Identify common ethical dilemmas and how to approach them in case management?

• A. Conflicts between resource limits and patient needs; confidentiality vs safety; autonomy vs beneficence; approach with policies, ethics consultations, and documentation.
• B. Conflicts between patient needs and staff schedules; ignore ethics; proceed regardless.
• C. Always defer to physician authority with no ethics review.
• D. Withholding information to avoid upset; no documentation.

Answer: (A)

Ethical dilemmas in case management arise when there are competing duties to the patient, to others, and to the system, requiring a careful balance of rights, safety, and practical constraints. The best approach recognizes core ethical principles—autonomy (honoring the patient’s preferences and decision-making capacity), beneficence and nonmaleficence (doing good and avoiding harm), and justice (fairness in resource use and access)—and applies them within your organization’s policies. It also uses formal mechanisms to guide decisions, such as ethics consultations, and documents the process and rationale clearly.

This option identifies the common tensions you’ll encounter: resource limits versus patient needs, confidentiality versus safety, and autonomy versus beneficence. It recommends a constructive path: follow established policies to provide a consistent framework, seek ethics consultations when the situation is unclear or contentious, and document the decision-making process and justification. This combination helps ensure decisions are transparent, defensible, and aligned with professional standards, while protecting patient rights and safety and maintaining accountability within the organization.

Why the other approaches don’t fit: ignoring ethics or proceeding without a framework bypasses essential safeguards and can lead to harm or injustices. Always deferring to physician authority without any ethics review disempowers other professionals and may neglect patient preferences and broader ethical obligations. withholding information to avoid upset and avoiding documentation breaches informed consent principles, undermines trust and the patient’s right to know, and can expose everyone to risk and liability.