Melanie Jones - Reflective Entry - 3rd Blog

Melanie Jones - Reflective Entry - 3rd Blog: 

Ethical Dilemmas and Critical Thinking in Health and Social care

What is an Ethical Dilemma?

Ethics and ethical principles are fundamental within health and social care practice, as they underpin professional behaviour and ensure the safety, respect, and dignity of both service users and practitioners. Ethical practice promotes integrity, fairness, and accountability, helping professionals provide care that is both compassionate and measured (Beauchamp, 2019).

An ethical dilemma occurs when a professional is faced with a situation involving two or more conflicting moral principles, and there is no single clear or “right” answer (Johnstone, 2016). In these situations, each possible course of action may have both positive and negative consequences, requiring the practitioner to carefully evaluate which decision aligns most closely with ethical and professional standards. For example, dilemmas often arise when balancing a person’s right to autonomy with the professional’s duty of care and responsibility to prevent harm (Banks, 2012).

Health and social care professionals must therefore use critical thinking, reflection, and ethical frameworks to guide their decision-making. This involves considering individual rights, professional codes of conduct, and the potential impact of their actions (Department of Health and Social Care, 2015). Ultimately, resolving ethical dilemmas requires striking a balance between respecting service users’ choices, maintaining professional integrity, and safeguarding wellbeing, ensuring that care remains person-centred, fair, and ethically sound (Cowley, 2013).

 

(SlidesCarnival, 2025)

 

Example: Reflection on Ethical Dilemma

During my attendance at the hospital for cataract surgery, I observed an ethical dilemma involving an elderly patient who initially refused to proceed with the operation despite receiving clear medical advice. The healthcare team respected her autonomy, in line with professional obligations and the Mental Capacity Act (2005). However, her deteriorating vision presented significant risks, including progressive vision loss, increased likelihood of falls, reduced independence, social isolation, and potential medication errors.

Observing this situation, I felt conflicted as the staff balanced the patient’s right to make her own decisions with their duty of care to safeguard her wellbeing. Using Gibbs’ Reflective Cycle (1988), I explored my feelings of frustration, empathy, and concern, and questioned whether the patient was fully informed, whether fear or misunderstanding influenced her decision, and if improved communication could have affected the outcome.

Through critical reflection, I recognised that cultural beliefs, past medical experiences, and the need to build trust were influencing the patient’s decision. The team arranged a family meeting, providing a safe space for her to express her fears. With empathetic support from the professionals and encouragement from her family, the patient ultimately agreed to proceed with the surgery.

This experience highlighted the importance of ethical reflection, empathy, and collaborative problem-solving in health and social care. It demonstrated how patient-centred communication and teamwork can resolve ethical dilemmas while respecting autonomy, promoting safety, and achieving positive outcomes.

The Impact of Misinformation on Health and Social Care Practice

Throughout the last 20 years, social media has become an influential tool in health and social care, providing opportunities for education, communication, and public health promotion. However, there have also been a number of significant ethical dilemmas raised that can affect professionals, service users, and the wider community (Beauchamp, 2019).

Such dilemmas involve the newfound ability of unqualified individuals giving critical medical information and advice online. Influencers or social media users without professional training are able to share personal experiences and opinions that appear credible but are not based on evidence (Tarlier, 2010). This undermines trust in qualified professionals and creates confusion for vulnerable people seeking help (Banks, 2012).

Ethically, professionals must navigate these challenges by promoting truthfulness, integrity, and accountability online. They should engage with social media responsibly using it to educate, raise awareness, and advocate for public health while maintaining professional boundaries and respecting confidentiality (Bradshaw, 2010). Preventing ethical dilemmas related to social media use requires clear professional boundaries, education, and responsible online behaviour (Fawcett, 2012). Health and social care organisations should provide training and guidance on professional use of social media, ensuring staff understand confidentiality laws, data protection, and organisational policies. This helps prevent accidental breaches of patient privacy or the sharing of sensitive information online (Johnstone, 2016).

References:

Banks, S. (2012) Ethics and Values in Social Work. 4th edn. Basingstoke: Palgrave Macmillan.

Beauchamp, T.L. and Childress, J.F. (2019) Principles of Biomedical Ethics. 8th edn. New York: Oxford University Press.

Bradshaw, A. and Stratford, N. (2010) The Reflective Practitioner in Health and Social Care. London: Learning Matters.

Cowley, S., Whittaker, A. and Whittaker, S. (2013) Ethics in Health and Social Care Practice. London: Routledge.

Department of Health and Social Care (2015) Code of Conduct and Professional Standards for Health and Social Care Practitioners. London: DHSC.

Fawcett, J., Desanto-Madeya, S. and Watson, J. (2012) Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories. 3rd edn. Philadelphia, PA: F.A. Davis.

Gibbs, G. (1988) Learning by Doing: A Guide to Teaching and Learning Methods. Oxford: Oxford Polytechnic.
UK Government (2005) Mental Capacity Act 2005. London: The Stationery Office. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents (Accessed: 13 November 2025).

Johnstone, M.J. (2016) Bioethics: A Nursing Perspective. 6th edn. Chatswood, NSW: Elsevier.

SlidesCarnival (2025) Simple Ethical Dilemmas Infographics [online image]. Available at: https://www.slidescarnival.com/wp-content/uploads/Simple-Ethical-Dilemmas-Infographics-9.jpg (Accessed: 14 November 2025).

Tarlier, D.S. (2010) ‘Ethical reasoning in nursing practice: A reflection on patient autonomy’, Nursing Ethics, 17(4), pp. 419–431.