When treating patients, healthcare professionals may have different approaches for determining a plan of care. One viewpoint is seen as ‘acting in the best interest of the patient’. Another perspective a practitioner may have is ‘first, do no harm’. Regardless of which mindset one chooses, moral awareness, moral judgement, and ethical behavior are all intricate components of the decision-making process. Overview of the Case Study E. L. Straight was hired as Director of Clinical Services at Hopewell Hospital 2 years ago. Since taking the position, Mr. Straight has focused on quality assurance by implementing measures to improve the delivery of healthcare within the facility. As part of his risk management, the director is making attempts to decrease or eliminate surgical schedules for physicians who have shown to have higher rates of adverse incidents. A recommendation to reduce the privileges of a long-time Hopewell Hospital employee and town patriarch, Dr. Cutrite, has been filed with hospital administration. The process is lengthy and presently the revocation status is pending which means the privileges of the general surgeon remain intact until an outcome is rendered. As the director waits for the decision, the operating room supervisor informs Mr. Straight of a recent surgical mishap involving Dr. Cutrite. A needle cap from a syringe Cutrite used during patient Jameson’s procedure was unaccounted for when the nurse circulator submitted an end of the week instrument inventory. Therefore, it is believed the protective sheath was never removed from the abdominal cavity prior to the final incision. The supervisor told Mr. Straight the patient had since been discharged and Dr. Cutrite instructed staff to not alert the patient to situation. Cutrite stated “..it cannot possibly hurt her. Except for a little discomfort, she’ll never know it’s there.” Following his chain of command, Mr. Straight contacted the chief surgeon and relayed the scenario to him as though it were a hypothetical situation. Not asking for specific details, the chief of surgery had the opinion the condition did not appear to be life-threatening. However, he did end the phone call by saying, “although, one never knows”; referring to the seriousness of patient Jameson’s outcome (Capella, 2020). Analysis of Ethical Issues in the Case Study A suspicion of wrongdoing by hospital staff has been brought to the attention of E. L. Straight. As Director of Clinical Services, he is justified in raising concerns about quality of care and patient safety. However, he is faced with the conundrum of remaining quiet to avoid causing unneeded stress to the patient in the event the situation is harmless. Or, should Mr. Straight advocate for Mrs. Jameson and risk being labeled a “whistle-blower”? Data collected from Leino-Kilpi, et al. (2019) suggests healthcare workers are less likely to expose unethical activity for fear of the negative consequences that may follow. Research from the study indicates the career of the “whistle-blower” can be greatly impacted in the form of an unwanted transfer or job loss. Although the individual feels the need to disclose the wrongdoing based on his/her moral integrity, the norms and values of the workplace may not equally align; leading to the end of the employee’s career (Leino-Kilpi, et al. 2019).