Ethical Dilemma on Competency and Self-Determination of Client

            The situation talks about e 14-year old girl who seeks birth control in the local community clinic but is not agreeable on the idea that her parents and his boyfriend should know about her move. For a 14-year old girl to seek help on this matter, numerous ethical dilemmas will surely arise on the part of the health practitioner. As what was described in the case, some health workers were concerned about her situation and other commend her for taking such initiative at an early age.

            Ethical dilemma, according to Spinoza (2006), is a situation in which a person is torn between two opposing values that can either question his own beliefs or decide on something that is contradictory to his or her personal beliefs to justify a certain decision or action made. Ethical dilemma in an interplay between personal views which is, in one way of another, were influenced by societal conditions on what is right or wrong, and immediate concerns that needs to be addressed by the person-in-dilemma.

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The ethical issues involved in the situation of Sandra revolve around the issue of age, maturity and decision-making over an issue that is crucial for her holistic well-being. On the part of the health workers, the dilemma circles over competency, of being non-judgmental, and their view on the capacity of the client for self-determination.

It is vital that the health workers as professional practitioners know about ethical dilemma in the course of their daily work, and are equipped with the knowledge, skills and attitude good enough to deal with different circumstances. In the case on Sandra, health workers must demonstrate non-judgmental attitude towards the client on the basis of her maturity and age. Despite the fact that the child can still be considered under the definition of a child, health workers should act in a manner that will not hinder the client to open up and seek help on the issue of reproductive health.

 Non-judgmental attitude require that health practitioners must assume a non-blaming attitude and behaviour towards the client and avoid conclusions on the client’s situation. This is crucial given that ethical conducts require health workers not to be judgmental.

To enable health workers to be fair and non-judgmental, they need to have a high level of self-awareness. Self-awareness requires health workers to continually reflect on their reactions to clients and their situations. It is also about examining the health worker’s biases, prejudices and perspectives on the client’s situation. When a health worker deals with ethical dilemma, he or she should always maintain his or her objectivity and should always consider options not based on his or her opinion of what is right, but should be based on what is best for the client.

Health workers are also responsible for enabling clients to link with necessary resources, opportunities and services to address the client’s immediate needs. If the client asked for help on reproductive health particularly on the use of contraceptive, then health workers must link the client to available resources or best, health workers can provide the client with his or her needs if resources are readily available in the community clinic.

The last ethical dilemma in Sandra’s case is the dilemma on self-determination. Self-determination is based on the recognition of client’s rights to make decision over their personal issues and make choices based on what her or she thinks is best. In other words, clients have the right to control their own destiny and circumstances. Self-determination on the part of the client is a process of being aware to his or her situation and problems as well as his or her aspirations that could lead to a decision that he or she deemed fitting for the situation. Self-determination is also about giving the client freedom to solve their own problems given their capacities and resources to transform their current situation and realize their aspirations for their holistic development and well-being. Self-determination is based on the premise that clients have inherent capacity and strength to address and give solutions to their problems.

Given the ethical issues above, it is then the responsibility of the health workers to solve the dilemma based on their professional knowledge, skills and attitude. The best thing to do to resolve the issue is to provide Sandra with her contraceptive needs on one condition. The health workers should explain the range of choices for the client in terms of the benefits of contraception as well as the consequences of having an active sex-life at an early age. It is the responsibility of the health worker to provide as much information to the client for her to have a wide range of choice in which to base her decision.

Because health workers are knowledgeable on health issues, they should discuss with the client the adverse effects on health is ever she will contract sexually transmitted diseases that can permanently damage her over-all well-being. When the client is aware of the pros and cons of her actions, it will pave way for her proper decision.

Throughout the process of equipping the client with knowledge on reproductive health, it is vital that health workers should maintain self-awareness, acceptance on the client’s situation, non-judgmental attitude and belief of self-determination on the part of the client. When everything has been done to inform the client on which action to choose, the health worker should let the client decide on her matter.


Spinoza, B. (2006). The Ethics. Teddington, Middlesex: The Echo Library.


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Ethical Dilemma on Competency and Self-Determination of Client. (2016, Sep 03). Retrieved from