Evaluate “Access to Health Insurance” and apply the MORAL model to the decision making process.
MORAL MODEL FOR ETHICAL DECISION MAKING
M = MASSAGE THE DILEMMA
O= OUTLINE THE OPTIONS
R= REVIEW CRITERIA AND RESOLVE
A= AFFIRM POSITION AND ACT
L= LOOK BACK
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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 whose 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?

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