Ethics and Morality (Ethical distress)

The health care has become very complex and ethics has increasingly become a required component of clinical practice. (Kalvemark, et al 2004). This writing will cover some ethical distress.

Ethical distress is defined as a situation when one knows what is right to do but institutional constraints or other constraints make it difficult to pursue the desired right action to do(Kalvemark, et al 2004 ).

In South Africa the health car professions are under the Health Professions Council of South Africa (HPCSA), which a lot of things when it comes to health professions. The HPCSA has also outlines ethical guidelines that are supposed to guide how health care professionals behave and act in their workplace. Some of these ethical guidelines include respect for persons, equal and fairness in the treating of patients, best interest/ wellbeing, integrity, etc.

During my first clinical block this year, I have come across many ethical dilemmas and ethical distress, some of which I experienced myself and some of which I witnessed others experiencing. In this institution that I was working in, there was a patient who had just been transferred from the ICU ward to a general ward that I was working in. this patient’s condition was improving, hence the transfer to a general ward but the patient still needed a lot of suctioning and chest physiotherapy treatment.

According to how we were taught in ICU class and practicals, one is supposed to use the sterile suctioning line only once and dispose it due to hygiene purposes and prevention of further complications to the current condition, and this had formed and become part of my ethics and ethical reasoning. But in this institution, it was not allowed to use the sterile suctioning line once as the main reason was funds. The suctioning line was used several times before disposal and nurses would become trouble to anyone who uses the suctioning line once and dispose it.

This had put me already in an ethical dilemma as I knew the right thing to do but the institutional constraints were in my way of doing that right action (Kalvemark, et al 2004) . I was deeply troubles as I knew the consequences of using that suction line several times. Here I had to first be on the lookout for nurses and when I was finally alone I would then open a new sterile suctioning line, use it, and dispose it making sure that no one saw me. It has been a serious struggle for me for the six full weeks.

Lack of funds to purchase resources also plays a role in ethical distress, as this whole situation that I was facing was merely caused by lack of funds (Kalvemark, et al 2004).


Kalvemark, S., Hoglund, A. T., Hansson, M. G., Westerholm, T.,& Anertz, B. (2004). Living with conflicts-ethical dilemmas and moral distress in the health care system. Social Science and Medicine, 58, 1075-1084.

Health Professions Council of South Africa. (2008). General ethical guidelines for the healthcare professions, booklet 1.



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