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Ethical Dilemma Proposal
Ethical Dilemma Proposal
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Ethical Dilemma Proposal
1. Problem StatementAn ethical dilemma is a situation in which involves a lack of a clear action to take due to conflicting values. Solving this kind of dilemmas requires an individual to have a high moral intelligence. Even though ethical dilemmas are challenging, having a clear decision making framework can improve the decision making process. There are several advantages of establishing a decision-making framework. First, it helps to make decisions quickly thereby improving efficiency. Second, it improves the confidence to handle challenging decisions. Third, it increases self-respect (Roberts, 2013).2. Outcome and PerformanceI first encountered an ethical dilemma in high school when my best friend decided to cheat in the exam. To make it even more challenging for me, he asked if he could copy my research project that I had done the previous year. He grew up in, and an orphanage after his parents passed away when he was a young boy. He was also a beneficiary of a government sponsorship program. I was in a dilemma because I valued my friendship with him while at the same time, I knew that it was unethical. If I allowed him to copy my research, this would constitute to breaking the rules and regulations of the school. Nevertheless, it this cheating would not present any harm to anyone including myself.3. StructureCheating is a general problem in many educational institutions all over the world. This is despite the existence of very strict rules and regulations (Johnson, 2009). As such, many students do not see any harm in engaging in this practice. Are they right? From an ethical standpoint, how does cheating measure up? Is it right or wrong?4. Representation of DataLet us illustrate this with an example. Two friends, John and James are studying together. They are in the same school and the same class, but they have different strengths in different subjects. John is good in mathematics, computers and science. James is good in history, languages and philosophy. They care a lot about each other and wish each other the best in life. They study together and help each other to improve each other’s weaknesses. John improves James’ science papers by rewriting them. In return, James will copy John’s mathematics homework. When both are taking exams, they position each other so that each can easily copy answers from the other one’s work. They do this so that they can improve each other’s weakness. It is a perfect arrangement. Both are getting good grades which none can achieve solely. On one, hand, this looks like a good friendship because they are helping each other. On the other hand, they are engaging in a massive cheating scandal. What is unethical about this?5. Theoretical EvidenceOne of the primary functions of ethics is to evaluate a particular action against a primary standard of a person’s well being, satisfaction, and happiness in life. Ethical issues arise when we need these things. These needs fall into two categories, i.e. particular material conditions and the condition and manner of our treatment. We evaluate to see which is on the line. Once we see a threat to any of the needs, we resort to dismissing the ethical standards and plan how to satisfy our lives (Gates, 2013).6. Empirical EvidenceGoing back to our example, we can see several reasons why this is an ethical problem. One can conclude that there is deception because one student is claiming the other’s work as his own, which is also manipulating the professor and breaking an agreement. This also brings inequality between friends and the rest of the students in class who do not have such an arrangement. Besides helping each other, their actions also hinder them and the rest of the students in getting what they want in life, which are good grades and a diploma that will assist them in getting a good career. This has a great effect in getting satisfying and happy life, which is the mandatory demand for this situation to qualify for ethical analysis. Considering the analysis of what we do to see if it presents potential harm to others, and ourselves this case qualifies for more scrutiny. 7. Comparison with Other MethodsWhen we identify ethical issues involved in an action, it does not mean that we have judged what is going on. Our next step is to evaluate the case. It could turn the tables and justify cheating. We might have misunderstood the situation originally. A closer look may lead us to believe that inequality, deception and harm are not that dangerous or that the good that results in cheating is more. On the other hand, this may even convince us that cheating is completely wrong. We might make a conclusion that the harm is greater than the good or that the whole act is wrong. At least, we can see that a careful consideration of the case is necessary.8. Limits and Scope of System (in Relation to Stated Problem)Analyzing the actionsAccording to Garber (2008), deontological approach is harder to explain than the teleological one. It becomes easier when analyzing an actual ethical case by looking at the actions. Several aspects about this case make it unethical. They are deception, inequality, breaking an agreement, manipulation, and conflicting responsibilities. DeceptionJames and John are misrepresenting to their teachers that they originally did the work, and this seriously violates the integrity of the educational process. The “rules of the game” are well known and explicitly stated in the regulations of every college and university. One job of educational institutions is to evaluate their students’ intellectual abilities. When I give James a B in my ethics course, I am saying, “I hereby certify that I have examined James’s work and found that he has an above average ability in analyzing ethical issues and presenting arguments in support of his positions”. However, for that statement to mean what it says, I have to be speaking about James’s work, not John’s work handed in under James’s name. If it is John’s work, then James is lying to me. Therefore, the first problem here is that truth is a casualty in the process. ManipulationIt is necessary to keep in mind why James and John are lying about whose work it is. If James hands in a paper done originally by John, they are trying to mislead me as I evaluate their work. That is, John is trying to manipulate me so that I can give James a higher grade than what he deserves. He is trying to deceive me because he knows that this is something I cannot tolerate. He is trying to compromise me as a professional in my work by making me lie that I have certified James’s work as originally done by James. In addition, because I cannot accept to do that, John tries to trick me. This is the second ethical problem. John is using me for his own ends. Breaking the AgreementNotice there is a problem with these friends keeping their word. When they enrolled in the institution, they agreed to behave in a manner that they shall respect and adhere to the rules and regulations of the institution. This is similar to making an agreement. Part of the agreement is that they should only hand in their original works. Irrespective of who gets hurt, or who benefits by the deception, when James hands over John’s work or vice versa, the agreement made between them and the institution broke. It does not matter whether they signed the statement or pledged formally. The fact that they broke this agreement is a serious issue. The requirement that students should only hand in their original works makes it possible to evaluate, grade and offer degrees. Without this, it would be impossible to give grades and degrees. Their act means they made a false promise to the institution. This becomes unethical.Conflicting responsibilitiesMaybe these two great friends know they are breaking their word, but do you think there is justification for their actions. They may feel that they have conflicting responsibilities. For example, John can think that although he has an obligation to keep an agreement between him and the school, he also has an obligation to help his friend. After all, that is what defines a good friendship. He might see that keeping an agreement as being cold, abstract and rational. In addition, he may perceive that helping his friend is humane and promotes human good. After all, that is what being ethical means. Although he has a good point, he paints a picture showing conflicting responsibilities.InequalityThis arrangement between John and James creates inequality. This is because the conditions of judgment for these two friends and the rest of the students changes. This is like an unfair race where you have your friend run half for you while you cover the other half yet the rest of the runners are running the full course without getting assistance from anyone.9. Suggestions for Further ResearchThe consequencesThe fundamental question is does any real harm come because of what these two friends are doing? They can say that what they are doing is not stealing, they are not taking anything from anyone without their permission, and there is no loss to anyone. James can say that John does not suffer any harm in this arrangement. He can also say that if he graduates and becomes a psychologist, it will not matter to his patients whether he knows Boyle’s gas laws. However, it will matter greatly if he joins the medical school. With this, he can easily show that the bottom line is positive. However, if harm is a significant issue, then James can reason that by getting assistance from John to do the work, he is protecting himself from harm by the consequences of a reduced grade. These two friends can defend themselves by saying that they are both hardworking, they are helping each other, and that this arrangement is in fact, a self-defense strategy.In conclusion, if one carefully looks at this case, one could say that I he had proper justifications to help his friend, and that helping him being an orphan was more moral than obeying to school rules. However, the most significant thing to avoid this situation is to analyze your life values. If you rank honest higher than friendship, then you cannot help your friend cheat. This means that the solution to avoiding ethical dilemmas comes from having a clear rank of life value (Bulowski, 2009).
References
Bulowski, J. (2009). Managing Ethical Dilemmas. 6th ed. London: Queens Publishers.
Garber, P. (2008). The ethical dilemma. Amherst, Mass.: HRD Press.
Gates, R. (2013). Values and Ethics. New York Star, 3rd June, pp. 5-6.
Johnson, K. (2009). Ethical Dilemmas in School Institutions. New York: HarperCollins Publishers.
Roberts, G. (2013). Avoiding Ethical Dilemmas by Having a Clear Values System. Ethical Corporation, Iss. 120 pp. 15-16.
Policy Analysis Of Immigration In Kentucky
Policy Analysis Of Immigration In Kentucky
Introduction
The population in Kentucky increased by more than ten percent in a period of ten years- that is between 2000 and 1990. This translated to an increase in the population with about 350,000 people. The census bureau identified Spencer County as the fastest growing county in the Kentucky state with an increase of about 73 percent between the same periods. According to the argument of the Census Bureau, trends in the future include at least a 16 percent increase in the population of the state leading to about 4.3 million people by the end of 2025. In addition to this, indicators of demography and population indicate that the state, although not yet having an explosive population growth as compared to other southern states, is following in the same path with an estimation of an increase in population of about 45 percent by the end of 2030. Experts in demographics have argued that the strains in the community will not be better with such remarkable increases in population. Without a doubt, concerns will arise concerning the implications such increases in population could have on water supply and the infrastructure system of state (US Census Bureau, 2000).
The USCIS projects that, with a rise of 150 percent, 15,000 illegal immigrants lived in the state as of 2000. As it is, the Kentucky continues to draw more illegal immigrants to the state every fall and spring as illegal immigrants move to the state to take advantage of the increase in job opportunities that come with the season of harvesting and planting crops. Many of the individuals who enter the state illegally end up living in houses that are either overcrowded or substandard, as most of them cannot afford the proper housing conditions with their wages. In the year 1999, the state demanded 643,000 dollars as compensation towards the illegal immigrants’ incarceration from the federal government (Massey & Espinosa, 1997). However, the state’s taxpayers ended up paying much of this amount as the federal government only paid part of it, about 248,000 dollars. As a result of this increase in population through immigration, Kentucky has come up with a number of policies aimed at checking its immigration trends. This paper, therefore, is going to look at these policies and analyze how the state is implementing the policies and the implications they are having on the state (Links to: Federal & State Agencies: Advocacy & Research).
The General Assembly that convened in 2000 adopted the HCR 53, requiring the staff of the Legislative Research Commission to research on the effects of immigration on the private and public sectors of Commonwealth. It is from the results of this study that we get to know that Kentucky experienced a bloom in population just like the other states in the US through immigration in the past ten years. However, when compared to the other states and the rest of the nation, the census indicated that the immigrants comprised only a small part of the population. The report indicated that only was the legal migrants constituted about 2.5 percent of the population, compared to about 10 percent of the same individuals in the US. Information from various sources indicates that the total number of immigrants who are undocumented, and especially those from Latin America, increased significantly during the past five years. According to the results of the report of the study that we earlier mentioned, the researchers made the following conclusions (Anderson, et al., 2002).
The study found out that the legal immigrant population of the state had grown three times since 1990, but it remains small at 2.5 percent of the whole population. The study also found that the legal immigrants were on average younger than the native Kentucky citizens were. In addition to this, the study indicated that the legal migrants from Latin American countries comprised about 11 percent of the whole population of the legal migrants in the 1990s. Further, legal migrants to Kentucky in the past decade had increasingly begun to come from China, Cuba, Vietnam, India and Bosnia. However, the researchers found that the amount of reliable data was not enough on the total number of immigrants who were undocumented. The INS, however, estimates that the number is about 6,000 the organization acknowledges that it might be small than the real figure (Anderson, et al., 2002).
Another conclusion that the study made was that more than a third of the legal population of immigrants to the south participated in jobs that were low paying and those that did not require any special skills or education; however, it was also found that a number of these individuals were highly educated and qualified. Just like the other employers in the rest of the nation, Kentucky employers report utilizing an increasing number of workers from the immigrant population, because they were not able to acquire the services of the native workers at the same wages. Some of the employers who the researchers interviewed indicated that the availability of cheap labor was essential in the sustenance of the business. However, the research that the study looked at did not have indications that cheap labor decreased the wages and employment opportunities for the native workers. Other findings in the study had a lot to do with the period illegal immigrants stay in the state, levels of education in the state the state of health services and departments in the state, the impacts of immigration on law enforcement and the impact this migration has on various social groups (Anderson, et al., 2002).
As a result, of the issues highlighted above, the Kentucky governing bodies had to establish several laws, policies and regulations to check the trend. The developments in immigrant law in 2001 can be put under two specific categories; the post terrorist and pre- terrorist categories. The whole nature of the debate concerning immigration has changed since the terror attacks on US in 2001. These laws and policies have less discussions of liberalizing requirements immigrations and much more attention concerning the assuring of the citizens that immigrants are all participating in activities that are legitimate (Links to: Federal & State Agencies: Advocacy & Research).
Immigration law and policies have changed significantly over the last ten years, and the debate today on the issue indicates essential, additional changes in the years to come. The US congress has passed notable immigration legislation since the 1950s, the year that marked the first ever overturn of the immigration laws in the nation. Since these periods, the nation’s lawmakers have fought with basic concepts concerning migration. Of course, debates have risen regarding the financial contributions this population bring to the US economy; the debate whether these individuals bring to the state more benefits or costs. As it follows, the legislation concerning legislation has reflected the divided situation f the views of most Americans concerning the issue of immigration. Immigration law, thus, is an indication of the continuing tension between the impulse to make the borders of the US tighter and the desire to keep the immigrants coming in, usually to augment the workforce in the nation or the reunite families. However, this debate almost was eliminated with the 2001 September terror attacks, which made it easier for the nation to pass bills that kept aliens out. The thoughts and arguments that this would affect the labor force were pushed to the background as the nation strived to keep its citizens safe (Palloni, Spittel & Ceballos, 1999).
The Kentucky legislature expected the immigration reform to be one of the most critical issues discussed during the first session of the legislature’s meeting. David Williams, president of the Kentucky senate is currently pushing for a bill or proposal that is designed and modeled around the similar, but controversial Arizona law. The proposal of the president will let the immigrants are illegal to be arrested and charged with trespassing if they happen to enter private or public property. The same proposal would require the local law enforcement to control and reduce the status of immigration without this role affecting their other law enforcing duties. David’s proposal is not independent as it is part of a larger agenda he is trying to campaign for and pass during the first few days of the new session, which the legislature usually uses for organizing committees. David is also vying for the republican nomination for the 2011 governor, and most think that this is one of the many reasons why he is so intend and ambitious with this particular agenda. The speaker of the house who is a democrat, Gregory Stumbo argued that the house was not in a hurry to move any bills fast. However, individuals argued that the speaker passed and endorsed legislation that would need the employers and farmers to check the citizenship status of the workers or potential employees, as a way of controlling the entry of immigrants into the country. He argued that if there were lesser jobs in the state then there would be lesser immigrants (Immigration debate begins to heat up in Kentucky).
The other legislature has to do with deporting immigrants who are in the country illegally convicted of serious crimes. Several studies have indicated that up to 75.6 percent of the individuals who the state deported were convicted without having committed a crime or of insignificant crime. There has been increasing criticism over these numbers leading to some states abandoning this initiative recently. The goals of these initiatives are to rid the state of overpopulation and the social challenges that result from overpopulation like substandard living conditions, increased crime rates, unemployment, less job opportunities and low- paying jobs (Immigration to Kentucky). The state and local governments are overseeing implementation and the funding of some of these policies, with some funding from the federal government. While the implementation of some of these policies has been successful, their feasibility is low, as immigrants contribute a large part of income for the state, and some individuals are reluctant to see it end. The low feasibility is also, as a result, of little or no funding for the projects. The funding has not been adequate to ensure that the initiatives run successfully and efficient (Honeycutt, 2011).
As we highlighted previously, there are two opposing groups debating on the issue. On one side is the group that is disagreeing with the initiative because of the large contributions the population contributes to the country, and the human rights and liberties involved. On the other side is the group that is agreeing with the proposal to kick all the illegal immigrants out of the state citing security, and employment reasons. The Kentucky Council on Churches is one such group that is opposed to the idea of immigrants in the state. The council has shown the issue of immigration as a critical challenge that the government has to deal with and is rallying its members to support its efforts. The council has, as a result, called for national reforms in the state that are comprehensive, and is fighting to have the government establish an appropriate process for earning legislation of persons who are undocumented. Though the church was open to keeping the state as welcoming as possible for the immigrants, it was firm that these immigrants must be documented and legal (The Kentucky Council of Churches).
The debate on the issue has led to a number of disadvantages affecting the initiative. For example, the funding is not sufficient enough as there is no firm supporter of one particular side, the debates have divided votes, and this makes it difficult to retain and acquire donors. In addition, the two- sidedness of the supporters is affecting the issue of administration. As a result, of these challenges, the policy has not been meeting its stated goals, as it was expected. For example, one of the initiatives that were one of the series of policies meant to reduce the number of immigrants entering the state, as a result, of little support and increasing criticism. The initiative was deporting illegal immigrants who the state found to be breaking the law. However, instead of doing this, the initiative opted to deport all of the immigrants it laid its hands on. This earned the implementers of the initiative a lot of criticism, something that led to its discontinuity (Colombo, 2010).
The main barriers to effective management and administration of the initiative include lack of support and lack of sufficient funding. Some individuals feel that kicking out illegal immigrants is an act that violates the rights of immigrants. Individuals disagreeing with the initiative have also argued that kicking all of these immigrants out would have consequential impacts on the economy of the state because these individuals contribute largely to the economy and GPD of the state through labor. Because of these problems, it has been difficult to find willing donors and sources of funds to support the extremely costly initiative. Implementation of the policies would be extremely expensive, and it could affect other areas that need funding like the provision and setting up of better health care centers and housing facilities (Office of the attorney general).
For such a policy to be more effective, the implementers might want to make a few adjustments to the policies. For example, they could earn more support from the citizens by making sure that only individuals who the state has truly convicted of a serious crime are the ones who get deported. They can also make changes that are desirable by making changes to the immigration system based on families to decrease the time of waiting for reunification of families. Further, the state could change the initiative to restore the due process for all immigrants (The Kentucky Council of Churches).
Conclusion
As we have seen above, the issue of immigration has been putting undue pressure on the state of Kentucky for the last ten years. As a result, of this increase in immigration population, the state has come up with policies meant for checking this population and for reducing the undesirable outcomes of the trend. The policies have, however, not been successful in implementing. It would be better if the policies were designed to be more humane as then they would attract more support from the state earning the initiative the support, it needs to acquire funding.
References
Anderson, L. et al. (2002). Immigration in Kentucky. A preliminary description. Research Report No. 305. Legislative research Commission.
Colombo, M. (2010). KY senate president proposes controversial immigration law. WHAS11.com. retrieved from http://www.whas11.com/news/local/KY-Senate-President-proposes-controversial-immigration-law-112683969.html
Honeycutt, V. (2011). Program criticized for deporting non- violent illegal immigrants in Lexington. Kentucky. Com. Retrieved from http://www.kentucky.com/2011/05/13/1739162/program-criticized-for-deporting.html
Immigration debate begins to heat up in Kentucky. Ballot News. Retrieved from http://ballotnews.org/2011/01/03/immigration-debate-begins-to-heat-up-in-kentucky/
Immigration to Kentucky. The Kentucky Council of Churches. Retrieved from http://www.kyforward.com/our-faith-and-values/2011/05/06/immigration-in-kentucky/
Immigration to Kentucky. US Migration Support. Retrieved from http://www.usimmigrationsupport.org/kentucky.html
Links to: Federal & State Agencies: Advocacy & Research. National Immigration Law center. Retrieved from http://www.nilc.org/links/index.htm#caexec
Massey, D. &. Espinosa, K. (1997). What is Driving Mexico-U.S. Migration? A Theoretical, Empirical, and Policy Analysis.’ American Journal of Sociology 102(4): 939-999.
Palloni, A., Spittel, M. & Ceballos, M. (1999). Using Kin Data to Falsify Social Networking Hypotheses in Migration. Paper presented at the annual meeting of the Population Association of America.
Office of the attorney general. Attorney General Stumbo issues immigration law alert. Kentucky.gov. retrieved from http://migration.kentucky.gov/Newsroom/aag/immigrationlawadvisory.htm
US Census bureau. (2000). Current population survey.
Ethical Dilemma in the Workplace
Ethical Dilemma in the Workplace
Author
Institution
Introduction
Issues pertaining to ethics in the workplace have become increasingly popular and controversial in the recent times. This may have resulted from the increase in the channels through which the activities in companies and business entities are exposed. Needless to say, different workplaces come with certain sets of code of conducts, with their employees being bound by these regulations and rules in an effort to ensure the smooth running of these organizations. However, there are instances where the expectations or the provisions of these statutes are in conflict with the personal beliefs, principles and relationships of the employees. These instances are referred to as ethical dilemmas where an individual would be required to weigh and evaluate the right and wrong pertaining to their actions (Clarkson, 2000). It is worth noting that, in cases of ethical dilemmas, the individual would be faced with two or more courses of action, both of which would have a negative aspect, albeit in varying degrees. In essence, this paper examines an ethical dilemma that may occur in the work place and attempts to use a number of ethical theories to come up with an appropriate resolution for the conflict of interest.
The ethical dilemma
Kelvin has been contracted as a technical communicator for one of the major healthcare sector Denver, Colorado. He is tasked with the development of an entirely new software system that would form a database, allowing for the gathering of all records from health maintenance organizations, clinics, hospitals, physicians and laboratories in the locality. The records incorporate personal information pertaining to the patients and are highly private and confidential in nature. In essence, they have to be handled with care as any revelation on the classified information may result in tremendous damage to all parties involved including the organization, the individuals whose information is in these records, as well as me. Indeed, such revelations may limit their capacity to get jobs or promotions as their employers may form pre-conceived ideas pertaining to the performance capabilities of these individuals. There may also be personal costs, stigma or even broken relationships. This underlines the importance of ensuring that the privacy and confidentiality of these records is guarded jealously.
However, the software development project allows him to come across some information pertaining to two of his friends. While going through the information in the healthcare organizations, he comes across the name of one of his best friends called Cathy. He realizes that she has been diagnosed with HIV, a terminal and sexually transmitted illness, and is undergoing counseling and treatment for the same in a local clinic. Cathy is dating one of Kelvin’s best friends named Michael, whom Kelvin has known since the elementary school as they lived in the same locality. Indeed, this is a friend who has stuck out for him in quite a number of instances. Kelvin thinks that Michael is unaware of Cathy’s status, otherwise he would have broken up the relationship and even informed him about it. The situation becomes even worse considering that Michael and Cathy are about to have their wedding in three weeks time.
This piece of information leaves Kelvin in an ethical dilemma as he is torn between the rules and regulations or obligations with which his job comes and the relationship with his friends. Failure to inform his friend would safeguard his integrity and allow him to keep the job that he desperately needs. However, such an action may jeopardize Michael’s safety and marriage. The option of revealing the information would allow his friend to make an informed choice, but may cost the organization its reputation and jeopardize his job, not only in the organization but also in others.
The resolution of this conflict necessitates that Kelvin determines the party whose interests he would have to sacrifice. The principled reasoning approach would come in handy in this case as it would allow him to assess all the issues that are in the dilemma. First, he would define the problem and determine the principles that have to be met. In addition, an identification of all stakeholders in the dilemma and the claims that they have to it would be carried out, before all likely solutions are determined. The consequences of the possible solutions would then be tested before an ethical process for the implementation of the solution is developed.
On the same note, two paradigms may be crucial in the evaluation of the dilemma. These include “Truth vs. loyalty” and “individual vs. community” (Clarkson, 2000). Kelvin may be obligated to tell his friend the truth about his fiancée, but he also owes loyalty to the healthcare organization. In addition, he may have to determine whether to save his own job and financial prospects through remaining silent, or giving out the information to his friend thereby saving his life while destroying the reputation of the company and probably jeopardizing his prospects of employment and financial freedom in the organization, as well as others. In addition, ethical theories such as utilitarianism, absolutism and virtue ethics would come in handy in the evaluation of possible ways of resolving the conflict. Of particular note is the fact that these theories and paradigms would never really resolve a dilemma, rather they allow an individual to determine the things that he or she can sacrifice or the things that really matter to them, thereby coming up with a decision. They strip away the unnecessary or unimportant details, thereby allowing the individual to determine only the fundamental aspects of the same (Clarkson, 2000). In essence, Kelvin will ultimately have to make a decision on the course of action to take.
Definition of the problem
Determining the problem or the issues that conflict would be imperative in the case of Kelvin. The key issue, in this case, revolves around the fact that the Kelvin has discovered that the fiancée of his friend has tested HIV positive. Of particular note is the fact that Kelvin discovered this piece of information while entering data for healthcare institutions as part of a contract for the digitalization of healthcare services. In essence, the healthcare institutions are obligated, or rather, required by the law to maintain the confidentiality and privacy of patients’ information, and ensure that all information is only revealed to authorized individuals. Indeed, the HIPAA Privacy Rule establishes national standards for the protection of individuals’ medical records, as well as other personal health information (Ezra, 2006). The rule is applied to healthcare clearing houses, health plans, as well as healthcare providers that carry out certain transactions pertaining to the healthcare electronically. The rule underlines the importance of putting into place appropriate safeguards for the protection of privacy of the patients’ healthcare information while setting conditions and limits pertaining to the disclosure and use of that information without the authorization of the patient. In addition, the rule allows patients to have the right over information pertaining to their health including the right to get a copy and examine their health records, as well as request for corrections. Covered entities may divulge Protected Health Information in an effort to facilitate payment, treatment and healthcare operations without the express written authorization of the patient. All other disclosure of the patient health information necessitate that the covered entity obtains a written or formal authorization for the disclosure from the individual. Nevertheless, in instances where the covered entity discloses such Patient Health Information, it is required to make reasonable effort to only disclose the most (minimum) necessary information that is required for the achievement of its purpose. Touching more on Kelvin’s case is the fact that the Department of Health and Human Services broadened the scope of HIPAA privacy rule to encompass independent contractors pertaining to covered entities that fit in the definition of business associates (Clarkson, 2000). This underlines the fact that Kelvin, as an independent contractor would still be required to obtain formal authorization from his friend’s fiancé to allow for the disclosure of such information.
If he discloses the information without such authorization, he would be violating the codes of ethics of the company and may end up losing the job that he so much depends on for survival (Ezra, 2006). If he chooses to keep quiet, he would be disloyal to his long time friend, and may put him under the risk of contracting a terminal illness. It is required that he observes the professional code of ethics pertaining to his job, yet it is equally important that he acts as his brother’s keeper and discloses that all-important information.
Principles that need to be satisfied/ Conflicting Principles
Kelvin’s case necessitates an examination of the principles that must be satisfied. Indeed, Kelvin’s dilemma would be perfectly explained by the paradigm of Truth vs. loyalty. An examination of the different course of actions and the possible outcomes of the same reveals that Kelvin’s dilemma has its foundation on the values that the society holds as fundamental.
Kelvin, on one hand, has the option of telling Michael about the health condition of his fiancée Cathy, an option that is rooted in the fundamental value of truth. Considering that he knows the risk in which Cathy’s health condition or HIV status puts Michael, who is his long time and close friend, Kelvin is primarily obligated to disclose the information to Michael.
On the other hand, Kelvin has the option of keeping the information to himself, an option that has its roots on the fundamental value of loyalty. Indeed, it is imperative that Kelvin retains his loyalty to the company and the healthcare institutions that have given him the responsibility to digitize the healthcare records (Clarkson, 2000). Kelvin is required by the HIPAA rule to protect the confidentiality of such information and only divulge it after obtaining formal authorization for the same. This underlines the fact that Kelvin is required to balance the two fundamental values, both of which are right and the defiance of which would have dire consequences on both his life and the life of his friend, or even their friendship.
These two courses of action are in conflict with each other. Kelvin’s decision to tell his friend Michael the truth about his fiancée is in conflict with the statutory requirement that he remains loyal to the hospital through maintaining confidence. He would, undoubtedly, be right to disclose the information to his friend Michael as he would essentially save a life. On the same note, he would be right to remain silent as he would be adhering to the professional code of ethics for which he signed under the HIPAA rule.
Stakeholders and an assessment of their claims
The dilemma that Kelvin faces revolves around the obligations that he has to his company or employer and those that he owes to his friend Michael. Indeed, these are the two fundamental or crucial stakeholders whose claims he has to consider when coming up with a decision on the appropriate course of action. First, the contracting healthcare institution has put in place a code of ethics that requires all individuals handling the personal health information to maintain its confidentiality and never divulge such information to any unauthorized individuals. This is also a requirement that is stated in the constitution governing all healthcare institutions and providers. The consequences of divulging such information are extremely undesirable and far-reaching, stretching from the personal lives of the patients, to their careers and even the future of the healthcare institutions in question. Indeed, such disclosure could result in litigations against the healthcare institution, tattered reputation and even affect its profitability and sustainability in the present and the future. This, in essence, also puts Kelvin’s financial future at stake as it could result in the termination of the contract and loss of the much-needed income. It goes without saying that the trust that the healthcare institution has for Kelvin would be irreparably damaged. This underlines the high stakes under which Kelvin is operating, as well as the necessity of maintaining the confidentiality and privacy of the healthcare records.
Such disclosure would also affect Michael’s future extensively. The disclosure would, undoubtedly, necessitate that Michael confronts his fiancée and possibly calls off the wedding, which is in two weeks’ time. Indeed, the disclosure would also affect the friendship and trust that Cathy has for Kelvin. It is reasonable that Michael would expect that Kelvin gives him every information and detail that he feels would be important to him, irrespective of the manner in which he obtained it considering that they have been close friends for a long time.
Possible solutions
The resolution of this moral dilemma necessitates that the options that Kelvin has are laid out and examined in line with their implications. Indeed, the dilemma would only be resolved once in the analysis of a rigidly bipolar ethical dilemma, a middle way or ground between the two rights is opened up. Of particular note is the fact that moral dilemmas do not emanate from instances that have “right” or “wrong” decisions, rather it is a conflict between two rights. In fact, the dilemma is a representation of conflicts between moral temptations and ethical decisions. Needless to say, coming up with a middle ground is considerably difficult in Kelvin’s case as the options are rigidly bipolar. He has the option of disclosing the information to Michael or failing to disclose it thereby jeopardizing his life. A closer examination of the dilemma, however, may reveal some other options or courses of action that Kelvin may take. For instance, Kelvin may broach the subject of the increasing cases of HIV/Aids and how it has affected the society in general. He could then underline the importance of being tested or rather knowing one’s status, as well as that of one’s partner before getting intimate or getting married. He could then ask Michael casually whether he has taken the test or whether he knows Cathy’s status and insist that he goes ahead and knows it before getting intimate with her or even going ahead with the wedding.
The decision seems a bit wanting especially considering that he would essentially not be giving the all-important information to Michael, rather it would be some form of advise. Indeed, it is highly likely that Michael would not feel any need to change his plans and course of action as there he would be unaware of any threat to his health just yet.
Testing the Consequences of the Decision or Course of Action
The resolution of the moral and ethical dilemma in this case necessitates the testing of the chosen resolution so as to determine the side that comes closest “right” in the prevailing circumstances. This can only be achieved through a close examination of the consequences of the different course of action using varied theories espoused by philosophers (Ukens, 2008). The consequentialist approach, commonly referred to as utilitarianism, would be helpful in this case. The approach involves an evaluation of the course of action in terms of the outcomes or consequences. In this case, the net costs and benefits for all stakeholders at an individual level would be considered. This approach aims at achieving the greatest good for the highest number of people, while preventing the highest amount of suffering or generating the least amount of suffering and harm. This approach underlines the fact that the interests of ever entity must be equally considered when making a decision, including the interests of other species as that have the capacity to suffer. Of particular note is the fact that the weight of the benefits and costs would not be limited to those pertaining to tangible value, rather it would stretch to the intangible. The application of consequentialist approach underlines the fact that any course of action has its pros and cons.
Disclosure of the information to Michael will undoubtedly give him an opportunity to rethink his decision to get married to Cathy. It will, undoubtedly, save him from the risk of contracting the terminal ailment and, of course, underline the untrustworthy nature of his fiancée. However, it would be detrimental to the company and may jeopardize the job prospects of Kelvin alongside to other workers that primarily depend on the healthcare institution for their livelihood. On the same note, it may cause breakage of marriage and friendship, not to mention the immense loses pertaining to the finances used in planning the wedding.
Failure to disclose the information to Michael, on the other hand, would jeopardize the latter’s health and life in the short-term and long-term (Harding, 2010). This course of action, however, would retain the reputation of the healthcare institution with which he works and save jobs for its workers. In addition, it would ensure the sustainability of the institution, as well as his continuous earning potential.
Looking at the tangible benefits, it would appear that keeping the information from Michael would be the best option in this case, at least going by the utilitarianism. However, the greatest good, including the intangible benefits, would revolve around disclosing the information to Michael. There is absolutely no way that the financial benefits pertaining to keeping his job or retaining the reputation of the healthcare institution can be equated to the preservation of life. Indeed, life is costly and has to be protected at all costs (Ukens, 2008). In fact, there are high chances that Michael will eventually discover his wife’s health status after they go ahead with the wedding, but it may be too late to reverse the consequences. In addition, the information may be passed to him in a manner that would not jeopardize the reputation of the healthcare institution. Indeed, passing the information to him does not necessarily mean that he has to inform his fiancée about the source of information. Informing him of the consequences of such a thing would allow him to rethink the manner in which he broaches the subject (Harding, 2010). He could simply ask his fiancée to accompany him to take the test, without showing any signs that he knows or has been informed that she is HIV positive. In addition, the risk of breaking up the wedding of his friend becomes mute especially considering that Michael’s life is at stake and there are high chances that the marriage will break up if Michael discovers that the wife has not been into full disclosure.
Emanuel Kant’s duty or deontological ethics may also be used in determining the course of action that would be most appropriate in this case. Deontological theory underlines the fact that human beings are under a moral obligation to act in line with a certain collection or set of rules and principles irrespective of the outcomes. This means that there are certain things that human beings are obligated to do irrespective of how bad the outcomes may be. This theory is, undoubtedly, a complete opposite of the utilitarian theory. The deontological theory is built on three imperatives. First, it underlines the fact that individuals should only “Act only according to that maxim whereby you can at the same time will that it should become a universal law without contradiction”. Moral propositions, according to Kant, should not be tied to any conditions. Moral maxims should be disconnected from physical details pertaining to the proposition and should be universally applicable to all rational human beings. Even closer to the situation at hand is the insinuation that human beings have imperfect duties that have their foundation on pure reason while allowing for interpretation pertaining to their performance. Imperfect duties are still reliant on people’s subjective preferences, in which case they are not as strong as their perfect counterparts. However, they still come as morally binding. The imperative bears some similarities with the Golden Rule, which states “Do not impose on others what you do not wish for yourself.” (Shakil, 2012). Kant’s second imperative cautions against the use of individuals as a means to an end rather, they should be seen as an end to themselves. It states that individuals should only “Act in such a way that you treat humanity, whether in your own person or in the person of any other, never merely as a means to an end but always at the same time as an end” (Shakil, 2012). In the third imperative, Kant suggests that “Therefore, every rational being must so act as if he were through his maxim always a legislating member in the universal kingdom of ends.”. This imperative underlines the fact that laws should only be seen as laws of conduct in instances where they are universal. Individuals should not treat other peoples a means to an end, rather they should see them as ends. They should only act on laws that are in harmony with the likely kingdom of ends. They have a duty to only act by rules that generate possible and coherent states of natural affairs in instances where they try to universalize them. They also have an imperfect duty to not act by rules that result in greatly undesirable or unstable state of affairs for the parties concerned.
Developing an Ethical Solution Implementation Process
Using Kant’s theory and the utilitarian or consequentialist theory, it is imperative that Kelvin informs his friend about the status of his fiancée and future wife. The utilitarian theory underlines the importance of establishing the benefits and the costs of the different courses of action and determining the one that carries more weight. Irrespective of the tangible benefits and costs that may be at play, at no one time will the life of an individual be substitutable with any material property. In essence, saving the life of Michael comes as the greatest good, in which case Kelvin should do all he can to inform Michael about the health status of his fiancée. In addition, Kant’s theory underlines the importance of examining individuals not merely as means but also as ends in themselves. Failure to disclose the information to Michael would be tantamount to using him as a way of sustaining his job and that of others. Examining him as an end would entail disclosing the information to him, considering that he has a life to live and the feelings of a human being.
References
Shakil, A (2012). Kantian Duty Based (Deontological) Ethics. Seven Pillars Institute, web retrieved from HYPERLINK “http://sevenpillarsinstitute.org/morality-101/kantian-duty-based-deontological-ethics” http://sevenpillarsinstitute.org/morality-101/kantian-duty-based-deontological-ethics
Harding, C. G. (2010). Moral dilemmas and ethical reasoning. New Brunswick [N.J.: Transaction Publishers.
Clarkson, P. (2000). Ethics: Working with ethical and moral dilemmas in psychotherapy. London: Whurr.
Ukens, L. L. (2008). What would you do?: A game of ethical and moral dilemma : participant’s workbook. San Francisco, Calif: Jossey-Bass.
Ezra, O. (2006). Moral dilemmas in real life: Current issues in applied ethics. Dordrecht, the Netherlands: Springer.