Midterms

• Ethical theories

  Ordered set of moral standards to be used in assessing what is morally right and what is morally wrong regarding human action
• Ethical dilemma

  Situations necessitating a choice between two equal (usually undesirable) alternatives
• Types of ethics

  • Meta-ethics
  • Normative ethics
  • Applied ethics
  • Descriptive ethics

  
• Meta-ethics

  Concerned with the nature of ethical judgments and theories

  
• Normative ethics

  Seeks to establish norms or standards of conduct
• Applied ethics

  The actual application of ethical theory for the purpose of choosing an ethical action in a given issue

  
• Descriptive ethics

  Empirical research into the attitudes of individuals or groups of people
• Normative ethical theories

  • Utilitarianism
  • Virtue theory
  • Deontological theory
  • Kantian duty-based ethics
  • Rossian duty-based ethics
  • Rawls' theory of justice

  
• Utilitarianism


  A moral theory that advocates actions that promote overall happiness or pleasure and rejects actions that cause unhappiness or harm
• Utilitarianism examples

  • Pharmaceutical companies releasing drugs with known minor side effects because the drug helps more people than are bothered by the side effects
  • Using the organs of a deceased patient without relatives to help four other patients needing organ transplants
• Virtue theory


  Based on the virtues of the person making a decision
• Virtue theory examples

  • A compassionate employee who helps his colleagues
  • A good nurse who provides excellent care to patients
  • An individual who returns to the store to pay for a product he forgot to pay for
• Deontological theory

  People should adhere to their obligations and duties when analyzing an ethical dilemma
• Deontological theory examples

  • A deontologist will always keep his promise to a friend and will follow the law
  • Telling a hopeless cancer patient the truth
  • Telling a diabetic patient to take their medicine, pay attention to their diet, and follow medical recommendations
• Kantian duty-based ethics

  Distinction between "I want" and "I ought", moral actions are not spontaneous but based on duty
• Rossian duty-based ethics

  Prima facie duties (self-evident and obvious duties) and actual duties (determined by the balance of responsibilities)
• Prima facie duties

  • Fidelity - keeping promises
  • Reparation - making up for wrongdoing
  • Gratitude - returning a favor
  • Non-maleficence - avoiding injuring others
  • Justice - fair distribution of happiness
  • Beneficence - improving conditions of others
  • Self-Improvement - Making oneself better
• Rawls' theory of justice


  Attempts to combine the strengths of utilitarianism and deontology while avoiding the weaknesses of each view
• Top 10 ethical issues in healthcare

  • Patients' Rights
  • Equity of resources
  • Confidentiality of the patients
  • Conflict of Interests
  • Patient Safety
  • Informed Consent
  • Dealing with the opposite sex
  • Ethics of privatization
  • Beginning and end of life
  • Healthcare team ethics
• Bioethical issues

  • Physician patient relationship
  • Beginning of Life
  • Extension of Life
  • Death and dying
  • Resource Allocation
  • Assisted reproductive techniques
  • Genetic testing
  • Sexuality and gender
• What is understood to be morally right by an individual depends (at least in part) on that person's race, ethnicity, and culture
• Race

  Genetically there is only one race, which is the human race. Society makes judgments about the varieties of biological characteristics
• Ethnicity

  An individual's identification with a particular cultural group to which they are biologically related
• Top 10 Ethical Issues in Healthcare

  • Patients' Rights
  • Equity of resources
  • Confidentiality of the patients
  • Conflict of Interests
  • Patient Safety
  • Informed Consent
  • Dealing with the opposite sex
  • Ethics of privatization
  • Beginning and end of life
  • Healthcare team ethics
• Bioethical Issues

  • Physician patient relationship
  • Beginning of Life
  • Extension of Life
  • Death and dying
  • Resource Allocation
  • Assisted reproductive techniques
  • Genetic testing
  • Sexuality and gender
• Culture

  A set of beliefs, values and traditions that are socially transmitted from one generation to another. It defines a group's norms or community's identity
• Cultural difference involves the integrated and maintained system of socially acquired values, beliefs, and rules of conduct which impact the range of accepted behaviors distinguishable from one societal group to another
• Cultural difference can affect the quality of client care, can have a negative effect on the family, and should be evaluated carefully to improve healthcare outcomes and prevent misunderstandings, stereotyping, barriers, and conflict
• Stereotypes

  Oversimplifications to conceptions or images of what a particular group or person should look like, or how they should act by disregarding each person's uniqueness
• Cultural Assimilation


  A process by which persons of different backgrounds adopt another group's main values, traditions and mores
• Generalizations


  Statements that represent common trends in a group with the understanding that further information needs to be gathered to verify its application to a particular person
• Cultural Relativism


  To avoid judging the cultural practices of groups that are different to yours. Cultural relativism refers to not judging a culture to our own standards of what is right or wrong, strange or normal
• Although "everyone does it", it still comes down to an individual's decision about how one is going to act using or not using ethical principles
• Ethical Analysis - 7 "What" Questions

  • The Facts?
  • What are the Ethical Issue/s?
  • What are the Alternatives?
  • What will happen to the stakeholders?
  • What are the Ethics of the Alternatives?
  • What are the Practical Constraints?
  • What is action to take?
• ADPIE Decision-Making Model

  Assess<|>Diagnose<|>Plan<|>Implement<|>Evaluate

  
• Husted's Formal Ethical Decision-Making Model


  Centered on the health care professional's implicit agreement with patient/client

  
• Ethics committees are found in most healthcare facilities, usually with 12-15 multidisciplinary members including representatives from the Board of Trustees, administration, nursing, physicians, clergy, social workers, attorneys, ethicists, and lay community members
• Patient Self Determination Act of 1990 (PSDA)


  The principle of self-determination plays a crucial role in contemporary clinical ethics, stating that it is ultimately the patient who should decide whether or not to accept suggested treatment or care

  
• Health Insurance Portability and Accountability Act of 1996 (HIPAA)

  Ensures privacy and confidentiality of medical records, healthcare providers are responsible for hiring and educating personnel to be knowledgeable of HIPAA rules and regulations
• Durable Power of Attorney for Health Care


  A document that lets you name someone else to make decisions about your health care in case you are not able to make those decisions yourself