HCS/335 Version 4 / 4
Weekly Overview
Week One
Overview
The framework of ethics is established by exploring the basic concepts needed to guide a person’s decision-making skills. You will be provided with an overview of ethical theories, such as deontology, natural law, virtue and Rawls’, principles like beneficence and nonmaleficence, and other related concepts. These serve as an important foundation for ethical issues that will be made in your career.
Ethical principles and theories may help you make effective ethical decisions in health care. Think of these principles and theories as the foundation for all ethical decision making. Just as a strong foundation keeps a building stable, so will these principles bring stability to the way you view ethical dilemmas. This does not mean all situations you encounter will be easy, but it does mean these principles will keep your values from crumbling as you untangle ethical dilemmas.
In addition, we will differentiate law and ethics using key legal concepts and case study examples. You may find that, even though one incident may require you to respond to legal and ethical issues, the elements are different paradigms. Always ask yourself, “What are the ethical implications?” Then, use the principles and theories we discuss as tools to respond. The principles we discuss may be applied in all you do in health care. As you complete future courses focusing on the quality of care and health care policies, integrate these principles when making decisions.
What you will cover
- Ethical Theories, Principles, and Concepts
a. Differentiate between legal and ethical issues.
1) Ethics defined
a) Definition depends on who is asked
(1) Philosophers say ethics is a formal study of morality
(2) Sociologists say ethics is a culture’s morals, customs, and behavior
(3) Physicians say ethics is meeting the expectations of the profession and society, and acting in specified ways toward patients
(4) Health service managers say ethics is a charge and responsibility to the patient, to the organization and its staff, to themselves and the profession, and to society
b) General definition: principles and values that guide an individual’s or population’s actions when faced with questions of right and wrong
c) Administrative versus biomedical ethics
(1) Administrative: involves manager, profession, organization, patients, and society
(2) Biomedical: involves individual patients or groups of patients in their relationships with each other or with providers and organizations
2) Law
a) Definition: a system of principles and rules of human conduct prescribed or recognized by a supreme authority
b) Types of law
(1) Customary: develops over time through trial and error; is never made at a specific point in time, but develops through habit and custom
(2) Legislative: created according to a specific plan to resolve actual or potential social conflict and may replace customary law
c) Classification of laws
(1) Public: criminal, administrative, constitutional, international
(2) Private or civil: tort, contract, property, inheritance, family, corporate
(3) Civil law: Concerns relations between individuals or between individuals, business, and government
(4) Tort law: Civil injury or wrongful act committed against another person or property.
(a) Intentional torts include assault, battery, false imprisonment, defamation of character, fraud, invasion of privacy.
(b) Unintentional torts include negligence or an unintentional action that occurs when a person either performs or fails to perform an action that a “reasonable person” would or would not have committed in a similar situation. Involves performing carelessly or failing to perform a task.
d) Formal sources of law, such as constitutions, statutes, rules and regulations, and judicial precedents, etc.
e) Nonformal sources of law
(1) Have not received authoritative formulation and embodiment in a formalized legal document
(2) Examples include standards of justice, principles of reason, social trends, etc.
3) Relationship between ethics and law
a) Law is the minimum standard of morality established by society to guide interactions among individuals, and between them and government.
b) Law includes few positive duties.
c) Law concentrates on prohibitions, and professions are bound by law.
d) Even when law is clear, ethical concerns may remain.
e) Laws and ethics have a dynamic relationship; each affects and is affected by the other.
b. Analyze major ethical theories and principles.
1) Ethical theories
a) Utilitarianism
(1) This measures morality by the amount of pleasure obtained.
(2) John Stuart Mill stressed individual freedom.
(3) Ignore the means of achieving the end.
(4) Judge an action’s results by comparing the good brought about by a particular action to the good brought about by alternatives, or the amount of evil avoided.
b) Deontology
(1) Relations with others must be based on duty.
(2) An action is moral if it arises solely from goodwill, not from other motives.
(3) Golden rule: Do unto others as you would have them do unto you.
(4) Immanuel Kant was an 18th century German moral philosopher.
c) Natural law
(1) Ethics must be based on the concern for human good.
(2) The potentiality of humans is based on a uniquely human trait—the ability to reason.
(3) Do good and avoid evil.
d) Rawls’ theory
(1) Permits disproportionate distribution of goods to certain groups, but only if doing so benefits the least advantaged
e) Casuistry
(1) Case-based reasoning
f) Virtue ethics
(1) Traits of character, habits, tendencies, and dispositions. How we ought to be, not what we should do
g) Ethics of care
(1) A reaction to the rules and system-building of traditional theories; do what is right, and respond to warmth, compassion, sympathy, etc.
2) Ethical principles
a) Beneficence: acting with charity and kindness
b) Nonmaleficence: opposite of beneficence; refraining from actions that aggravate a problem or cause other negative results
c) Justice
(1) Rawls: fairness; people get what is due to them
(2) Aristotle: equals treated equally and unequals treated unequally
d) Respect for people
(1) Autonomy: requires that people act toward others in a way that allows them to govern themselves
(2) Truth-telling: honest in all activities
(3) Confidentiality: managers keeping what they learn about patients confidential
(4) Fidelity: doing one’s duty or keeping one’s word
c. Identify problem-solving methodologies.
1) Solving problems
a) Components
(1) Analyzing: separating a problem’s overall structure in a particular case into its major components
(2) Weighing: assessing the strengths and weaknesses of various alternatives that could be used in solving the problem by balancing them against each other
(3) Justifying: providing a compelling and sufficient moral reason that appeals to an established moral principle
(4) Choosing: selecting one or more available alternatives, preferably on the basis of a position that can be and has been justified
(5) Evaluating: re-examining the choices and their justifications, identifying unanswered questions, and relating decisions about a particular case to similar cases
b) Three-step model
c) Seven-step model
d) Dr. Bernard Low’s clinical model
e) May be divided into two basic types
(1) Rational: assumes that a person is faced with a specific problem and focuses primarily on a search for the optimal solution
(2) Heuristic: acknowledges that some problems may be more diffusely defined, poorly structured, and are often not routine
2) Developing a personal ethic
a) Necessitates introspection and self-examination
b) In selecting principles included in a personal ethic, managers should apply three criteria:
(1) Comprehensiveness
(2) Consistency
(3) Coherence
DISCUSSION PROMPTS
- Are laws and regulations the problem or the solution in addressing ethical problems? Explain. What would be an alternative?
- How might you apply ethical philosophies and principles that summarize what you perceive to be the top five ethical issues challenging health care delivery today?
- How are some problem-solving methodologies applied in the health care industry?
Copyright © 2016 by University of Phoenix. All rights reserved.