Navigating Ethical Dilemmas in Medicine: Right vs. Right Decisions

October 5, 2024

In medicine, ethical issues are often seen as clear-cut choices between right and wrong. However, in reality, they are frequently far more complex, especially when multiple legitimate solutions exist for the same problem. Joseph L. Badaracco, a distinguished professor at Harvard Business School, introduced the concept of “Right vs. Right” decisions—situations where conflicting values or duties create ethical dilemmas without an obvious answer. These “Right vs. Right” dilemmas are a common occurrence in medicine, challenging both physicians and patients nearly every day.

Consider the following scenarios:

  • An obstetrician is treating a pregnant patient whose life is at serious risk due to her pregnancy, but the patient refuses to consent to a termination that could save her life.
  • An orthopedic surgeon recommends amputating a gangrenous limb to prevent life-threatening sepsis, yet the patient declines the procedure.
  • An oncologist advises a patient with an early-stage cancer to begin chemotherapy to prevent further spread, but the patient chooses to pursue an unproven alternative treatment instead.

In each case, both the patient’s autonomy and the physician’s duty to preserve life clash, leading to ethical dilemmas where both choices can be viewed as “right” from different perspectives. So, what should physicians do when confronted with such dilemmas?

The Digital Age: Adding Complexity to Ethical Decision-Making

Today, the digital landscape has only amplified the complexity of medical ethics. With unprecedented access to information, alternative healers, and aggressive marketing—sometimes promoting unproven or even harmful treatments—ethical principles can feel more prescriptive than practical.

The issue isn’t that healthcare professionals don’t understand ethical frameworks. The real challenge lies in applying these principles in a world that is increasingly dynamic, unpredictable, and digital. The real question isn’t just what the ethical principles are, but how and why they should be applied in the context of evolving patient behaviors, informed (or misinformed) by online sources.

In this discussion, we’ll explore how physicians can navigate “Right vs. Right” decisions in their daily practice.

Here are the guiding questions for our chat:

T1. Have you encountered a “Right vs. Right” ethical dilemma in your practice? How did you resolve it?

T2. What was your primary challenge in resolving such a dilemma?

T3. In today’s digital world, what ethical framework would you recommend for resolving “Right vs. Right” dilemmas?

Don’t forget to use #HealthXPH in all your tweets. See you this Saturday, October 5, 2024, at 9 PM (Manila time)!

Remo Aguilar

Hi, I'm Dr. Remo Aguilar! I am an orthopedic surgeon, healthcare administrator and educator. My writing and speaking interest is in the intersection of healthcare, technology and education.I use all these learning to positively change people lives.

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