Ethical Decision-Making in Healthcare


Healthcare and Project Management


By Dr. Deepa Bhide, MBBS, DCH, PMP

Hyderabad, India


The Healthcare industry workforce that deals with “life” faces ethical dilemmas frequently on medical and moral dimensions. These dilemmas range from care equity, access to healthcare, patient privacy and confidentiality, course of treatment, and so on. But the most important of these is dealing with the issues that concern the care delivery of patients with multimorbid disabilities and chronic diseases, especially around end-of-life care. As the healthcare workforce struggled to deal with the patient deluge in the face of limited resources, the Covid-19 pandemic brought huge ethical dilemmas to the fore. In this unprecedented situation, International and national bodies sprang into action, creating guidelines for crisis management to support the healthcare workforce.

Decision-making while dealing with ethical challenges is a step-by-step process. Project Management Institute’s (PMI) Code of Ethics and Professional Conduct is a well-referenced and adopted framework for dealing with ethical issues related to global projects and programs.

In this article, the author tries to increase awareness of and importance of ethical decision-making in healthcare situations. Patient care delivery needs to be envisioned as a project. Using scenarios from the healthcare world, the author would like to impress the relevance and value of using PMI’s Code of Ethics and Ethical Decision Making Framework (EDMF) as one of the multiple available reference frameworks for dealing with ethical issues in the healthcare domain.

Key terms: Healthcare ethical dilemmas; quality of life; ethical decision making; Ethical Decision Making Framework (EDMF)


Mary*: Good morning, doctor. How are you doing today?

Author: Good morning, Mary. I am doing well. How have you been?

Mary: Thank you. I have been held up with taking care of my friend. Her father, about 86 years old, is admitted to the local hospital for feeling dizzy and unable to sit down. He has been suffering from high blood pressure and diabetes mellitus for over three decades now and has developed complications of diabetes, such as kidney failure and foot ulcers. My friend knows the prognosis but is concerned about her father’s health. The team of physicians is attending to the frail older man. She just got home after discussing a do-not-resuscitate order for her father. I would like to know more about ethics or ethical considerations in patient care projects.

Author: Oh! I am sorry to hear that. I can understand your friend’s condition. It’s a challenging situation to handle. Let’s get going with our discussion on this topic.

Maintaining high ethical standards in care delivery1 is a must for anyone in healthcare, whether physicians, nurses, administrators, or those supporting the healthcare industry. That increases their credibility with patients and their families. The healthcare workforce faces ethical dilemmas in various forms in their day-to-day work lives. Even though “dilemma” literally means “two choices” (comes to us from Greek dilēmma, from di- ‘twice’ + lēmma ‘premise’), there are usually more than two paths to a solution, and most of the time, both approaches seem correct. That’s the dilemma! A dilemma increases the complexity of the decision from an ethical angle.

I present three scenarios to explain the ethical dilemmas faced by the healthcare workforce.


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Editor’s note: This series of articles about project management in healthcare is by Dr. Deepa Bhide, a pediatrician with additional experience in information technology and project management. Being a physician herself, she has recently experienced healthcare from a patient’s perspective while recovering from a broken ankle.  In this series, Dr. Bhide will reflect on programs, projects, and project management in various aspects of healthcare from industry, provider, and human patient perspectives. Learn more about Dr. Bhide in her author profile at the end of this article.

How to cite this paper: Bhide, D. (2023). Ethical Decision-Making in Healthcare, Healthcare and Project Management, series article, PM World Journal, Vol. XII, Issue V, May. Available online at https://pmworldlibrary.net/wp-content/uploads/2023/05/pmwj129-May2023-Bhide-Ethical-Decision-Making-in-Healthcare-series-4.pdf

About the Author

Dr. Deepa Bhide

Hyderabad, India


Dr. Deepa Bhide, MBBS, DCH, PMP, has over 20 years of professional experience where she has blended medical practice and research with IT and Project Management. She juggles consulting, training, and operations and is proficient in clinical medicine, project management, and healthcare information technology. Starting her career as a medical practitioner, she has worked with varied organizations before her current stint as director and clinical expert for Inventurus Knowledge Solutions.

Her passion for IT and Project Management was born from her day-to-day patient interactions. Deepa’s growing interest and work in these areas helped her view Project Management as a backbone of progressive healthcare. Her paper on “Patient Care – A Project Management Perspective” has received global recognition and acclaim. Deepa is an active contributor to PMI with her articles on a cross-domain confluence of Healthcare and Project Management. With a physician background as a solid foundation to leverage IT/PM skills and knowledge, Deepa has blended her broad-based experience and learnings to present a unified, holistic, wholesome view of Project Management and Healthcare. Through various webinars, events, talks, and writings across platforms, Deepa has been an evangelist in championing global project management during the Covid-19 pandemic.

A Gold medalist from Osmania University for standing First in the MBBS course and also for Human Physiology, she went ahead to pursue her DCH in Pediatrics and Child health. Deepa is an active member of their volunteer initiatives. Deepa has served a variety of roles in local and global PMI regions. The part of Council Lead for PMI’s Healthcare Community of Practice for two years (2013-15) involved identifying and mentoring volunteers and collaborating across geographies for knowledge assets. Deepa is currently a part of PMI’s Ethics Insight Team, a global team of 7 volunteers advocating PMI’s Code of Ethics and Professional Conduct.

Deepa lives in Hyderabad, India, and loves to travel, sing and experiment with global cuisine. She can be contacted at deepabhide@gmail.com.