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Chapter 2

Health Care Ethics

LEARNING OBJECTIVES

Describe the concepts of ethics & morality.
Describe how an understanding of ethical theories, principles, virtues, & values are helpful in resolving ethical dilemmas.
Explain the relationship between spirituality & religion.
Discuss situational ethics & how one’s moral character can change as circumstances change.
Explain how one’s reasoning skills influence the decision-making process.

I expect to pass through this world but once. Any good therefore that I can do, or any kindness I can show to any creature, let me do it now. Let me not defer it, for I shall not pass this way again

−Stephen Grellet

Ethics

Branch of philosophy that deals with values relating to human conduct with respect to rightness & wrongness of actions & goodness & badness of motives & ends.
Focus on rightness & wrongness of actions.
Concerned with what is morally good & bad, right & wrong.

Ethics – II

Microethics
individual’s view of right & wrong.
Macroethics
global view of right & wrong.

Ethics – III

Philosophical Ethics
involves inquiry into
ways of life
rules of conduct
Religious Ethics
a general pattern or“Way of Life”
Professional Ethics
a set of rules or moral code

Morality

Code of conduct
Guide to behavior
Describes class of rules held by society to govern conduct
Moral dilemmas occur
when moral ideas of right & wrong conflict

Morality Legislated

Law is distinguished from morality in that
law has explicit rules, penalties, & officials who interpret laws & apply penalties.
Laws created to set boundaries for societal behavior.
laws are enforced to ensure expected behavior happens.

Moral Judgments

Judgments are concerned with
what an individual or group believes to be the right or proper behavior in a given situation
No Universal Morality
right varies from nation to nation, culture to culture, religion to religion, as well as from one person to the next

Code of Conduct

Prescribe standards of conduct
States principles
Expresses responsibilities
Defines rules expressing duties of professionals to whom they apply

Ethical Theories I

Normative Ethics
attempt to determine what moral standards should be followed so that human behavior & conduct may be morally right
General Normative Ethics
Applied Ethics
Descriptive Ethics
Meta-ethics

Ethical Theories II

Consequential Ethics
theory of ethics that emphasizes morally right action is whatever action leads to maximum balance of good over evil
Utilitarian Ethics
concept that moral worth of an action is solely determined by its contribution to overall usefulness

Ethical Theories III

Nonconsequential Ethics
Denies consequences of an action are only criteria for determining morality of an action
Deontological Ethics
doing right thing is good
might not always lead to or increase the good & right thing sought after

Ethical Theories IV

Ethical Relativism
morality is relative to the norms of one’s culture

Principles of Ethics – I

Ethical principles
universal rules of conduct, derived from ethical theories that provide a practical basis for identifying what kinds of actions, intentions, & motives are valued.
Autonomy
Life or Death: the Right to Choose

Principles of Ethics – II

Beneficence
Nonmaleficence
Justice
Distributive Justice

Virtues & Values

Virtue
normally defined as some sort of moral excellence or beneficial quality.
Moral value
relative worth placed on some virtuous behavior
What has value to one person may not have value to another.
A value is a standard of conduct.
Values used for judging goodness or badness of an action

Pillars of Moral Strength - I

Courage
Wisdom
Temperance
Commitment
Compassion
Conscientious
Discernment
Fairness

Pillars of Moral Strength - II

Fidelity
Freedom
Honesty/Trustworthiness/Truth-Telling
Integrity
Kindness
Respect
Hopefulness
Tolerance

Spirituality & Religion

Spirituality
in the religious sense implies that there is purpose & meaning to life; spirituality generally refers to faith in a higher being
Religion
serves a moral purpose by providing codes of conduct for appropriate behavior through revelations from a divine source

Religions – I

Judaism
Hinduism
Buddhism
Taoism
Zen
Christianity
Islam

Secular Ethics

Based on codes developed by societies that have relied on customs to formulate their codes
Code of Hammurabi
Atheism

Situational Ethics - I

Outcome or consequences of an action in which ends can justify the means
Moral values & moral character can be compromised when faced with difficult choices

Situational Ethics - II

Good people behave differently in different situations.
Good people sometimes do bad things
One’s moral character sometimes change as circumstances change
thus the term situational ethics

Sustaining Life
Situational Ethics

Decision not to use extraordinary means to sustain life of an unknown 97 year old “may” result in a different decision if the 84 year old is one’s mother.

Reasoning
Decision-Making – I

Reason includes the capacity for logical inference and the ability to conduct inquiry, solve problems, evaluate, criticize, and deliberate about how we should act and to reach an understanding of other people, the world, and ourselves.

Reasoning
Decision-Making – II

Partial reasoning involves bias for or against a person based on one’s relationship with that person.
Circular reasoning describes a person who has already made up his or her mind on a particular issue and sees no need for deliberation.

Reasoning
Decision-Making – III

Ethics in decision-making involves the process of deciding the right thing to do when facing a moral dilemma.
Ethical dilemmas occur when ideas of right and wrong conﬂict.

Review Questions – I

1. Discuss the concept of morality.

2. Describes the various theories of ethics.

3. Describe the various principles of healthcare ethics.

4. Describe desirable virtues and values in the healthcare setting.

5. Given an example of situational ethics.

6. Discuss the importance of reasoning in the decision-making process.