Ethics, social justice , and advocacy

• Ethics


  A branch of philosophy that includes both a body of knowledge about the moral life and a process of reflection for determining what persons ought to do or be, regarding this life
• Some general ethical obligations we have as members of society

  • To not harm others
  • To respect others
  • To tell the truth
  • To keep promises
• Veracity


  Telling the truth
• Consequentialism


  Decision based on outcomes or consequences
• Utilitarianism


  A well-known consequentialist theory that appeals exclusively to outcomes or consequences in determining which choice to make
• Deontology


  Persons should always be treated as ends in themselves, and never as mere means to the ends of others
• The 4 Ethical Principles

  • Respect for Autonomy
  • Nonmaleficence
  • Beneficence
  • Distributive justice
• Respect for Autonomy


  Based on human dignity & respect for all (autonomy = freedom of choice)
• Nonmaleficence


  "do no harm" (no malice)
• Beneficence


  "to do good" [an obligation to care for others – to promote wellness]
• Distributive justice


  Fair distribution of benefits & burdens within a society based on needs & contributions
• Communitarianism


  Maintains that abstract, universal principles are not an adequate basis for moral decision making. Instead; history, tradition, and concrete moral communities should be the basis of moral thinking and action.
• Virtue ethics


  One of the oldest types of ethical theory (dating back to ancient Greek philosophy). "What kind of person should I be?" Virtues are acquired, excellent traits of character that dispose humans to act in accord with their natural good.
• Caring and the ethic of care

  Based on feminist theory. A response to the technological advances in health care science, to the desire of nurses to differentiate nursing practice from medical practice. Emphasizes a belief in the morality of responsibility in relationships that emphasize connection and caring.
• Feminist ethics


  Supports critical thinking and focus on issues such as gender, power, and socioeconomic status. Entails knowledge about and critique of classical ethical theories developed by men and women, and knowledge about the social, cultural, political, economic, environmental, and professional contexts that insidiously and overtly oppress women as individuals or within a family, group, or society.
• Distributive Justice


  The allocation of benefits and burdens to members of society. Material & social goods, liberties, rights, entitlements. Benefits: wealth, educating, public services. Burdens: taxes, military services, location of power plants. Equity: based on need. Equality: equal for all.
• Theories of Distributive Justice

  • Egalitarian
  • Libertarian
  • Liberal Democratic (Rawls 2001)
• Advocacy


  For community health nursing: The application of information and resources to effect systemic changes that shape the way people in a community live. Address quality of life for individual in a community. For public health nursing: Advocacy is intended to benefit aggregates, e.g., to reduce death or disability in groups of people, and uses information and resources to reduce the occurrence or severity of public health problems. Address quality of life for populations.
• Conceptual Framework for Advocacy (Cristoffel, 2000)


  • Information Stage
  • Strategy Stage
  • Action Stage
• Practical Framework for advocacy

  • Act in the patient's (group's, community's) best interests
  • Act in accordance with the patient's wishes and instructions
  • Keep the patient properly informed
  • Carry out instructions with diligence and competence
  • Act impartially and offer frank, independent advice
  • Maintain patient confidentiality
• Principles for the Justification of Public Health Interventions

  • Harm Principle
  • Principle of Least Restrictive Means
  • Reciprocity Principle
  • Transparency Principle
• Harm Principle


  A foundational principle for ethics that sets out the justification to take action to restrict the liberty of an individual or a group in order to prevent harm to others
• Principle of Least Restrictive Means


  Recognizes that a variety of means exist to achieve public health needs, but the full authority and power should be used for exceptional circumstances. Education, facilitation, and discussion should precede any restriction or coercive measures.
• Reciprocity Principle


  Society must be prepared to facilitate individuals and communities in their efforts to discharge their duties.
• Transparency Principle


  Refers to the manner and context in which decisions are made.