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Ethical Dilemma of Patient’s Disease Awareness

Dilemma Description

A social worker, Marcia working at Owing Mill General Hospital, faces a significant ethical dilemma. A patient called Michael is an older man with relatively fragile mental health and an unstable emotional state. Michael is diagnosed with terminal cancer, and his family is informed about his disorder. However, Michael’s daughter Ellen does not want the staff to inform her father about his condition. She believes that information may traumatize him.

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The case provides two mutually exclusive decisions that may resolve the dilemma. First, Marcia may ignore family’s request and tell Michael the truth about his condition. Second, she may support the family’s decision and encourage other workers to withhold the truth. Both of these decisions have several advantages and disadvantages. Hence, the issue may be considered an ethical dilemma with two “goods” in conflict. It may be necessary to evaluate diverse aspects and core values in order to provide a solution with minimum harm. The dilemma in the case may be defined as a conflict between professional algorithm and ambiguous request from patient’s family members.

The above-mentioned ethical dilemma impacts the patient and Ellen’s family as well as the social worker. The patient will be withheld from the truth, which may not cause any harm. The family wants Michael to live as long as it is possible without having any emotional or physical letdowns related to telling him the truth. The issue also impacts the family as they will be carrying the burden of the truth being withheld. It may also influence the social worker as she is the primary decision-maker in this dilemma. The social worker may undergo emotional stress as she may be responsible for the outcome of the dilemma. The staff is also influenced by the issue as they have to follow the decision regardless of their personal values and principles.

“Gut” Feeling

The social worker is in a controversial and complicated position, which requires significant decision-making. Marcia has to not only help Ellen explain her, and her family’s decision but also Marcia needs to try to understand why Ellen does not want to tell her dad. I believe it may be wrong not to inform your close family member about the results. However, I also do understand that the choice was made under the circumstances that Michael is “emotionally fragile” and may not handle the situation well, which may even result in a fatal outcome. I also understand that the family members see the situation as a “family” issue and want to take it into their own hands, as they have a right to it.

Ethical Aspects and Core Values

An ethical dilemma implies a conflict between two values, both of which may be considered positive. A conflict between justice and mercy may serve as a prime example of an ethical dilemma. According to the National Association of Social Workers, there are six core values that should be implemented by social workers (2017). These values include providing high-quality service, maintaining social justice, acknowledging the dignity and worth of the person, understanding the importance of human relationships, providing integrity and competence (National Association of Social Workers, 2017). In Michael’s case, some of these values may contradict each other. Firstly, the value of the importance of human relationships may conflict with the value of integrity and, to some extent, with the value of dignity and worth of the person. The integrity value implies that a social worker should act honestly and responsibly, which means Marcia should tell Michael the truth. However, the importance of human relationships suggests that the family’s decision should be the priority.

The value of service may also conflict with the value of integrity. As already mentioned, the ethical principle of integrity suggests behaving in a trustworthy manner, which means that Michael should be provided with critical information regarding his disorder. Nonetheless, the ethical principle of service implies that the primary objective is to help people. Considering Michael’s “emotionally fragile” characteristics telling the truth, indeed, may lead to significant emotional and physical harm. Such consequences contravene with the social work’s core values. Both decisions have their advantages and disadvantages in terms of core values. Therefore, Michael’s case may be viewed as an ethical dilemma and requires careful consideration.

Personal Decision

The case mentioned above represents a complicated and controversial ethical issue. It may be necessary to evaluate as many factors as possible in order to develop a proper decision. Personal beliefs and values have a considerable influence on decision-making in ethical dilemmas. Hence, it may be beneficial to be self-aware and acknowledge the interrelation between personal experience and final decisions. Nevertheless, such cases may not have a possible “right” decision. Hence it may be more important to provide timely actions rather than focus on finding the best solution.

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The first “gut” solution to the problem is to act in accordance with the family’s request. Such decision aligns with the principle of integrity listed in the NASW code of ethics (National Association of Social Workers, 2017). According to the Bible, the core value of integrity is also an essential principle of life in general, as people should be honest in order to find salvation (Rogerson, 1993). However, even though the decision conflicts with some core values, it may have a positive effect in terms of human relationships and even the physical health of the patient. The decision may be influenced by my personal experience, as I view family relationships as a primary value and consequently believe that the family members know what is best. Nevertheless, I would suggest the family an alternative option of telling the truth and providing needed support in order to provide Michaels with critical information and minimize emotional stress.


National Association of Social Workers. (2017). Code of ethics of the National Association of Social Workers.

Rogerson, J. W. (1993). The Bible. Facts On File.

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