Week 9 and 10 Ethical Foundations Flashcards
What is ethics
Ethics is knowing the difference between what you have a right to do and what is right to do
What are morals/morality
A sense of right and wrong
What is related to values, duty and character
Morals
What are ethics
A systematic study of and a reflection on morality
A system of moral beliefs that deals with the concepts of right and wrong
What are the three types of morality?
1)Personal
2)Group
3)Social
What is personal morality
The values and principles individuals personally live by and believe to be morally right and sound
What is Group Morality
The values that are adopted as part of a self-selected subgroup
What is societal morality
What our society approves of being right and acceptable
What six things influence our personal ethics and morals
1)Personal/spiritual/religious values
2)Authority Figures
3)Family
4)Cultures
5)Societal Norms
6)Personal Experiences
Teleological Theory
-Focus is on the effect, the consequences, the end result
-Minimizing adverse consequences while bringing about the greatest good
The ends justify the means would be what ethical theory
Teleological Theory
Difference between ethics and foundational constructs
ETHICS: Concerned about the outcome of a decision and will be less inclined to follow rules if I am not happy with outcome
CONSTRUCTS: Rules are fair and equitable resolution of any problem, regardless of result
Deontological Theory
Focus is on the rules without particular concern for the consequences.
Forms the basis for religious commandments and edicts, prof. codes of conduct and societal laws
Don’t Lie. Don’t Steal. Don’t Cheat would be a example of what ethical theory
Deontological theory
What are biomedical ethics?
A field of study and prof. practice interested in ethical issues related to health
The field grows with advances in med. tech.
What are Health care ethics unique? x3
1) Patients are injured and in pain and are, therefore, more VULNERABLE to exploitation
2)Delivery of health care to patients is often necessary on a emergency basis
3)Consequences of bad decisions have the potential to be life-altering or to result in dire consequences
6 Ethical Principles
1)Autonomy
2)Beneficence
3)Non-malefience
4)Justice
5)Fidelity
6)Veracity
What is autonomy
-Self-determination that is free from controlling interferences by others and personal limitation preventing meaningful choice (inadequate understanding or faulty reasoning)
-Self governance or to function independently
What is Beneficience
Patient care is in the best interests of the patient
-do only good
What is Non-Maleficence
Providing care without doing harm by omission or commission
-Do no harm
What is justice
Fairness
What are the 2 types of justice
1)Distributive
2)Comparative
What is distributive justice
How equitably are health care services distributed at the societal level
-Are resources equally available to people?
-Are certain diseases such as cancer, heart disease, arthritis and others likely
to get more attention?
- Is there an unequal distribution of resources at either the end or the
beginning of life?
What is comparative justice
Distribution of health care services at the level of the individual.
Comparative Justice issues x2
1)Reimbursement and denial of care involving individual patients
2)Disparate treatment of patients based on age, disability, gender, race, ethnicity or religion
What is fidelity
Maintaining your commitments to your patients, your profession, your employer, etc.
What is veracity
Duty to be truthful and honest
What does REACH stand for
Respect
Excellence
Autonomy and Well-Being
Communication, Collaboration and Advocacy
Honesty and Integrity
What is respect
Members are respectful of the differing needs of each individual and honour the patient’s right to privacy, confidentiality, dignity and treatment without discrimination
What is Excellence
Members are committed to excellence in professional practice through continued development of knowledge, skills, judgement and attitudes
What is autonomy and wellbeing
Members are at all times guided by a concern for patient well-being
Patients have the right to self-determination and are empowered to participate in decision about their health-related quality of life and physical functioning
Communication, Collaboration and Advocacy
Members values the contribution of all individuals involved in the care of a patient
Communication, Collab, and Advocacy are essential to achieve the best possible outcomes
Honesty and Intergrity
Each members commitment to act with honesty and integrity is fundamental to the delivery of high-quality, safe, and prof. services
CKO 6 Steps to Ethical decision making
1)Recognize that there is an ethical issue
- (smth is making you uncomfortable)
2)Identify the problem and who is involved
3)Consider the relevant facts, laws, principles and values.
-(what laws and standards may apply, and what ethical value/principle)
4)Establish and analyze potential options, weigh possibilities and outcomes, use moral imagination
5)Choose course of action and implement it
-Barrier and Record
6)Evaluate the outcome and determine if further action is needed
-Learned, how to be prevented in future
What are the 3 ethical frameworks?
1)Moral and Legal Template (Geddes)
2)Quadripartite Ethical Tool by Drolet and Hudson
3)Realm-Individual Process-Situations (RIPS)
Realm x3
Individual
Organizational/Institutional
Societal
Individual Process x4
Moral Sensitivity
Moral Judgement
Moral Motivation
Moral Courage
Situation x5
Issue or Problem
Dilemma
Distress
Temptation
Silence
Step 1 RIPS
Recognize and Define Ethical Issues
-Gather info
-Id realms, individual process, situation
Realm Individual
Concerned with the good of the patient, focusing on the rights and duties and relationship with the patient
Realm Organization/Institutional
Concerned about the good of the organization and focuses more on structures and systems
Realm Societal
Focuses on the common good and is the most complex
What does indvidual process in RIPS mean
What does the ethical situation require of me?
Moral Sensitivity
Recognizing, Interpreting and Framing ethical situations
Moral Judgement
Involves generating options, selecting and applying ethic principles and making a decision
Moral Motivation
Emphasis on ethical values over other values, self-interest, status, financial gain
Moral Courage
Implementing the chosen ethical action - develop a plan in the face of barriers and adversity
Issue or Problem
Important values are present and may be challenged
Dilemma
2 Alternative courses of action may be taken “right vs. right”
Distress
You know the right course of action but are not authorized to empower or perform it
Temptation
Right vs Wrong, situation in which you may stand to benefit from doing the wrong thing
Silence
Ethical Value are challenged, but no one is speaking about this challenge
Step 2 Rips
Reflect
-Reflect on the info gathered in step 1
-Who are the interested parties
-What are the relevant laws, regulations, and prof. standards, and codes of ethics
-What are possible consequences -intended and unintended
-Are any of the right vs. wrong tests positive
What are the 4 right versus wrong tests
Legal
Stench
Front Page
Mom
RIPS step 3
Decide the right thing to do
Step 3 RIPS for Ethical Dilemmas x3
1)Rule-Based: Follow the rules, duties, obligations or ethical principles already in place
2)Ends-Based: Determine the consequences or outcomes of alternative actions and the good or harm that will result from all interested parties
3)Care-Based: What are the relationships and concerns of others
If the situation is right versus wrong what to do in RIPS steps
Skip Step 3 go to step 4
Rules Based
Follow the rules, duties, obligations or ethical principles already in place
Ends Based
Determine the consequences or outcomes of alternative actions and the good or harm that will result from all interested parties
Care Based
What are the relationships and concerns of others
RIPS Step 4
Implement, Evaluate, Re-Assess
-Implement your plan
-Reflect both personally, professionally, what have you learned
RIPS Steps
1)Conflicting Ethics Principles
2)What Moral Problems
3)Ethical Problem
4)Resolve Problem
Legal Test
Is something illegal? (Be aware of your
Practice Act and the Rules
and Regulations that interpret the Act). If so, it is probably not a true dilemma but a
“hard choice.”
Stench Test
Does it “feel” wrong? Such as, “gut”
reaction?
Front-Page Test
How would you like this on the
front-page of your local newspaper?
Mom Test
If I were my mother (or parent), would I do
this?
Ethical Dillema Versus Moral Temptation
If any of these five tests
is “positive”, the situation
may be an issue of right versus wrong (moral temptation) and not an ethical dilemma.
When to use rules based
Use rules-based when there are clear policies or ethical codes.
When to use ends based
Use end-based when the focus is on evaluating consequences and maximizing overall good.
When to use care based
Use care-based to address relational dynamics or when compassion and empathy are central to the decision.
