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You may use your book or other resources, but you must cite the resource(s) both in-text and a reference list per APA guidelines. Minimum 250 words for initial post. Follow APA GUIDELINES WHEN WRITING. NO Plagiarism, use correct grammar and punctation To begin our study of ethics, each of you must first examine yourself. Consider your values on three levels: Personal Societal Health Care Professional List 5 values for each level. Explain how each is relevant in your life. Compare your values with those of other students. Do you see areas of conflict between your values and those of others? Identify these potential conflicts. Family is an important value to me (I have a husband of 7 years, a two-year-old daughter, and a 4-month-old son. I have always been family oriented however, having babies of my own make me value family that much more.) please include family being a value in the appropriate section chapter_1__sp2014__health_care_ethics.ppt chapter_2_3__sp2014__health_care_ethics.ppt chapter_4_1_sp2014__health_care_ethics.ppt Unformatted Attachment Preview HLST 3001 – Health Care Ethics Stacy Starks Morality and Ethics Morality and Ethics – What are they and why do they matter? • Learning Objectives – Define morality and ethics and distinguish between the two – Describe three moralities that health professionals must integrate into their own moral life – Identify some major sources of moral beliefs in the Western societies Morality and Ethics – What are they and why do they matter? • Learning Objectives – Distinguish between an ethical issue and an ethical problem – List three ways that ethics is useful in everyday professional practice – Identify some mechanisms available to protect the personal moral convictions of health professionals Professionalism and Ethics • Is it possible to be unprofessional and still not be unethical? Why Study Ethics? • Moral concerns are unavoidable in life. • Analogy: morality is a lot like nutrition. – Principal concern: health – The role of experts – Disagreement Ethics as an Ongoing Conversation • Professional discussions of ethical issues in journals. • We come back to ideas again and again, finding new meaning in them. Ethics Defined • Branch of philosophy • Study of morals & character • Study of principles of human dignity • Ethics provide us with moral principles or universal rules that help us know what to do. Ethics Defined • Involves how individuals decide to live – within accepted & desirable principles – in harmony with the environment & one another • Micro-ethics: individual’s view of right & wrong • Macro-ethics: global view of right & wrong Focus of Health Care Ethics • Values relating to human conduct. • Rightness & wrongness of actions. • Goodness & badness of motives & ends • Provides the tools for constructive deliberation & conflict resolution involving ethical dilemmas. MILESTONES - I • 1932–72 - Tuskegee Study of Syphilis • 1946 - Military Tribunal for War Crimes • 1949 - Nuremberg Trials – Int’l Code of Medical Ethics • 1954 - First Kidney transplant • 1960s - Cardio-pulmonary resuscitation MILESTONES - II • 1968 - Harvard Medical School – report on Brain Death Criteria • 1964 - World Medical Association • 1970 - Patient as a Person – by Paul Ramsey – “paternalism” questioned • 1971 - Kennedy Institute of Ethics at Georgetown MILESTONES - III • 1972 - Informed Consent • 1974 - National Research Act • 1976 - Substituted Judgment – In the Matter of Karen Ann Quinlan • 1978 - President’s Commission for Study of Ethical Problems in Medicine MILESTONES – IV • 1990 - Physician Assisted Suicide • 1990 - Patient Self-Determination Act • 1994 - Oregon’s Death with Dignity Act • 1996 - HIPAA MILESTONES - V • 2001 - Presidents Council on Bioethics • 2003 - Human Genome Fully Sequenced • 2006 - Stem Cell Research Controversy • 2008 – State of Washington approves physician-assisted suicide Ethics and Morality • Morality: first-order set of beliefs and practices about how to live a good life • Ethics: a second-order, conscious reflection on the adequacy of our moral beliefs Morality • Is a code of conduct • Implies quality of being in accord with standards of right & good conduct • Describes class of rules held by society to govern the conduct of its individual members. Morals • Ideas about what is right & wrong • Guides to behavior that rational persons put forward for governing their behavior Moral Responsibility • Requires a person to question his or her own values. • Requires a person not only to examine what one considers the right thing to do in given situation, but why it is the right thing to do. • A moral dilemma occurs when moral ideas of right & wrong conflict. Moral Judgments • Judgments concerned with what an individual or group believes to be right or proper behavior in a given situation. • Involves assessment of another person’s moral character based on how he or she conforms to moral convictions established by the individual &/or group. Moral Judgments • What is considered right varies from nation to nation, culture to culture, religion to religion, & person to person. • No “universal morality.” • Whatever guide to behavior an individual regards as overriding & wants to be universally adopted is considered that individuals morality. Moral Health • The goal of ethical reflection is moral health. • Thus we seek to determine what will nourish our moral life and what will poison it. Morality and Moral Values • Morality – Concerned with the relationships between people – How they can live in peace and harmony • Values – Has a popular meaning of those things a person holds dear Morality and Moral Values • Duties – Actions in response to claims placed on a person by himself/herself or others • Moral Character or Virtues – Traits or attitudes that are needed to be able to trust each other and to provide for human flourishing Value • The relative worth placed on some virtuous behavior. • What has value to one person may not have value to another. • Value is a standard of conduct. • Values are used for judging the goodness or badness of some action. • Values are standards by which we measure goodness in our lives. Values May Change If one’s basic needs for food, water, clothing & housing have not been met, one’s values may change in such a way that a friendship, for example, might be sacrificed if one’s basic needs can be better met as a result of the sacrifice. Values Can Change • People make value judgments & choices among alternatives. • Values one so dearly proclaims may change as needs change. • Motivating power of a persons actions are a necessity of survival. • Values give purpose to each life. They make up one’s moral character. The Moral Point of View • What makes something a moral issue? – Content: • duties, rights, human welfare, suffering, character, etc. – Perspective: • impartial, compassionate, etc. Example: Cheating Imagine a situation in which you see a classmate cheating. There are several elements from a moral point of view: – Some people are hurt by the cheating – There is deception in the situation – Cheating seems to be unfair to those who don’t cheat – There are conflicting values – honesty, loyalty, etc. – There are questions of character Example: Cheating • How are you expected to respond to cheating? – Expectations of • Faculty • Peers • ULM • Parents • Society The Language of Moral Concerns • Some philosophers have argued that moral issues are characterized by a particular kind of language – terms such as duty, obligation, right and good. Personal Morality • Made up of: – Virtues, values and duties you have adopted as relevant • Key part of this is “relevant” • Health care professional must take into account the morality of their patients Group Morality • Most people are/have some type of group morality – Religion, club, organization, school, political affiliation, etc. • Accepting the values, virtues, duties of a group is group morality • Health care professionals have their own group morality – Code of Ethics, Law governing the profession, etc. Group Morality • Health care professionals are a member of a special type of group morality because of the professional role they play in society • With that comes special moral expectations arising from that role From Moral to Ethical • Ethics is the study of and reflection on everyday morality • Functions as fundamental part of everyday life • Takes on specific form when one takes on special societal roles (health care, teachers, etc.) Using Ethics in Everyday Personal and Professional Situations • Ethics can be used to: – Analyze a situation based on sets of values – Resolve complex situations – As a guide to take action (moral agent) for or against a specific situation Situational Ethics • Situational ethics refers to a particular view of ethics, in which absolute standards are considered less important than the requirements of a particular situation. • The importance of a particular value may vary as one’s situation changes. Situational Ethics • Moral values & moral character can be compromised when faced with difficult choices. • Good people behave differently in different situations. • Good people sometimes do bad things • One’s moral character can sometimes change as circumstances change – thus the term situational ethics. Sustaining Life: Situational Ethics A decision not to use extraordinary means to sustain life of an unknown 84 year old “may” result in a different decision if the 84 year old is one’s mother. Ethical Decision-Making Ethical decision-making is the process of deciding, what the right thing to do is in the event of a moral dilemma. Case: High in the Andes Those who survived the plane crash high in the Andes Mountains were faced with some difficult survival decisions. Their need to survive illustrates to what lengths one may go in certain situations in order to survive. Case: High in the Andes • How might you change as circumstances change? • Describe how your consultative advice might change based on the patient’s needs, beliefs, & family influences. The Focus of Ethics • Ethics as the Evaluation of Other People’s Behavior – We are often eager to pass judgment on others • Ethics as the Search for Meaning and Value in Our Own Lives Ethics as the Evaluation of Other People’s Behavior • Ethics often used as a weapon • Hypocrisy • Possibility of knowing other people • The right to judge other people • The right to intervene • Judging and caring Ethics as the Search for Meaning and Value in Our Own Lives • Positive focus • Aims at discerning what is good • Emphasizes personal responsibility for one’s own life Principle of Material Cooperation • Justification for cooperation with wrongdoing • You may be in a situation where wrongdoing will be happening, but are not in complete control – Cooperation with wrongdoing cannot be directly intended • Cannot be guilty by association Protections to Ensure Ethical/Moral Behaviors • Protections allowing you to follow your conscience are made in: – Laws (local, state, federal) – Policies (professional/non-professional associations, employers) • In the end, it is up to you to defend your position. – Burden of proof for ethical actions falls on you, not the accuser Ethics & Good Health • Ethics is like nutrition – One studies bodily health, the other moral health – Significant disagreement in both fields – Still there is a significant common ground Ethical Situation Discussion • Abortion/Right-to-Life – Professional ethics says abortion is permissible – Legal law says abortion is permissible as long as conditions are met – Religious ethics says to take a life is wrong, no questions asked – Societal ethics is unknown HLST 3001 – Health Care Ethics Stacy Starks Ethical Goals of the Profession Ethical Goal of Professional Practice • Learning Objectives – Identify the goal of professional ethics activities – Describe the basic idea of “a caring response” – Identify three parts of any ethical problem – Describe the role of emotion in ethical situations Ethical Goal of Professional Practice • Learning Objectives – Describe an ethical dilemma that puts one’s own beliefs or desires in conflict with abilities – Compare and describe the differences between ethical distress and ethical dilemma “A Caring Response” • From time to time you will be torn by conflicting claims on you as health care professionals. • Your loyalty must be to the patient at all times “A Caring Response” • Characteristics of “A caring response” – Sometimes identical to the one you would show toward a friend or relative – Entails responsibilities that have clinical, ethical and legal dimensions – Includes professional duty – Highly individualized and changes from person to person “A Caring Response” • Fundamentals include: – Elements of human nurturance – The patient is the primary focus or loyalty – Limits guided by the patient’s vulnerability because of health-related concerns – Recognition of professional responsibility to the patient – The condition that has an individual component Ethical Problem • A situation that you have reason to believe presents serious negative implications or threats to important moral values, dispositions and duties, and will pose extremely difficult choices Ethical Problem • 3 types – Distress is a situation where you are faced with how to maintain your integrity or the integrity of the profession – Dilemma is a situation where you are faced with a challenge about what the morally right thing to do is; two or more courses of action diverge – Locus of authority problem is a situation where there is a challenge on deciding who is the primary decision maker Components of Ethical Problems • Moral Agent – The person responsible for the outcome • Course of Action – Includes analysis, judgment and ultimate decision on what to do • Desired Outcome – Intended or hoped for result of the decision process Ethical Distress • Occurs when the moral agent knows what the morally appropriate course of action is but cannot achieve it due to external barriers • Occurs when there is a high level of uncertainty about the information required to arrive at the desired outcome Ethical Distress • Occurs when the health care professional acts as a parent with all its negative and positive connotations – Conflict between the parent’s choice and professional’s judgment on the course of action • Occurs when the moral agent is faced with two or more conflicting courses of action but only one can be chosen Ethical Distress • Occurs when there is conflict on who is the moral/change agent – Policies in the institution – Authority – Experience/Expertise Ethical Distress Problem • You are the only healthcare provider in an emergency room. You hear a call that a badly injured patient is in route. When the patient arrives, you realize the patient is a close friend. • What do you do? What ethical problems are involved? Ethical Dilemma • An ethical dilemma involves two (or more) morally correct courses of action that cannot both be followed. Locus of Authority Problem • Who decides who decides? • Possibilities: – Team approach – Physician – committee HLST 3001 – Health Care Ethics Stacy Starks Ethical Theories and Approaches Ethical Theories and Approaches • Learning Objectives – Describe the usefulness of basic theories and approaches – Distinguish metaethics from normative ethics – List three reasons why your understanding of metaethics is relevant to health care – Name five types of normative ethical theories and approaches Ethical Theories and Approaches • Describe the role of moral character or virtue • Describe the function of a principle (norm, element) in ethical analysis and conduct • Identify six principles encountered in health care ethics Ethical Theories and Approaches • Ethical Theory is a general overview or statement that begins with an assumption about the very nature of doing wrong or right • Ethical Approach does not propose to be a complete system or model, but to be an aid to existing theories or other approaches Divine Command Theories • “Do what the Bible tells you” • Being good is equivalent to doing whatever the Bible tells you to do. • The 10 commandments • “What is right” equals “What God tells me to do.” The Ethics of Our Inner Voice • “Follow your conscience” • Conscience tells us what is right or wrong • Often has a religious source • Is often negative in character, telling us what is not right Ethical Egoism • “Watch out for #1” • Says the only person to look out for is yourself The Ethics of Duty • “Do the right thing” • Begins with the conviction that ethics is about doing what is right, about doing your duty • Duty may be determined by: – Professional role – Social role The Ethics of Respect • “Don’t dis’ me” • Human interactions should be governed by rules of respect • What is it that merits respect? The Ethics of Rights • “. . . all Men are created . . . with certain unalienable Rights” • Established minimal conditions of human decency Utilitarianism • “Make the world a better place” • Seeks to reduce suffering and increase pleasure or happiness • Utilitarians claim the purpose of morality is to make the world a better place. The Ethics of Justice • “Daddy, that’s not fair” • Begins early in the family with fairness to all family members • What is fair for one should be fair for all • Treating people equally may not mean treating them the same. Virtue Ethics • “Be a good person” • Seeks to develop individual character • Assumes good persons will make good decisions • Provides a way of integrating all theories What to Expect from a Moral Theory Functions of theory: • Describe • Explain • Give strength • Prescribe Part of Ethical Study • Metaethics – Tries to discover the nature and meaning of ethical reasons we propose as valid for making judgments about morality – Deals with the source of reasons we give for our positions. – An understanding requires you to become more aware of your beliefs • Religious, philosophic, what you have been told is right and wrong Part of Ethical Study • Most of us live by rules, obedience to which we take as a duty. – What are the most important rules you live by? – What were the most important rules in your family? – What rules have you rejected as you have gotten older? Part of Ethical Study • Metaethics – Absolutism • Rests on the notion that right or wrong is based on knowledge that can be known to be the truth • For example – Stealing is wrong. There is a law against it. Therefore it is the truth. Part of Ethical Study • Metaethics – Relativistic • Rests on the notion that ethical statements are not known to be true or false – Stealing is wrong. Unless you are in dire straights and need to steal to survive, but only used on a limited basis for a specific time and for specific items. Part of Ethical Study • Normative ethics – Asks more concrete questions related to morality – Deals with methods for ascertaining right and wrong actions and morally praiseworthy or blameworthy attitudes and behaviors Story or Case Ethical Approaches • Narrative Approaches – Are based on observations that humans pass on to tell a story • Stories are passed down from generation to generation among families or whole communities – Concludes that good moral judgment must rely on the analysis and understanding of the story – Narrative ethics require that all voices be considered before the situation is assessed for its moral significance Story or Case Ethical Approaches • Approaches emphasizing relationships – Seek to find a moral theme in the examination of relationships – Do you remember the Good Samaritan? • What relationship is this story telling us? Story or Case Ethical Approaches • Approaches Emphasizing Deep Diversity and Social Structures – Seeks to explain diversity and social structure issues – Do you remember Disney’s Beauty and the Beast? • What diversity and structure issue was this addressing? Story or Case Ethical Approaches • Postmodern and Diversity – Tries to state that because there are radical differences between groups, that no one set o ... Purchase answer to see full attachment