ethics and healthcare

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Eth 288 - 03 (spring 2015)

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Page 1: Ethics and Healthcare

Eth 288-03 (spring 2015)

Page 2: Ethics and Healthcare

• Ethics is two things.

• First, ethics refers to well-founded standards of right and wrong that

prescribe what humans ought to do, usually in terms of rights,

obligations, benefits to society, fairness, or specific virtues. Ethics, for

example, refers to those standards that impose the reasonable

obligations to refrain from rape, stealing, murder, assault, slander, and

fraud. Such standards are adequate standards of ethics because they

are supported by consistent and well-founded reasons.

• Secondly, ethics refers to the study and development of one's ethical

standards. It is necessary to constantly examine one's standards to

ensure that they are reasonable and well-founded. Ethics also means,

then, the continuous effort of studying our own moral beliefs and

conduct, and striving to ensure that we, and the institutions we help to

shape, live up to standards that are reasonable and solidly-based.

Page 3: Ethics and Healthcare

The Ethical process Experience: Experience tells me that the knowledge I

have is based on something that is really out there. Through experience we gather data.

Understanding: Understanding is called forth by the question “what is it?” Understanding puts the separate parts of the data into some kind of order so that we can grasp the whole of what is given in the data.

Judgment: In this operation we try to ask as many questions as we can about our understanding so that we may come to as accurate a judgment as possible.

Page 4: Ethics and Healthcare

Religious belief/Scripture: moral precepts: ie.

10 Commandments, Matthew 25, Beatitudes

“Do unto others as you would have them do unto you”

Virtuous/heroic stories: Moses, Jesus, Mohammed, Krishna

Martin Luther King Jr., Gandhi, Mother Theresa,

Natural Law: Reason and conscience, the natural state for

humans to comprehend and understand universal truths and insight. To derive formal moral norms through rational and observable methods that are generally accepted.

Page 5: Ethics and Healthcare

Professional Ethical Standards

American Nurses Association (ANA) Code of Ethics: The Code of Ethics for Nurses was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession.

◦ Provides a succinct statement of the ethical values, obligations, and duties of every individual who enters the nursing profession.

◦ Serves as the profession’s nonnegotiable ethical standard.

◦ Expresses nursing’s own understanding of its commitment to society.

National Association of Social Workers (NASW) Code of Ethics:

American Psychological Association (APA) Ethical Principles of Phycologists and Code of Conduct:

UN Global Conduct: Core global values for businesses to adopt on Human Rights, Labor Standards, the environment and anti-corruption.

The Nuremberg Code: Promoting the voluntary consent of the human subjects.

Page 6: Ethics and Healthcare

The moral life is a matter of doing the

good. The moral person and the moral

community must discover what is morally

good in reality. This is the fundamental

thrust of a natural law approach to morality

THE MORAL/ETHICAL LIFE

Page 7: Ethics and Healthcare

Ethical Considerations

• Emperical/Experiential – We come to know morality through our experience of reality, norms emerge through our experience.

• Consequential – An important focal point for moral meaning and formulating moral norms.

• Historical – Recognizing the unfinished, evolutionary character of human nature and the human world. Dismissing a “one size fits all” morality.

• Proportional – Looking at making a decision on what outcome would give us the greatest possible proportion of good over evil. Making prudential judgments based on proportionality.

Page 8: Ethics and Healthcare

Moral Philosophies Natural

Law/Thomism

Utilitarianism

Kantian Ethics

Ethics of Care

Existentialism

Page 9: Ethics and Healthcare

Approaches for Moral Choices

• Strict Consequentialist: Guided my a single formal norm, discovering the most loving action in the situation. In this instant, regardless of past experiences, the right moral action will produce the greatest good for the greatest number. (Utilitarian model)

• Mixed Consequentialist: recognizing the moral complexity of reality this approach considers a number of factors. “It tries to determine the means truly proportionate to the good intended and the evil inevitably caused without losing a grasp on the basic goods that define the human possibility for growth. (Ethics of Care model)

• Deontological Approach: Some acts and norms are always either right or wrong, no matter what the consequence, i.e. killing the innocent is “intrinsically morally evil.” Actions are right if they follow morally right norms. (Kantian model)

Page 10: Ethics and Healthcare

Virtue Ethics

Virtue Ethics: emphasizes the role of one's character and the virtues that one's character embodies for determining or evaluating ethical behavior. –(existentialist model)

“What virtues should a good person possess who happens to work as a physician?”

Page 11: Ethics and Healthcare

Conscience must be informed and moral judgment enlightened. A well -formed conscience is upright and truthful. It formulates its judgments according to reason, in conformity with the true good that is universally recognized through a consensus of values and ethical codes. The education of conscience is indispensable for human beings who are subjected to negative influences and tempted by self interest to prefer their own judgments and to reject broader principles of the common good.

-adapted from the Catechism of the

Catholic Church

FORMATION OF CONSCIENCE

Page 12: Ethics and Healthcare

Ground Rules for Civil DialogueWe are all called to engage in civil dialogue. Here are some possible ground rules for civil dialogue:1. Make sure everyone has an opportunity to speak.2. Share your personal experience, not someone else’s.3. Listen carefully and respectfully. Speak carefully and

respectfully. Do not play the role of know-it-all, convincer or corrector. Remember that a dialogue is not a debate.

4. Don’t interrupt unless for clarification or time keeping.5. Accept that no group or viewpoint has a complete monopoly

on the truth.6. “Be more ready to give a favorable interpretation to another’s

statement than condemn it” (St. Ignatius of Loyola).7. Be cautious about assigning motives to another person.

Page 13: Ethics and Healthcare
Page 14: Ethics and Healthcare

Beauchamp & Childress' principles

Autonomy: The right for an individual to make his or her own choice.

Beneficence: The principle of acting with the best interest of the other in mind.

Non-maleficence: The principle that "above all, do no harm," as stated in the Hippocratic Oath.

Justice: A concept that emphasizes fairness and equality among individuals.

Page 15: Ethics and Healthcare

THEORIES OF JUSTICE

Libertarianism:

Rawlsian:

Marxism: