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Ethics > Ethical Concepts > Flashcards

Ethical Concepts Flashcards

1
Q

what is morality?

A

principles, guidelines and standards of right/wrong or good/bad conduct

personal morality
societal morality
morality of health professions- PT as a moral agent

there may be conflicts between/among

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2
Q

what shapes our ideas about morality?

A 
religious teaching
culture
philosophy
parents
family 
friends
school
media
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3
Q

what are the 3 types of ethical problems?

A

1- ethical distress
2- ethical dilemmas
3- locus of authority challenges

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4
Q

what is an ethical dilemma?

A

values in conflict
“right vs. right”

honorable, moral, just individuals can come to different “solutions” for the same problem

serious losses are at risk or gains are at stake no matter what is done

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5
Q

what are ethical theories?

A

ethical theory guides us in choosing a course of action that is (hopefully) right or more right than others

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6
Q

what are 2 ethical theories?

A

1- Teleological - Utilitarianism

2- Deontological- Duty

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7
Q

what is absolutism?

A

what is right is based on knowledge that can be known to be a truth

ex: religious truths believed to be absolute

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8
Q

what is relativism?

A

all is relative

ethical statements are not known to be ultimately true or false, but “truth” is dependent on circumstances

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9
Q

what is teleological theory?

A

Tele= end or outcome

focus on the consequences of the actions

goal-based, consequentialist

only when the potential consequences of an action are taken into consideration can one determine the right course of action

moral task in life= produce as much good as you can

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10
Q

what are the 3 components of the teleological theory?

A

1-utilitarianism

2- hedonism

3- pluralism

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11
Q

what is utilitarianism?

A

an act is useful if it brings about the best consequences overall

good=happiness
bad= unhappiness

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12
Q

what is hedonism?

A 
pleasure= good
pain= bad

palliative care- relief from pain and suffering is a desirable goal

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13
Q

what is pluralism?

A

the ultimate good may be a variety of other values

ex: knowledge, beauty, freedom, etc

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14
Q

what are criticisms to the theological theory?

A

must be able to predict consequences (good intentions are not enough!)

defining happiness is problematic

happiness is different for each person

difficult to measure or compare happiness to decide on the greatest net happiness

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15
Q

what is the deontological theory?

A

Deonto= duty

based on obligation to duties or principles

most famous theorist= Immanual Kant
“can’t judge the rightness or wrongness of an act on the basis of its consequences alone. Some actions are intrinsically immoral no matter how positive and beneficial one might judge the consequences to be”

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16
Q

what are criticisms to the deontological approach?

A

moral rules may conflict with one another

absolute duties (Kant)

Prima facie (other things being equal)
-moral duty may be overridden by another moral duty

ethical conflict= determine which duty is weightier

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17
Q

what is a duty?

A

AKA ethical principles/elements

moral bonds or obligations

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18
Q

what are the 4 generally accepted duties in health care?

A

1- autonomy

2- non maleficence

3- beneficence

4- justice

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19
Q

what is autonomy?

A

self-determination

respect for patient’s decision making

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20
Q

what is non maleficence?

A

do no harm

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21
Q

what is beneficence?

A

promote good

sometimes considered on a continuum with non-maleficence

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22
Q

what is justice?

A

fairness in the distribution of benefits and burdens

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23
Q

what are 2 extra duties?

A

5- fidelity

6- veracity

24
Q

what is fidelity?

A

faithfulness to implicit and explicit promises (to patients, profession, colleagues, etc)

25
Q

what is veracity?

A

honesty, telling the truth

26
Q

what are specific ethical principles for PTs?

A

APTA CODE OF ETHICS:

a- general ethical guidelines that guide behavior
b- guide for professional conduct- more specific interpretation of the code
c- different codes for PTs and PTAs
d- not laws, no enforcement power of law
e- individual state regulations govern practice in each state
f- code is applicable in all states, but only to APTA members
g- ethical violations may or may not violate the law
h- violations reported to the APTA Judicial committee for review
i-Violation of Code can result in loss of APTA membership, with decision published
j- if violate State licensure laws, individual state boards take action; penalty, possible suspension or loss of license

27
Q

what are top ethical concerns in PT?

A

inequality of health services

utilization and supervision

business relationships

over-utilization

entry level qualifications

other professionals

education program accountability

informed consent

confidentiality

justifiability of fees

ethical limits of intervention

truth in advertising

billing fraud

sexual abuse

pts with HIV

clinical competency

documentation

legal vs. ethical

lack of evidence base

lack of cultural diversity

ethics in research

endorsement of products

ethics= personal gain

28
Q

ethical decision making models facilitate what?

A

facilitate resolution of ethical dilemmas

29
Q

what are advantages of ethical decision making models?

A

more systematic, don’t leave things out

organizes thinking

agree on language and terms

balanced debate of all sides

decreases emotionalism

30
Q

what are 2 ethical decision making models?

A

1- Purtillo

2- Realm-individual process-situation (RIPS) (PT specific)

31
Q

what are the 6 steps to the Purtillo model?

A

1- get the story straighter
-gather relevant facts

2- identify the type of ethical problem

  • ethical distress
  • ethical dilemma
  • locus of authority

3- use ethical theories to analyze the problem

  • Teleological
  • Deontological

4-explore the practical alternatives/options

5- complete the action

6- evaluate the process and outcome (reflect)

32
Q

what is an ethical distress?

A

right vs. wrong

barrier to doing what is right or don’t know what is the right thing to do.

maintain integrity

33
Q

what is an ethical dilemma?

A

right vs. right
values are in conflict

2 divergent courses of action

34
Q

what is locus of authority?

A

who is the primary decision maker? who should it be?

35
Q

what are the 4 main steps to the RIPS model?

A

1- recognize and define ethical issues

  • Realm
  • Individual Process
  • Situation

2- reflect

3- decide (chose a theory)

  • duty based (deontological)
  • ends based (teleological)
  • care based (golden rule)

4-implement, evaluate, re-assess

36
Q

what are the 3 sub-steps to step #1 of the RIPS model?

A

1- Realms (look at each realm –> pick a process and situation for each)

  • individual
  • organizational/institutional
  • societal

2- individual process (pick 1)

  • moral sensitivity
  • moral judgement
  • moral motivation
  • moral courage

3-situation (pick 1)

  • issue/problem
  • dilemma
  • distress
  • temptation
  • silence
37
Q

what is the individual realm concerned with?

A

concerned with the good of the patient/client and focuses on rights, duties, relationships and behaviors between individuals

38
Q

what is the institutional/organizational realm concerned with ?

A

concerned with the good of the organization and focuses on structures and systems that will facilitate their goals

39
Q

what is the societal realm concerned with?

A

concerned with the common good

40
Q

what are the 4 components of individual process?

A

1- moral sensitivity
2- moral judgement
3- moral motivation
4- moral courage

41
Q

what is moral sensitivity?

A

recognizing, interpreting and framing ethical situations

being sensitive to the fact this is immoral

42
Q

what is moral judgement?

A

deciding between right and right actions

considering ethical principles (autonomy, etc), then selecting and applying them

43
Q

what is moral motivation?

A

prioritizing ethical values over financial gain or self-interest

44
Q

what is moral courage?

A

implementing the chosen ethical action, even though doing so may cause adversity

45
Q

what are the 5 types of ethical situations?

A 
1- problem/issue
2- temptation
3- silence
4- distress
5-dilemma
46
Q

what is a problem/issue situation?

A

a situation in which important moral values are being challenged

47
Q

what is a temptation situation?

A

a situation in which a choice must be made between a right action and a wrong one, where the wrong action may benefit the decision maker in some way

48
Q

what is a silence situation?

A

key parties realize ethical values are being challenged, but do nothing

49
Q

what is a distress situation?

A

“ethical distress” right vs wrong

there is a structural barrier to doing the right thing

type A: there is a barrier keeping you from doing what you know is right

type B: there is a barrier bc something is wrong but you are not sure what that is

50
Q

what is a dilemma situation?

A

“ethical dilemma” right vs right

there are 2 or more correct courses of action that cannot both be followed

you are doing something right, and also something wrong

most often involve ethical conduct

may involve conflicting traits of character (honesty vs. compassion)

51
Q

what is step #2 of the RIPS model?

A

REFLECT

what are the relevant facts and contextual info?

who are the major stakeholders?

what are the potential consequences, intended or unintended?

what are the relevant laws, duties and ethical principles?

what professional guidance do we have?

what do the “right vs. wrong” tests suggest you do?

52
Q

what are right vs. wrong tests?

A

Legal test: did anyone do anything illegal?

Stench test: does the situation smell wrong?

Publicity test: would any of the parties involved be embarrassed by the truth coming out?

Universality (mom test): what would your mom do? is this the right thing to do regardless of who is involved?

Ethics test: do the code of ethics, guide to professional conduct or professionalism in PT: core values say anything about this situation??

53
Q

what is step #3 of the RIPS model? what are the 3 components of this step?

A

Decide what to do (use one of the following)

1- rule- based

2- ends-based

3- care-based

54
Q

what is a rule-based decision?

A

“deontological”

follow only the principle you want everyone else to follow

55
Q

what is a ends-based decision?

A

“teleological”

do whatever produces the greatest good for the greatest number

56
Q

what is a care-based decision?

A

“the golden rule”

do onto others as you would have them do onto you

57
Q

what is step #4 of the RIPS model?

A

Implement, evaluate, and re-assess

Implement: moral courage (role-play, prepare, imagine)

Evaluate and re-assess:

  • did things turn out the way you expected?
  • what did you do well? not so well?
  • what were the most challenging aspects of this situation?
  • how did this situation compare with others you have encountered or read about?
  • how will this experience make you a better professional?

Ethics (10 decks)

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