M = MASSAGE THE DILEMMA (ABORTION)

O= OUTLINE THE OPTIONS

R= REVIEW CRITERIA AND RESOLVE

A= AFFIRM POSITION AND ACT

L= LOOK BACK

M = MASSAGE THE DILEMMA

Collect data that identifies the dilemma

• Recognize that most problems have more than one component,

• Identify the facts relevant to the ethical decision

• Recognize the cultural, economic, and political contextual factors that are present

• Identify the laws, professional ethical codes, and government regulations that enter into ones choices

Identify who is responsible for making the decision (Ie who’s decision is it to make?)

• Consider who has important stakes in the decision. Consider the opinions of the major players as well as their value systems.

• Consider all claimants potentially affected by the decision, both the majority and the minority. Try to see from the other’s perspective

O = OUTLINE THE OPTIONS

• Clarify the options available and the consequences of each potential action. This step is used to better understand the options rather than make a final decision.

• Include at least three options in the listing. (It has been noted there are always at least two options and these two often represent the extremes)

R = REVIEW CRITERIA AND RESOLVE

• Determine the best/worse case scenarios of choosing each particular alternative?

• Evaluate from the various moral perspectives of beneficence, autonomy, and justice

-Which option will produce the most good and do the least harm (beneficence)

-Which option respects the rights and dignity of all stakeholders (autonomy) ?

-Which option promotes the common good? (justice)

• Answer the questions honestly while considering all sides of the issue. Do any rules or principles (legal, professional, organizational, or other) automatically invalidate a particular alternative?

• List options in a graph format if needed to help clarify alternatives and outcomes. Positive options can be indicated with a (+) and negative options with a (-).

A = AFFIRM POSITION AND ACT

• Based on the above review, determine which of the options is the best to do. Use the ANA Code for Nurses to support conclusions.

• Use a specific exercise to help check your decision and confirm your thinking.

-Consider if you told someone you respect about why you chose this option, what would that person say

-Write a letter defending your decision to the party who potentially has the most to lose.

-Write a letter to your most serious detractor explaining why you’ve made the decision you’ve made

• Decide on the appropriate action and develop a plan to achieve this action.

L = LOOK BACK

• Evaluate the success of your intervention. Were personal/professional values considered? Ethical principles applied?

• How did the process turn out for all involved? If it had to be done over, are there things that you would have done differently?