Chapter 8: Leadership Management

• Moral decision-making


  The ability to produce a reasonable and defensible answer to an ethical question as to what is the right thing to do in a certain setting
• Moral decision-making


  A decision made in a way so that action or inaction conforms to one's morals
• Moral decision-making is a complex process involving many processes and relationships between processes
• The moral domain covers the fairly universal principles of harm, justice, fairness and care
• Moral discernment


  The ability to discern the moral good, discern moral right from wrong and have the standard to measure or compare the good and bad
• Principles of moral discernment/judgment

  • Principle of Formal Cooperation
  • Principle of Material Cooperation
  • Principle of Lesser Evil
  • Principle of Double Effect
• Basic norms/principles affecting moral discernment


  • State of Life
  • Gifts and Talents
  • Desire
  • Organic Development
  • Serenity
  • Conformity to Scripture and Tradition
• Types of moral attitude

  • Callous
  • Strict
  • Pharisaical
  • Scrupulous
  • Lax
• Degrees of moral certitude

  • Certain
  • Doubtful/Probable
  • Perplexed
• Principle of well-formed conscience

  People are obligated to inform themselves about ethical norms, incorporate that knowledge into their daily lives, act according to that knowledge, and take responsibility for those actions
• Conscience


  Subjective norm of morality, based on human intellect which is imperfect and prone to miscalculations
• Types of conscience


  • Heteronomous conscience
  • Autonomous conscience
• You must follow your conscience, whether it is right or wrong
• Ways to follow conscience

  • Follow the law
  • Follow your cultural beliefs
  • Follow your feelings
  • Follow your religion
• Principle of well-formed conscience


  To attain the true goals of human life by responsible actions, one is morally obliged to: inform himself as fully as possible about the facts and ethical norms, form a morally certain judgment of conscience based on this information, act according to this well-formed conscience, and accept responsibility for his actions
• The education of conscience is indispensable for human beings who are subjected to negative influences and tempted by sin
• Conscience


  Judgement of reason whereby the human person recognizes the moral quality of a concrete act
• Natural law


  The norm that conscience judges a concrete act as good or evil in accord with
• Forming a well-formed conscience

  1. Inform himself as fully as practically possible about the facts and the ethical norms

  2. Form a morally certain judgement of conscience based on this information

  3. Act according to this well-formed conscience

  4. Accept responsibility for his actions
• Education of conscience


  • Indispensable for human beings subjected to negative influences and tempted by sin
  • A life-long task
  • Awakens the child to the knowledge and practice on the interior law recognized by conscience
  • Teaches virtue; prevents or cures fear, selfishness, pride, resentment, and feelings of complacency
  • Guarantees freedom and engenders peace of heart
• Informed conscience


  Needs knowledge of the facts and of the law, but also requires a disciplined or virtuous affection for what will truly satisfy our needs in an integral manner
• The Church equips its members to address political questions by helping them develop well-formed consciences
• The Church's process in forming one's conscience

  1. Begin by being open to the truth and what is right

  2. Study Sacred Scripture and the teachings of the Church

  3. Examine the facts and background information about various choices

  4. Prayerfully reflect to discern the will of God
• Conscience discovers moral truth; it does not create it
• Conscience alone is not infallible
• Conscience formation is influenced by many factors: education, family background, faith traditions, what we read and hear, political preferences, experiences in life, people whose voices we have come to trust
• Well-formed conscience


  • Judgement of reason by which the human person recognizes the moral quality of a concrete act
  • Man's most secret core, and his sanctuary
• Forming a good conscience

  1. Assimilating the Word of God by study, prayer, and practice

  2. Prudent advice and good example of others

  3. Authoritative teaching of the Church

  4. Gifts of the Holy Spirit

  5. Regular examination of our conscience
• Certain conscience


  We believe that our conscience is in conformity with what is objectively true
• Incorrect conscience


  The conscience is erroneous in its view of the truth
• Through loyalty to conscience Christians are joined to other men in the search for truth and the right solution to many moral problems
• Standards-Based Model for moral decision-making


  1. Determining primary dilemma

  2. Spell out ethical standards for response

  3. Determine if there is a reason to deviate

  4. Decide on a course of action
• The Moral Decision-Making Model

  1. Massage the dilemma

  2. Outline options

  3. Affirm position and act

  4. Look back
• Virtues-based Model


  • Make decisions based on the kind of person the decision-maker is or how they think of themselves
  • What kind of person will I become if I do this?
  • Is this action consistent with my acting at my best?
• Practice-Based Model


  1. Recognize problems, get facts

  2. Assess values, benefits, burdens

  3. Determine legal, social influences

  4. Generate solutions, outcomes

  5. Consult

  6. Act, review, reflect
• Ethical dilemma


  • Discusses solutions by identifying and weighing the benefits and disadvantages
  • Each proposed action is accounted for based on the individual's ethical perspective
• Ethical problem


  Arises when choosing between two contentious possibilities that are occasionally undesirable
• Process of an Ethical Dilemma

  1. Find the origin of the ethical dilemma

  2. Gather all information relevant to the case

  3. Examine and determine the nurse's values on the issues

  4. Verbalize the problem

  5. Consider the possible courses of action to address all sides of an issue

  6. Negotiate the outcome

  7. Evaluate the action

  8. Reconsideration and motivation
• Role of Nurse in Ethical Dilemma

  • Identify the Problem
  • Gather All Possible Information
  • List Options
  • Identify the Ethical Principles
  • Make a Decision
  • Act
  • Evaluate
• Ethical and Legal Issues in Management