Smoothly Untangle Dilemmas: Handle Tough Situations with Integrity and Grace

When does helping others bump up against your sense of right and wrong? Shauna, a mental health provider, struggles when a physician talks rudely to patients. Dan, a firefighter, gets frustrated each time his crew is called to move a care center resident off the floor to their bed while the facility’s staff watch. Lauren, a veterinarian, is troubled each time a sick animal’s owner can’t or won’t pay for treatment. Encountering ethical dilemmas is exhausting.

Demands to act in ways going against our beliefs can lead to moral fatigue and burnout. Even when we know this is true it can be difficult to discern how to respond correctly. Power differences, emotional reactivity, and systemic dysfunction often get in the way of quick, easy solutions. Dilemmas become like a tangled ball of twine without an end in sight.

You can untangle moral dilemmas by using a practical strategy. Remember that dilemmas are difficult situations, so they may not be quick and easy to deal with. Efforts to resolve them with integrity will promote personal wellbeing and help those you work with. The following steps can help you positively deal with difficult situations.

 1.    What? Define and write down the problem. Be specific and concise. Initial thoughts may be a symptom of the real dilemma, so dig deep. Shauna first identified a doctor’s communication as the problem. However, after thinking about it she realized the frequent lack of respect demonstrated by numerous providers was really the issue. Clarify the problem that challenges your beliefs and wellbeing.

 2.    Why? Note why it is important for you to deal with the situation. Consider personal wellbeing, values, virtues, and purpose. Remember professional or organizational expectations, and legal standards. Think about how others are affected. Get perspective from trusted people not immersed in the problem and use resources to decide whether to deal externally with a situation.  

Dan described the community’s expectations, his job description, and a professional code. He realized there was little he could change, but he was able to reframe his perspective. Dan focused on his values of care rather than what he perceived as the care centers’ abuse of first responders. Carefully determine whether to deal with a dilemma or let it go. If you decide to let go of a dilemma, but it keeps troubling you, this is probably a sign you should do something.

 3.    How? If you choose to do something, brainstorm potential solutions and their implications. Enlist help from others involved or creative people you trust. Ethical dilemmas seldom involve choosing between a right and wrong answer. If we are lucky, we can choose between ideal options, but most likely we are forced to select between difficult alternatives. 

Choose what you see as the best option and formulate how to make it a reality. Lauren met with her veterinary team to brainstorm ways to help pet owners who cannot afford treatment. Ideas included: offer free care, enlist staff to pay, develop a donation fund, or not do anything. After evaluating options, Lauren set up a successful donation fund to help patients with limited resources, and decreased moral fatigue in the process.

 4.    When? Choose timing that will promote the best chance of a positive outcome. Most likely this is when you are calm and thoughtful. If emotions are running high, take time to increase inner peace and allow others to do so as well. Create a plan to deal with the dilemma that includes a time to implement and evaluate your response.

Shauna was outraged after a physician talked to her client disrespectfully. She had worked through the what, why, how, and when after a similar previous experience.  She identified the importance of respect in personal and organizational beliefs, as well as in professional codes. Shauna knew she could not ignore such situations, so she took a deep breath and used a response prepared ahead of time.           

How we respond to dilemmas does matter. We should carefully choose battles, but we also need to honor our moral wellbeing. As long as we live in a complicated world, we will encounter problems challenging our sense of what is right and wrong. Dilemmas may seem like a knotted mess of twine, but we can untangle them with care and integrity. Efforts to untangle the messes help us function in healthier ways so we can promote resolution and sleep better at the end of day.    

This article contains excerpts from “Resilient and Sustainable Caring: Your Guide to Thrive While Helping Others” published by Whole Person Associates.