The ethical dilemma which I will describe in this paper occurred whilst I was working at a care-home for the elderly several years ago. I was working a night shift and was responsible for the care of fifteen elderly and severely disabled people between the hours of 10pm and 7am. One of these people, named Penny, was suffering from a large amount of pain in her legs due to persistent ulcers and inflammations and, as such, was prescribed a large dose of painkillers, including morphine. Upon commencing my shift, I performed the usual medication rounds and gave Penny her morphine, along with the other medications which she was prescribed. Due to other health concerns and the recommended dose, she was not to be allowed any more before 5am. It was hoped that she would sleep through until this time. At midnight Penny began calling out loudly and in obvious pain. I went to see her and she informed me that her legs were hurting uncontrollably and soon afterwards she began to demand more morphine immediately. I informed her that I was not able to provide this, as she ran the risk of overdosing and exceeding the recommended dose. She told me that she didn’t care about this and that all she wanted was for the pain in her legs to go away. At the same time people sleeping in rooms close to hers began to wake up as a result of her calling out and to question to me as to what the problem was, and to ask me to solve as they would be unable to sleep if the shouting continued.
The ethical dilemma with which I was faced was whether or not I should administer more pain killers before the recommended time. I knew that to do this would break the rules of the institution where I was working and that if I was found out then I would almost certainly be fired and lose my livelihood. I also knew there could be serious health consequences for the person who requested the painkillers. At the same time I was aware that I had a responsibility to do everything within my power to ease the suffering of an individual in my care. I also had to appreciate the fact that Penny was of sound mind and, despite the pain that she was in, should in an ideal situation be able to make her own decisions about her health. I also felt as if I had a duty of care towards all others in the home that night and that my capacity to fulfil this would be greatly impeded by the attention which Penny required.
I managed, eventually, to solve this dilemma by contacting my supervisor who was off sick that night but who informed that other, weaker painkillers could be given alongside the morphine. I was aware that this was unlikely to help Penny sleep but that it might have some effect. I also relocated myself from the front lounge of the home, which is equidistant from most rooms, to Penny’s room where I attempted to take her mind off the situation that she was in by talking about relatives and her grandchildren. This did mean that I had to slightly compromise my capacity to care for others as well as I should, however I compensated for this by doing extra rounds and checking on them every half hour rather than every hour. I attempted to reassure Penny that she would be given her morphine at exactly 5am and that before then I would do everything which I could to help her. Eventually this reassurance had a positive effect and she began to become more calm and was able to sleep for several hours before 5am, at which time her morphine was given and she slept soundly until her next dose was due at 9am.
In conclusion, I feel that I managed to solve the ethical dilemma I was faced with which concerned both my own well being and that of several others. I feel that I did this through a combination of flexibility where it was possible and a strict adherence to rules where it wasn’t. I feel that this dilemma was especially important as it manifested a common clash between an individual person’s wishes, their relative ability to carry them out and their overall well being.