Ethics, also known as moral philosophy, addresses questions about morality and what is good, evil, right or wrong, justice and crime. The ethical values help us to judge right or wrong under the circumstances and the corrective action that need to be taken. Ethics is very important in life and is applicable to all activities that we do. Being ethical also improves our reputation and work life, and installs a sense of self esteem, respect, rules and regulations and makes us trustful and reliable. International council of Nurses has released a guide “ICN Code of Ethics for Nurses” for action based on the social needs and values. 
Due to advances in medical technology, political and social changes result in moral dilemmas for both patients and physicians. This in turn creates conflicts for nurses. (Martin Benjamin, 2010 p. 1).We are very fortunate to have a variety of ethical theories which provide support for making ethically correct decisions and solving difficult issues. Ethical theories take the support of ethical principles which help to decide what is right or wrong, when trying to reach the best decision. When one understands each individual theory, and its strengths and weaknesses, decisions can be taken when trying to achieve an ethically correct answer to a dilemma. Developing a balanced approach to ethics with an emphasis on the positive benefits of ethics and development of a good character is good, and there are positive advantages of being ethical and negative results of being unethical. The primary purpose of ethics is to take the right decisions and is the medium for the development of a person’s character to use the knowledge to benefit him and others. 
The National Center for Ethics in Health Care was founded in 1971, Washington DC and administers various fields including medicine, nursing, philosophy, law, policymaking, education, theology, social work, and health care administration. The activities and initiatives of the organization include support for clinical ethics, organizational ethics, and research ethics and VHA’s National Ethics Committee provides analysis and guidance on controversial ethics issues affecting patients, providers, health care managers, and health policy makers. 
Ulrich et al. (2010) studied the nature of ethical issues faced by nurses and it was seen that more than 60% of nurses said that the patient’s right to autonomy, and consent was the cause of frequent problems faced by them. The other issues were decision making, advanced care planning, confidentiality and end-of-life decision (Ulrich et al., 2007. It was found that ethical issues, actions and regrets of nurses resulted in pain and suffering, delinquency in patient autonomy and difficulty in decision making, To solve these problems the nurses communicated and spoke up by advocating and collaborating (Pavlish et al., 2011).
To deal with ethical issues an organization has to be comprehensive, and establish clear standards, roles, competencies, methods, and performance metrics for its members and the patients. Everyone in the organization should be accountable through performance plans and require continuous monitoring and quality improvements, providing the much needed assistance to patients, families, and staff and deal with any eventually that might have occurred. The organization has to provide patient rights, have committed to quality and have a moral duty towards those being served in line with laws and regulations.
The most common issues affecting health care and the patients are the high costs of health care and the payers like third party insurance companies are more than less willing to take on the burden of various procedures and in some cases legal issues. There is a scarcity of resource allocation decisions both by managers and physicians, and with limited financial, technical and knowledge resources, equitable and appropriate distribution has become necessary. This is where administrative ethics come into play as it provides the moral decision making tools that individuals, organizations and communities need to determine and justify the norms and structure the terms under which scarce resource allocation decisions are required to be made to balance costs.
Healthcare professionals may in the name of technical expertise impose their professional values on others without justification(Martin Benjamin, 2010 p. 12) Most of the time therapists face ethical and moral dilemmas while treating patients and have to ponder on the legal and ethical values before treatment.
Take an example of a female patient who was on alcohol for some years and a mother of two children and wanted treatment to solve her drinking problem. She had stopped drinking for a few months, but received news that her company was on verge of closing down and may file for bankruptcy. The patient had started drinking again and appeared for the therapy session drunk and had even abused her children due to the pressure. As the therapist was in two minds whether to treat her or report her for abuse.
In the first instance, it appeared that the patient should be treated and if she responds positively, then as a therapist, he should ignore the legal implications and other factors. In this case the ethical conflicts occurred due to outside factors.
The conflicts were to be addressed through proper understanding of the conflict and the factors that caused the conflict to take place. The solutions to resolve the conflict was done by finding the nature of the conflict, clarifying wherever necessary, proposing verification, using alternative methods and taking preventive and corrective measures to end the conflict and action in this case being alcoholic.
It required giving into a client’s request as the patient who would otherwise quit therapy and it would not solve the problem. The second issue was that it would make the client depend on you or if termination of the therapy was the most suitable option to take.
It showed a desire for the negative feelings towards a client due to the situation and feeling upset over it. This also showed that the client’s moral values were different from my own and the client’s character was something which was disliked and resembled those people whom we would like to avoid in life.
Here such factors come into play, which include our emotions and vulnerabilities, and therefore influence our decision making process on how to deal with patients in such situations. So it is not always possible to help each and every client, but the goal is that if the patient is treated properly, he may not cause harm to his children or abuse them. There is also a question of autonomy and respect of personal information which the client has shared and they have the right to live their lives provided it does not harm others, particularly in the case of counseling by mental health experts making the treatment viable and client safe from external and legal implications.
We should also be courageous and kind towards our patients making them feel welcome and complete the treatment in hope for a better and healthy life both physically and mentally.
Such cases, mostly take place in mental health problems where most patients need to get over their bad habits and need the help of mental health therapists where secrecy is of most importance.
In such cases we need to be sympathetic to the patient so treatment of the patient is of utmost importance in such cases. The Charter in Medical Professionalism states that professionalism demand placing the interest of patients above those of the physician and setting and maintaining standards of competence and provide expert advice to society on the matters of health (Albert R. Jonsen, Mark Siegler, 2015 p. 14).
If secrecy is broken treatment of the patient is not possible and legal remedies would only aggravate the problem. Legal implications would only be an alternative if the patient did not respond to treatment or was unwelcome to treating himself which was not a factor in this case.
Not taking the problem of the patient seriously would only aggravate the problem and act as a barrier and considering the legal implications would only make matters worse and would be a hindrance to treatment as the patient may have been subject to accusations of abuse and alcoholism.
Facilation the treatment if available and providing the necessary moral support would enable the patient to overcome his bad habits and also improve his quality of life. The patient will also will also take the treatment steps to improve his quality of life and avoid further abuse of his children in the future..
The patient was genuine in his case to solve the problem and had himself approached the therapist to get himself treated and if such treatment is available the best course would be to continue treatment of the patient till the problem is resolved to the satisfaction of all concerned. The best solution in this case would be to treat the patient and help him and the society in general.
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