7-Step Decision Making Model: ethical dilemma assignment

You invent the dilemma, which means you also decide whether the worksheet has anything to work on. A scenario with an obvious right answer produces seven sections in which nothing happens, and that is the most common way this assignment goes wrong before a word of it is written.

Both examples the brief offers are instructive because neither is a temptation. A medical assistant asked to perform procedures they are not trained for, and a biller asked to overbill — in each case the wrong course of action is obvious, and what makes them dilemmas is the cost of refusing. That is the shape to copy. A usable dilemma has two defensible options with a real price attached to each, and the price is usually where the second value lives: your job, a colleague's, a patient's continuity of care, a clinic that closes if it cannot bill. If you can state your scenario and a reader instantly knows what you should do and what it costs you nothing to do, steps five and six will have nothing to compare and nothing to weigh.

Step three is where the model earns its keep, and it is the step most often reduced to a single word. It asks for the major principles, rules and values, and those are three different things. A rule is external and specific — a scope of practice regulation, a billing code, a licensure requirement, an employer policy. A principle is a general commitment such as beneficence, non-maleficence, autonomy or justice. A value is what you or the organisation actually prizes, which the brief itself lists as integrity, quality, respect for others or profit. A dilemma exists precisely when these three point in different directions, so naming which rule, which principle and which value are in tension is the analytic core of the whole worksheet. Write the scenario, then read steps five and six and ask what you would put in them. If the answer is nothing, change the scenario, not the worksheet.

Steps five and six do different jobs and are routinely merged. Step five asks whether there is one principle or value, or a combination, so compelling that the proper alternative is clear — a question about whether something outranks everything else, such as a legal obligation or patient safety. Step six is separate and it is about outcomes: short-term and long-term, positive and negative, for each major alternative. The brief flags what it wants from that step in a sentence students skim — the short-term gain is often overridden by long-term consequences, and the step often reveals an unanticipated result. So step six should surface something you had not already decided in step five. If your answer to six simply repeats five, the analysis stopped early. Getting this right also makes step five answerable, because you cannot ask whether one value outranks another until you have named more than one.

Two smaller things carry marks and cost almost nothing. Step four says to include alternatives that represent some form of compromise, so a list of two — do it or refuse — has not followed the instruction. The middle options are usually the realistic ones: escalate to a supervisor or compliance officer, document the request in writing, ask for the training that would make the task appropriate, request the instruction in writing, or seek an external opinion. And the submission has a specified filename format — first initial, last name, underscore, assignment name, underscore, date, saved as a Word document. That is free and it is checked. Compromise options are also the ones a real employee would consider first, which makes the worksheet read as practice rather than as theory. Getting the filename right takes ten seconds and is the cheapest mark on the sheet.