Microethical and macroethical dilemma that might occur in health care organizations

Full Answer Section

Macroethical Dilemma:

• Definition: Macroethical dilemmas involve ethical conflicts at the organizational or societal level, affecting larger groups of people or the entire healthcare system. These dilemmas often involve resource allocation, policy decisions, and systemic issues.
• Example:
  • A hospital administrator is faced with the decision of how to allocate limited resources during a pandemic. The hospital has a shortage of ventilators, and difficult choices must be made about which patients receive them. The decision will impact many lives and raises questions of distributive justice.
  • This is a macroethical dilemma because it involves a systemic issue (resource scarcity) and affects a large group of patients.

Legal Case Law Example:

• Cruzan v. Director, Missouri Department of Health (1990):
  • This landmark Supreme Court case involved Nancy Cruzan, who was in a persistent vegetative state after a car accident. Her parents sought ¹ to terminate her life support, but the state of Missouri required clear and convincing evidence of the patient's wishes.  
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  • Microethical Relevance:
    • The case highlights the importance of patient autonomy and the right to refuse medical treatment. It forced healthcare professionals to grapple with the ethical implications of end-of-life care and the need for advance directives.
  • Macroethical Relevance:
    • The case also raised broader societal questions about the role of the state in healthcare decisions and the definition of "clear and convincing evidence." It influenced the development of healthcare policies and legislation related to advance directives and end-of-life care.
    • This case has been used to set precedence regarding patients rights, and advanced directives.
  • This case helps to display the balance between micro and macro ethical concerns.

By understanding the distinction between micro and macroethical dilemmas, healthcare professionals and organizations can better navigate the complex ethical challenges they face.

Sample Answer

Microethical Dilemma:

• Definition: Microethical dilemmas involve ethical conflicts faced by individual healthcare professionals in their direct interactions with patients. These dilemmas often center on patient autonomy, beneficence, non-maleficence, and justice at the individual level.
• Example:
  • A nurse in a busy emergency department is caring for a patient who is refusing a potentially life-saving blood transfusion due to religious beliefs. The patient is conscious and competent, but the nurse believes the refusal will lead to the patient's death. The nurse is torn between respecting the patient's autonomy and the duty to preserve life.
  • This is a microethical dilemma because it involves a direct conflict between the nurse's personal ethical obligations and the patient's rights.