A dilemma is when you are forced to choose between two options with equally compelling consequences. A moral dilemma is when you are forced to choose between two options with equally compelling moral consequences. A dramatic dilemma is when a fictional character is forced to choose between two options with equally compelling consequences whose choice drives the course of the narrative.
A typical moral dilemma is illustrated by the famous trolley question. There is a rail car speeding down the tracks on course to kill five people. There is a rail switch near you and and you can change the course of the rail car, but if you do, it will be on course to kill one person. Is it moral to exchange the life of the one person for the life of five?
You can turn this into a dramatic dilemma by stressing the fact that it is not your fault that the rail car is speeding toward five people. You had nothing to do with it. If you let the car go, nobody will blame you. But if you flip the switch, you will become actively responsible for the death of one person. That death will be on you. The situation has not changed, but just changing the perspective has changed this from a universal moral dilemma to a more personal dramatic dilemma. If the man by the switch were the protagonist, this event could easily be the inciting incident of a story, or perhaps the midpoint, or the break into the second or third acts. In short, the choice drives the narrative.
Here is another moral question: What if pedophilia was decriminalized in the same way heroin use had been decriminalized in some countries? Pedophiles, in order to avoid capture, sometimes kill their victims. If pedophilia was decriminalized, fewer victims will be killed and more pedophiles would seek treatment, leading to fewer victims in the future. The cost of this is that the victims will not get justice. This is a serious moral question and one without a simple answer, but it is not a dramatic question because the decision does not rest on a single person.
You could turn this into a dramatic question by giving the protagonist the power to change the outcome. Say it was one pedophile and it was one person who knew about it. The question would be whether to turn him in or cut him loose. The scope of the dilemma would be much smaller, but the issue would be the same. And it can become more personal. The outcome will hinge on the decision of the protagonist and the choice will drive the narrative.
Now let’s say there was a pair of magical glasses. This pair of glasses would tell you which people among the general population are pedophiles. It only works for the you and not for anyone else. Through these glasses you can see that a prominent man in your society is a serial pedophile. There is no way to gather evidence because nobody is talking, so your choice is to either remain silent or to take matters into your own hands. That is a dramatic dilemma, but what if you threw in an added twist? What if you were not sure that the glasses were real? It could be a hallucination. You might have a history of mental illness and talking about something nobody else can see might send you back to the psychiatric ward. You might also have a very important thing to do, taking care of a child, say, or running a business, and your presence is needed outside of psychiatric care. Now you have a moral dilemma, to take action or not take action, and a question of legitimacy, whether to trust your source of information or not. You now have two intertwined dilemmas.
Astute readers would already know where I am going with this. This is basically the plot of Hamlet. Hamlet was tipped off by his father’s ghost, an entity that he does not entirely trust. So he had to embark on a roundabout quest to confirm that the ghost’s testimony was true. On top of that was the question of whether or not to avenge his father at the price of killing a sitting king, who was also his mother’s new husband. Shakespeare took this double dilemma and used it to drive the narrative into a horrible conclusion.
Dilemmas are great narrative devices. But in order for a dilemma to be dramatic, the protagonist must be the one standing close to the rail switch and the outcome must hinge on the choice the protagonist makes.