Ethics in Health Care Flashcards
The discipline that examines one’s moral standards or the moral standards of society
Ethics
The standards that an individual group has about what is right and wrong, good or bad
Morality
Where moral standards come from
Upbringing
Friends
Religion
Pharmaceutical and medical device manufacturers are required to report anything of value given to doctors or teaching hospitals
Sunshine Act of the United States
Moralities in the Stages of Moral Development (Kholberg)
Pre Conventional (2-7) Conventional (7-12) Post Conventional (12 above)
Stages under preconventional morality
Reward and Punishment
Individualism and Exchange
Stages under conventional morality
Interpersonal Concordance
Law and order
Stages under post conventional morality
Social Contract and Individual Rights
Univeral Principles
Morality as it affects the self
Pre-conventional Morality
Morality that exhibits loyalty or subordination to the group
Conventional Morality
Morality that examines the values and norms of his or her group
Post-conventional Morality
Stage wherein the sense of right or wrong is determined by physical consequences
Stage 1 Reward and Punishment
Stage wherein there is an acceptance of the authority of powerful individuals who have a right to hand down a fixed set of rules
Stage 1 Reward and Punishment
Stage wherein the individual focuses on personal, self-satisfaction as the determinant of morality
Stage 2 Individualism and Exchange
Stage wherein the person is aware of others and relates to them in terms of benefit to self
Reciprocity
Stage 2 Individualism and Exchange
Stage wherein the person seeks conformity to expected social conventions and approval by having good intentions or being nice
Stage 3 Interpersonal Concordance
Stage that focuses on rules, social order and respect for authority
Stage 4 Law and Order
Stage wherein there is an awareness of conflicting views within society
Stage 5 Social Contract and Individual Rights
Stage wherein there is a belief that all values and norms are relative and should be tolerated
Stage 5 Social Contract and Individual Rights
Stage that emphasizes fair ways of resolving conflicts and reaching a consensus, mainly through democratic means
Stage 5 Social Contract and Individual Rights
Stage that shows a commitment to the universal principles of equal rights, social justice and respect for basic dignity
Stage 6 Universal principles
Anatomy of an Ethical or Unethical Decision by Manuel Velasquez
Ethical Reasoning
1) Moral Standards
2) Factual Information about the Dilemma
3) A good moral judgement
Ethical Action
4) Choose a course of action
5) Communicate well
Defines what you consider good
Ethical Framework
Ethical framework wherein actions and policies are evaluated on the basis of benefits and costs they will impose on society
Utilitarianism
Ethical framework that believes that the right action or policy is the one that will produce the greatest net benefits or the lowest net costs
Utilitarianism
How to be Utilitarian
1) Determine the alternative actions
2) Estimate the direct and indirect benefits and costs
3) Choose the alternative that produces the greatest sum total of utility
Attractions of Utilitarianism
1) Simplicity
2) Intuitiveness
3) Impartiality
4) Efficiency
Criticisms of Utilitarianism
1) Does not take into account intentions or character formation
2) End justifies the means thinking
I ought never to act except in such a way that I can also will that my maxim should become universal law
Principle of Universality
Act in such a way that you always treat humanity never simply as a means but always at the same time as an end
Principle of Humanity
Requires that the action can be safely prescribed as law for everyone
Categorical Imperative
Underlying philosophy or morality for the Categorical Imperative
if man thought well enough about it he would come to the same conclusion and would act in the same way in similar situations
Criticisms of Kant
Too rigid
Morality cannot be reason alone
“Consequences are irrelevant”
Ethical framework that believes that an action is right when it is what a virtuous person would do
Virtue Ethics
Morality is based on what will bring the best that a person can be because self actualization will bring about man’s authentic happines
Virtue ethics
Criticism for Virtue Ethics
No specific direction
No perfectly virtuous person
Doesn’t quickly respond to changes in practice that require new moral responses
Idealized roles may conflict
Merits of Virtue Ethics
Reminds us of the importance of Character
Gives importance to accumulated wisdom (Wisdom of Ages)
Framework that states if you believe in God then you are bound to subscribe to his claims and the duty of these claims
Christian ethics
Criticism for Christian ethics
Assumes belief in divine being
May lead to fundamentalism, no exemptions
Difficulty in adapting with changes in biotechnology
Scripture is interpreted in many different ways
Variables to calculating utility
Intensity Duration Certainty Proximity Fecundity Purity Extent
Principles of ethics
Nonmaleficence
Beneficence
Respect for Autonomy
Justice
Requires intentionally refraining from actions that may cause harm or risks harm
Nonmaleficence
A practitioner should act in the best interest of the patient involved
Beneficence
One chooses the action or policy that will produce the greatest net benefit or the lowest net cost
Net Utility
One ought to act in such a way that enables another person to act fully in accordance with his or her self chosen plan
Respect for Autonomy
Components of Respect for Autonomy
Liberty
Agency
Free from controlling influences
Liberty
Capacity for intentional action
Agency
An individual’s entitlements to act in a certain way or his being entitled to have others act in a certain way towards him
Moral rights
Giving what is due to a person
Justice
Imposition of punishments and penalties upon those who do wrong
Retributive justice
Compensation for the aggrieved
Compensatory justice
concerned with the fair distribution of society’s benefits and burdens
distributive justice
Framework that emphasizes attending to and responding to the good of particular and concrete people
Ethics of care
Sees concrete communities and communal relationships as having a fundamental value that should be preserved and maintained
Communitarian ethic
Five central values of ethics of care
Moral attention Sympathetic understanding Relationship awareness Accommodation Response
Criticisms for Ethics of care
Can degenerate into conventional thinking or unjust favoritism
can lead to burnout
Merits of Ethics of care
focus on the moral value and awareness of impact
focus on particularizing our responses
Angeles model for ethical reasoning
1) Gather facts
2) Identify stakeholders
3) Articulate dilemma
4) List alternatives
5) Compare values
6) Determine consequences
7) Make a decision
Guidelines on making a decision
Test of publicity
Test of time
Test of legality
UNESCO’s 5 Step Ethical method of reasoning
1) Fact Deliberation
2) Value Deliberation
3) Duty Deliberation
4) Test of Consistency
5) Final Decision
