical challenges requiring them to behave in a certain manner, but their moral values say otherwise. In certain occasions they feel prevented from carrying out proper ethical action due to their moral values.
In the end, which is more important? Ethical behaviour? Or moral values? In my opinion, there should rather be a balance between the two. In certain situations the one will be preferred over the other as per professional requirements, however, we are all only human and do have our own personal challenges.
Aultman, J. (2008). Moral courage through a collective voice. The American Journal of Bioethics, 8(4), 67
Ajmera, S. (2015). Ethics vs Morals: Difference between ethics and morals. Retrieved November 1st, 2016 from https://www.youtube.com/watch?v=Og2lXHHWCJ4
Day, L. (2007). Courage as a virtue necessary to good nursing practice. American Journal of Critical Care, 16(6), 613 – 616.
Kidder, R.M. (2005). Moral courage. New York, NY: Harper Collins Publishers.
Lachman, V. (2007a). Moral courage: A virtue in need of development? MEDSURG Nursing, 16(2), 131 – 133.
Mitton, C., Peacock, S., Storch, J., Smith, N., & Cornelissen, E. (2010). Moral Distress among Healthcare Managers: Conditions, Consequences and Potential Responses. hcpol, 6(3), 99-112.
Murray, J.S., (Sept 30, 2010) “Moral Courage in Healthcare: Acting Ethically Even in the Presence of Risk” OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 3, Manuscript 2.
Sekerka, L.E., & Bagozzi, R.P. (2007). Moral courage in the workplace: Moving to and from the desire and decision to act. Business Ethics, 16(2), 132 – 148.