Moral Courage in Health Care

Moral Courage in Health Care Abstract This review critically analyzes the arguments placed by Colonel J.S. Murray, in his article Moral Courage in Healthcare: Acting Ethically Even in the Presence of Risk.   Murray argues that the nursing professionals used to face complex ethical dilemmas in their workplaces. According to him, moral courage instills ethical responsibility on them for taking action when confronted with ethical issues. However, nurses should not confuse moral courage with moral arrogance. The Code of Ethics for Nurses  provides the differences between public and private morals, and warrants wholeness of character in nurses. They must integrate the personal and professional values in the system. The ethical values are shared across different cultures in the form of honesty, integrity, justice, respect, dependability, empathy, compassion, and courage. Strategies for improving moral courage, embrace open discussions about the ethical principles and systems, case studies, and role modeling, as well as reh earsals. The guidelines provided by Dr. Murray are exceptional, which can mold the nurses into leaders with strong ethical values, integrity and courage. Introduction In the journal article, Murray, J.S., indicates that the healthcare professionals who are working in clinical practice, education, research, and administration usually encounter ethical dilemmas in their workplaces. According to him, inadequate staffing in delivering patient care, cost-effective measures, unification of healthcare organizations, and the failing leadership are the major elements that escalate ethical dilemmas faced by the nurses. Here, moral courage involves the readiness to speak out, and doing what is right, though vulnerable to risk. Murray unequivocally affirms that moral courage is the capability of the individual in triumphing over fear and standing up for values and ethical obligations, that one cherishes. This is evident in the principles stipulated by the American Nurses Association (ANA, 2001)  Code of Ethics for Nurses  for practicing professional nursing. Nurses with moral courage have the pre-notion about the undesirable consequences for their actions ; yet they realize that adhering to integrity is more important than compromising with the consequences. Summary To address his arguments, Murray illustrates a case study of Emily, who was a novice nurse, employed at an academic medical center, the name unrevealed. Her peers respected her for her honesty, meticulous behavior, and strong work values. During the practice, she was confronted with a serious ethical issue in her workplace, and knowing that her mentioning about it would bring severe hostilities from the superiors, she sought guidance from the nurse Ethicist of the medical center. The guidance and support received from the Ethicist gave her courage to stand firm and stay determined in doing what she thought right. Likewise, healthcare institutions can insist for moral courage and ethical principles in their position descriptions, performance evaluations, and strategic planning programs. Moral courage is a great trait found in individuals, who overcome fears of adversities and personal risks in acting upon for the sake of others during ethical dilemmas. Moral courage is the pinnacle of ethical behaviors embodied in commitments to ethical principles, in spite of potential risks, such as defamation, emotional anxiety, retaliation, isolation, and loss of employment. For the ancient Greeks, courage meant only the response to physical hazards, but, for the contemporary scholars it is one’s commitment to stand for his or her ethical beliefs, which is a vital virtue for the nursing professionals, today.   However, moral courage is different from moral arrogance, as the latter involves only the individual’s personal moral judgment about a controversial issue, though others think differently. Moral courage occurs when individuals adhering to ethical standards overcome their conflicting values. This is evident in the case of Emily, who refused to document the ungiven medical care, in spite of the repeated insistence of the administration. Conclusion/Review This article has highlighted the critical need for healthcare professionals, who understand the importance of moral courage in the workplace, and are willing to take action when the ethical values are being compromised. Providing awareness about moral courage and its importance will help educators, researchers, and leaders in healthcare confront ethical challenges. Therefore, it is vital for the healthcare professionals to value and support their peers, who show courage against unethical behaviors. The strategies for improving moral courage include embracing open dialogue about ethical principles, case studies, and role modeling, as well as ethical and moral rehearsals. The guidelines provided by Dr. Murray are exceptional and executable, as they intend to make the nurses, the leaders with strong ethical values, integrity and moral courage.

Quarter Wit, Quarter Wisdom Solving the Pouring Water Puzzle

Some time back, we came across a GMAT Data Sufficiency word problem question based on the pouring water puzzle. That made us think that it is probably a good idea to be comfortable with the various standard puzzle types. From this week on, we will look at some fundamental puzzles to acquaint ourselves with these mind benders in case we encounter them on test day. Today, we will look at the popular â€Å"pouring water puzzle†. You may remember a similar puzzle  from the movie  Die Hard with a Vengeance, where Bruce Willis and Samuel L. Jackson had to diffuse a bomb by placing a 4 gallon jug of water on a set of scales. Here is the puzzle: You have a 3- and a 5-liter water container each container has no markings except for that which gives us its total volume. We also have a running tap. We must use the containers and the tap in such a way that we measure out exactly 4 liters of water. How can this be done? Don’t worry that this question is not written in a traditional GMAT format! We need to worry only about the logic behind the puzzle   we can then answer any question about  it that is given in any GMAT format. Let’s break down what we are given. We have only two containers one of 3-liter and the other of 5-liter capacity. The containers have absolutely no markings on them other than those which give us the total volumes, i.e. the markings for 3 liters and 5 liters respectively. There is no other container. We also  have a tap/faucet of running water, so basically, we have an unlimited supply of water. Environmentalists may not like my saying this, but this fact means we can throw out water when we need to and just refill again. Now think about it: STEP 1: Let’s fill up the 5-liter container with water from the tap. Now we are at (5, 0), with 5 being the liters of water in the 5-liter container, and 0 being the liters of water in the 3-liter container. STEP 2: Now, there is nothing we can do with this water except transfer it to the 3-liter container (there is no other container and throwing out the water will bring us back to where we started). After we fill up the 3-liter container, we are left with 2 liters of water in the 5-liter container. This brings us to (2, 3). STEP 3:  We gain nothing from transferring the 3 liters of water back to 5-liter container, so let’s throw out the 3 liters that are in the 3-liter  container. Because we just threw out the water from the 3-liter container, we will gain nothing by simply  refilling it with 3 liters of water again. So now we are at (2, 0). STEP 4:  The next logical step is to transfer the 2 liters of water we have from the 5-liter container to the 3-liter container. This means the 3-liter container has space for 1 liter more until  it reaches its maximum volume mark. This brings us to (0, 2). STEP 5: Now fill up the 5-liter container with water from the tap and transfer 1 liter to the 3-liter container (which previously had 2 liters of water in it). This means we are left with 4 liters of water in the 5-liter container. Now we are at (4, 3). This is how we are able to separate out exactly 4 liters of water without having any markings on the two containers. We hope you understand the logic behind solving this puzzle. Let’s take a look at another question to help us practice: We are given three bowls of 7-, 4- and 3-liter capacity. Only the 7-liter bowl is full of water. Pouring the water the fewest number of times, separate out the 7 liters into 2, 2, and 3 liters (in the three bowls). This question is a little different in that we are not given  an unlimited supply of water. We have only 7 liters of water and we need to split it into 2, 2 and 3 liters. This means we can neither throw away any water, nor can we add any water. We just need to work with what we have. We start off  with  (7, 0, 0) with 7 being the liters of water in the 7-liter bowl, the first 0 being the liters of water in the 4-liter bowl, and the second 0 being the liters of water in the 3-liter bowl and we need to go to (2, 2, 3). Lets break  this down: STEP 1: The first step would obviously be to pour  water from the 7-liter bowl into the 4-liter bowl. Now you will have 3 liters of water left in the 7-liter bowl. We are now at (3, 4, 0). STEP 2: From the 4-liter bowl, we can now pour water into the 3-liter bowl. Now we have 1 liter in the 4-liter bowl, bringing us to  (3, 1, 3). STEP 3:  Empty out the 3-liter bowl, which is full, into the 7-liter bowl for a total of  6 liters no other transfer makes sense  [if we transfer 1 liter of water to the 7-liter bowl, we will be back at the  (4, 0, 3) split, which gives us nothing new]. This brings us to (6, 1, 0). STEP 4: Shift the 1 liter of water from the 4-liter bowl to the 3-liter bowl. We are now at (6, 0, 1). STEP 5: From the 7-liter bowl, we can now shift 4 liters of water into the 4-liter bowl. This leaves us with  with 2 liters of water in the 7-liter bowl. Again, no other transfer makes sense   pouring 1 liter of water into some other bowl takes us back to a previous step. This gives us  (2, 4, 1). STEP 6:  Finally, pour water from the 4-liter bowl into the 3-liter bowl to fill it up. 2 liters will be shifted, bringing us to (2, 2, 3). This is what we wanted. We took a total of 6 steps to solve this problem. At each step, the point is to look for what helps us advance forward. If our next step takes us back to a place at which we have already been, then we shouldn’t take it. Keeping these tips  in mind, we should be able to solve most of these pouring water puzzles in the future! Getting ready to take the GMAT? We have  free online GMAT seminars  running all the time. And, be sure to follow us on  Facebook,  YouTube,  Google+, and  Twitter! Karishma, a Computer Engineer with a keen interest in alternative Mathematical approaches, has mentored students in the continents of Asia, Europe and North America. She teaches the  GMAT  for Veritas Prep and regularly participates in content development projects such as  this blog!