Ethical Dilemma on Competency and Self-Determination of Client

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The situation involves a 14-year-old girl who is seeking birth control at the local community clinic. However, she is not comfortable with the idea of her parents or boyfriend knowing about her decision. This presents several ethical dilemmas for the health practitioner assisting her. As described in the case, some health workers are concerned about her situation while others 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. This can either question their own beliefs or force them to decide on something that contradicts their personal beliefs in order to justify a certain decision or action. An ethical dilemma arises from an interplay between personal views, which are influenced by societal conditions regarding what is right or wrong, and immediate concerns that need to be addressed by the person facing the dilemma.

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The ethical issues involved in Sandra’s situation revolve around her age, maturity, and decision-making ability regarding a crucial aspect of her holistic well-being. The health workers face a dilemma concerning their competency, impartiality, and perception of the client’s capacity for self-determination.

It is vital for health workers, as professional practitioners, to be aware of ethical dilemmas that may arise in their daily work and to possess the necessary knowledge, skills, and attitudes to handle various situations. In the case of Sandra, health workers must demonstrate a non-judgmental attitude towards the client based on her maturity and age. Despite the fact that Sandra can still be considered a child by definition, health workers should act in a manner that will not hinder her from seeking help regarding reproductive health.

A non-judgmental attitude is required of health practitioners. They must assume a non-blaming attitude and behavior towards the client, avoiding conclusions about their situation. This is crucial because ethical conduct requires health workers to refrain from being 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 also involves examining the health worker’s biases, prejudices, and perspectives on the client’s situation. When a health worker faces an ethical dilemma, they should always maintain objectivity and consider options based on what is best for the client rather than their personal opinion of what is right.

Health workers have the responsibility of enabling clients to access necessary resources, opportunities, and services to address their immediate needs. If a client requests help with reproductive health, specifically regarding the use of contraceptives, health workers must connect them with available resources. Ideally, if resources are readily available in the community clinic, health workers can provide clients with their needs.

The last ethical dilemma in Sandra’s case is the dilemma of self-determination. Self-determination is based on recognizing the client’s right to make decisions about their personal issues and choose what they believe is best. In other words, clients have the right to control their own destiny and circumstances. The client’s self-determination involves being aware of their situation, problems, and aspirations that could lead to a decision that they deem fitting for the situation. It also means giving them freedom to solve their own problems using their capacities and resources to transform their current situation and achieve holistic development and well-being. Self-determination is based on the premise that clients have inherent capacity and strength to address and provide solutions for their problems.

Given the ethical issues above, it is the responsibility of health workers to solve the dilemma based on their professional knowledge, skills, and attitude. The best way to resolve the issue is to provide Sandra with her contraceptive needs under one condition. Health workers should explain the range of choices available to clients in terms of the benefits of contraception as well as the consequences of having an active sex life at an early age. It is also their responsibility to provide as much information as possible so that clients can make informed decisions.

Health workers, being knowledgeable on health issues, should discuss with their clients the adverse effects of contracting sexually transmitted diseases that can permanently damage their overall well-being. When clients are aware of the pros and cons of their actions, it will pave the way for proper decision-making.

During the process of providing information on reproductive health to clients, it is crucial for health workers to maintain self-awareness, accept the client’s situation without judgment, and believe in the client’s ability to make their own decisions. Once all information has been provided and discussed, it is important for the health worker to allow the client to make their own decision.


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

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