Description
Discussion Question 400 words:
Please respond to ONE of the following prompts.
Describe an example of how you as a professional nurse have used ethical theories or ethical principles in a clinical practice setting.
OR
In your clinical setting, consider the many times and various ways in which you acted as a patient or family advocate. Which model did you follow in advocating for the patient: rights protection model, values-based model, or respect for persons model? Would having used a different model have changed the outcome? Were there also instances when you chose not to be an advocate for a particular patient? What circumstances or events prevented you from serving in this role?
REQUIRED SOURCES
Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Prentice Hall. ISBN: 9780134701233. Read Chapters 3 & 4.
Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Jones and Bartlett. ISBN: 9781284144185. Read Chapters 1 & 4.
THESE ARE THE SOURCES YOU NEED TO USE AND CITE
DQ1 UMBO – 4
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DQ1 CLO – 3, 4
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Criterion Score
Content of Initial Thread/Post Weight: 40%
0 points
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5.6 points
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6.4 points
Response addresses prompt requirements. Content is relevant and germane to the intent of the prompt; 1 or more references are scholarly (if required) and/or appropriately reflect topic, and have few APA formatting errors.
8 points
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1.4 points
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1.6 points
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2 points
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4.2 points
Occasionally makes meaningful reflection on group’s efforts; Marginal effort to become involved with group; Made one response to classmates
4.8 points
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6 points
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/ 6
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PART II Ethics in Nursing Practice
Chapter 3
Introduction to Ethics
Learning Objectives
3.1 Compare and contrast the different ethical theories that underlie ethical nursing practice.
3.2 Contrast law from ethics.
3.3 Apply the ethical principles of autonomy, beneficence, nonmaleficence, veracity, fidelity,
justice, paternalism, and respect for others to nursing practice settings.
3.4 Analyze the roles of hospital ethics committees and ethics grand rounds.
3.5 Evaluate the concept of organizational ethics and explore strategies for implementation of
organizational ethics in everyday clinical settings.
Introduction:
Nurses, in all practice arenas, continue to be confronted with the interplay between ethical and
legal concepts, often asking themselves if the legal rights of the patients have been fully protected
while also being sensitive to the individuals’ ethical rights. Though it may seem that these are two
wholly separate entities, in reality legal and ethical issues often intertwine, greatly affecting
professional practice. Nurses must be knowledgeable about both concepts so that the legal and the
ethical rights of patients are protected and advanced.
Nurses continue to struggle with complex ethical concerns, including how to best ensure that the
ethical issues of all involved persons are considered and evaluated. Though some of these
decisions may seem clearer and more easily made than others, all ethical situations demand
considerable reflection and evaluation. Nurses often find themselves trapped in the midst of
ethical dilemmas among physicians, patients, family members, and even their own peer group.
This chapter explores the distinction between law and ethics, describes the various ethical
theories and principles employed in health care settings, and highlights the importance of
institutional ethics committees and organizational ethics.
I.
Definition of Ethics and Values
A. Ethics: the branch of philosophy concerned with evaluating human action
1. Derived from the Greek word “ethos” meaning character, customs, or habitual uses
2. Encompasses a process of determining right conduct from wrong conduct
3. Involves the principles or assumptions underpinning the way individuals or groups
ought to conduct themselves
4. Concerned with motives and attitudes and the relationship of these attitudes to the
individual
5. Morals are personal principles that are acquired from life experiences: family and
peer relationships, religion, culture, law
6. Morals are appropriate for routine decisions, but not adequate for resolving complex
issues arising in clinical settings
7. Ethics is a system or philosophy of conduct and principles, whereas morals give the
boundaries for acceptable behavior; thus ethics provides structure for placing conduct
into action
8. Values (personal, professional, societal) are personal beliefs about truths and worth
of thoughts, objects, or behavior—a code of conduct for living, which may include:
honesty, hard work, truthfulness, sincerity
9. Ethics may change as an individual matures or encounters new environments and
cultures
10. Understanding one’s ethics and values is the first step in understanding the ethics and
values of others and in assuring the delivery of appropriate nursing care
11. Individual and health care values may change over time as mainstream societal
values change
PowerPoint Lecture Slides
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Definition of Ethics
Definition of Morals
Definition of Values
Ethics and Nursing
II. Distinction Between Ethics and the Law
A. The legal system is founded on rules and regulations that guide society in a formal
and binding manner
1. Ethical values are subject to philosophical, moral, and individual interpretation; both
providers and recipients have a system of rights and values
2. Law is the general foundation that gives continuing guidance to health care providers,
and gives patients certain rights regardless of providers’ personal views and value
system
3. Patient treatment wishes may be overridden by state interests (e.g., mandatory
immunization statutes, fluoridation of water, and cases concerning Jehovah’s
Witnesses)
B. Areas transecting both ethics and law: issues relating to death and dying, genetics
and genomics, abuse of others, and futility of health care treatments
PowerPoint Lecture Slides
• Distinction Between Ethics and the Law
III. Ethical Theories
A. Ethics involves systematizing, defending, and recommending concepts of
appropriate and acceptable behaviors
B. Non-normative ethics
1. Descriptive ethics: uses scientific techniques to understand how individuals reason
and act
a. Individuals use descriptive ethics to better understand the norms and attitudes
that are expressed in professional codes, institutional mission statements, and
public policies
b. Health care context: descriptive ethics help describe the attitudes and norms that
underlie patients’ informed consent and surrogate decision making
2. Metaethics: seeks to understand the nature of statements, attitudes, and concepts
(e.g., questioning “What is goodness?”)
a. Attempts to analyze the meaning, justification, and inferences of moral concepts
and statements, investigating where ethical principles originate and what they
mean
b. Explores whether moral values are external truths that exist in an “otherworldly” realm or are merely aspects of human conventions; asks why one should
act in a moralistic manner rather than how one should act to be of moral
character
C. Normative theories
1. Concern norms or standards of behavior and values, and the application of these
norms or standards to everyday life
2. Involve questions and dilemmas requiring a choice of action
3. Arrive at standards that regulate right and wrong conduct
4. Universally applicable; assume that there is but one ultimate criterion of moral
conduct
D. Deontological theories
1. Derive norms and rules from the duties human beings owe one another by virtue of
commitments that are made and roles that are assumed
2. Deontological ethics look to the intention of the action; not the consequence
3. Greatest strength of this theory is its emphasis on the dignity of human beings
4. Virtue ethics: places less emphasis on learning rules and regulations and more
emphasis on the development of good or appropriate character and habitually
performing in this quality character mode
a. E.g., because a person has mastered the concept of benevolence, he or she will
continue to act in a benevolent manner toward other persons
b. Virtues: wisdom, courage, temperance, justice, fortitude, generosity, self-respect,
good-temper, and sincerity
5. Duty ethics: based on the premise that there are some obvious obligations that one
has as a human being, such as the duty to not commit murder and a duty to tell the
truth
a. Duties to self: avoiding wronging others, treating people as equals, and
promoting the good of others
b. Prima facie duties (W. D. Ross); fidelity, reparation, gratitude, justice,
beneficence, self-improvement, nonmaleficence
6. Situation ethics: takes into account the unique characteristics of each individual, the
caring relationship between the person and the caregiver, and determines the most
humanistic course of action given the circumstances; e.g., when a nurse has cared for
a particular patient over a long time; also called love ethics
7. Act deontology: based on the personal moral values of the person making the ethical
decision
8. Rule deontology: based on the belief that certain standards for ethical decisions
transcend the individual’s moral values; e.g., “all human life has value” and “one
should always tell the truth”
E. Teleological theories
1. Derive norms or rules for conduct from the consequences of actions; often referred to
as utilitarianism
a. Rule utilitarianism seeks the greatest happiness for all
b. Act utilitarianism attempts to determine, in a given situation, which course of
action will bring about the greatest happiness, or the least harm and suffering, to
a single individual
2. Applied ethics: branch of ethics that concerns the analysis of specific, controversial
moral issues such as abortion, euthanasia, genetic manipulation of fetuses, and the
status of unused frozen embryos
3. Principlism: attempts to resolve conflicts by applying principles more so than ethical
theories; used often in professional decision making
a. Principles encompass basic premises from which rules are developed
b. Moral norms that nurses both demand and strive to implement daily in clinical
practice settings
c. Ethical principles considered in most traditional view of principlism: respect for
autonomy, nonmaleficence, beneficence, and justice
4. Relational ethics: views the relational commitments that individuals have to each
other; ethics of care and caring
a. Emerging ethical framework to help care deliverers apply ethical principles in
clinical situations
b. Redirects the issue of rights and responsibilities of the autonomous individual
into the context of the environment in which these decisions are made and
creating a more“practical action–oriented” ethics
c. Components of relational ethics: engagement, mutual respect, embodiment, and
environment
d. Engages all parties to a potential dilemma, creating continued dialogue and
consideration of all possible and realistic outcomes
PowerPoint Lecture Slides
• Ethical Theories
• Non-normative Ethics
• Normative Theories
• Deontological Theories
• Deontological Theories—Continued
• Teleological Theories
IV. Ethical Principles
A. Autonomy
1. Autonomy: personal freedom and self-determination; the right to choose what will
happen to one’s own person
a. E.g., legal doctrine of informed consent
b. Involves health care deliverers’ respect for patients’ rights to make decisions
affecting care and treatment regardless of personal opinion
c. Not an absolute right; e.g., a person’s right to endanger others in the case of
communicable diseases
d. To make an autonomous choice the individual must have the capacity to fully
comprehend and the needed information with which to make an informed choice
e. Components of autonomy: liberty, self-determination, independence, and agency
f. Respects that individuals deciding not to follow specific recommended medical
options is based on patient’s need to follow his or her own value system and
ethics and in effect are preserving their agency and independence
B. Beneficence
1. Beneficence: the actions one takes should promote good; it is the basic obligation to
assist others
2. “Good” can be defined in multiple ways (e.g., allowing a patient to die without
advanced life support)
3. The subjectivity of the concept of “good” complicates this principle
4. Health care providers are cautioned to promote what is good as seen through the eyes
of the patient and his or her family
C. Nonmaleficence
1. Nonmaleficence: one should do no harm, including the inflicting of pain and
suffering on others, and one should not impose risks of harm
a. Detriment-benefit analysis: focus of the projected treatment or procedure rests on
the consequences of the benefits to the patient and not on the harm that occurs at
the time of the intervention (e.g., weighing the discomfort of a shot against the
benefit of relief felt by the patient due to the medication)
b. Concept of double effect: used to ethically support interventions that could have
some harmful effects
D. Veracity
1. Veracity: concerns truth telling and incorporates the concept that individuals should
always tell the whole truth
2. Followed when one completely answers patients’ questions, giving as much detail as
patient can understand, and being honest when information is not available or
unknown
3. Difficulty arises when family members or other health care professionals are
demanding information that would enable autonomous decision making to be
withheld; interest in hiding information may center on the perception that patient
would forgo needed and appropriate medical care if he or she knew the entire truth
4. Possible violations of the principle of veracity include telling a falsehood, omission
of critical and relevant facts, omission of alternative options, or the cloaking of the
truth in medical jargon such that full understanding by the patient and family is
impeded
E. Fidelity
1. Fidelity: keeping one’s promises or commitments; not promising what cannot be
delivered or controlled; core value in nurse-patient relationship
2. Arises during emergencies when procedures must be implemented rapidly and family
members cannot be fully informed about their loved one’s condition
3. Also when nurses assure patients that they will be kept pain free following a surgical
procedure, as complications may arise that prevent adequate pain medications, such
as a hemodynamic instability
F. Paternalism
1. Paternalism (aka parentialism): completely making the final decisions for others, and
thus seen as an undesirable or negative ethical principle
2. Allows no collaboration in the decision-making process, but totally removes the
decision from the patient or the patient’s family members
3. Seen as an appropriate principle when used to assist in decision making with
competent patients who lack the expertise or ability to fully comprehend the data
needed to make decisions; in this case paternalism becomes shared decision making,
allowing patient to make a more appropriate and informed decision
4. Also viewed as part of the advocacy role of nurses; especially when patients inquire
as to what the health care providers would do in the same situation themselves
G. Justice
1. Justice: people should be treated fairly and equally; giving to each person what he or
she deserves or giving each person his or her due
2. Fairness: refers to the ability to judge without reference to one’s feelings or interests,
allowing for equal treatment; ability to make judgments that are specific and concrete
to a particular case or set of circumstances
3. Justice arises in times of short supplies or when there is competition for resources or
benefits (e.g., when two equally deserving patients are awaiting an organ transplant,
when there is only one intensive care bed available for multiple individuals)
4. Distributive justice or social justice: refers to the extent to which society ensures that
benefits and burdens are distributed among society’s members in ways that are fair
and just
5. Retributive or correctional justice: extent to which punishments are fair and just;
often cited when disciplinary outcomes appear to be very different for similar
infractions of rules
6. Compensatory justice: refers to the extent that people are fairly compensated for their
injuries by those who have injured them with just compensation proportional to the
loss that has been inflicted on an individual
H. Respect for others
1. Acknowledges the right of individuals to make decisions and to live or die based on
those decisions
2. Highest principle incorporating all other principles
3. Core value underlying Americans with Disabilities Act and other anti-discrimination
statutes
PowerPoint Lecture Slides
• Ethical Principles
V. Ethics Committee
A. Ethics committees
1. Goals:
a. Promote the rights of patients
b. Promote shared decision making between patients (or surrogates) and their
health care providers
c. Promote fair and equitable policies and procedures that maximize the likelihood
of achieving appropriate and acceptable quality patient-centered care
d. Enhance the ethical tenor of health care professions and health care institutions
2. Provide structure and guidelines for potential problems, serve as an open forum for
discussion, and function as a true patient advocate
3. Committee should be composed of nurses, physicians, clergy, clinical social workers,
nutritional experts, pharmacists, administrative personnel, and legal experts
4. Patients and their families may also be invited to committee deliberations
B. Three structures of ethics committees
1. Autonomy model: facilitates decision making for the competent patient
2. Patient benefit model: uses substituted judgment and facilitates decision making for
the incompetent patient
3. Social justice model: considers broad social issues and is accountable to the
institution
C. Implementing Ethics
1. Joint Commission for the Accreditation of Healthcare Organizations mandates ethics
committees or other vehicles for addressing ethical concerns
2. Policies must include a means for resolving conflicts in decision making and a
description of the respective roles of physicians, nurses, and family members in
decisions involving do-not-resuscitate orders or the withholding of treatment
3. Alternatives to ethics committees
a. Ethical grand rounds allow staff members to become familiar with ethical issues
and their resolution
b. Bioethics consultant or pastoral staff care member is employed
PowerPoint Lecture Slides
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Ethics Committees
Ethics Committees Goals
Three Structures of Ethics Committees
Implementing Ethics
Allowable Alternatives to Ethics Committees
VI. Organizational Ethics
A. Organizational ethics
1. An ethical culture and set of values that determines how an organization responds to
both internal and external stimuli
2. Ethical underpinnings that the organization uses to conduct business affect the
reputation, productivity, and economics of the institution; requires the following:
a. Written code of ethics and standards
b. Ethics training for executives, managers, and all employees
c. Availability of ethical situational advice (such as a formal ethics committee)
d. Confidential reporting system
3. Healthcare executives and upper-level managerial personnel must demonstrate the
importance of ethics in their everyday actions and decisions, but also ensure that all
working in the institution follow the same ethical code
4. An ethically aligned organization is dependent upon the knowledge, skills, and
practices of all individuals within the organization
5. Nurses at the bedside may also initiate and assist in creating a more optimum ethical
culture; measures to ensure this include:
a. Developing more evidence-based programs
b. Enacting better systems for monitoring transitional care processes
c. Instigating a program for enhanced communication
d. Working with the institution’s ethics committee
PowerPoint Lecture Slides
• Organizational Ethics
• Measures to Ensure Organizational Ethics
Chapter 4
Application of Ethics in Nursing Practice Settings
Learning Objectives
4.1 Evaluate professional codes of ethics.
4.2 Analyze and apply decision-making models in resolving ethical dilemmas, with specific
application of the MORAL model.
4.3
Analyze moral distress, its effect on nurses in practice settings, and evaluate ways of coping
with moral distress.
4.4 Compare and contrast advocacy, therapeutic jurisprudence, and slippery slope arguments in
ethical decision-making.
4.5 Evaluate the role of health policy as it relates to resolving ethical dilemmas in nursing
practice.
Introduction:
Understanding ethical theories and principles is the first step in applying these concepts in
nursing practice settings. As previously noted, the more familiar one is with ethical theories and
principles, the more confident and prepared the individual becomes in applying these concepts
and the more assistance one can give colleagues as they encounter ethical situations and issues.
Additionally, knowledge of decision-making models to assist in resolving complex ethical
dilemmas, how the nurse can employ the advocacy role, situations when moral distress may
occur, and how therapeutic jurisprudence may begin to lessen the impact of future dilemmas is
important in resolving ethical dilemmas. This chapter explores these concepts and concludes with
a section outlining how implementing health policy complements nurses’ ability to resolve ethical
issues in everyday clinical practice settings.
I.
Professional Codes of Ethics
A. Enumerate standards of integrity, professionalism, and ethical norms
1. Professional codes of ethics inform the public of the minimum standards acceptable
for conduct by members of the discipline and assist the public in understanding a
discipline’s professional responsibilities
2. Outline the major ethical considerations of the profession
3. Provide guidelines for professional practice and the discipline’s self-regulation
B. Codes of Ethics for Nurses
1. ICN Code of Ethics for Nurses by the International Council of Nurses
2. Code of Ethics for Nurses with Interpretive Statements by the American Nurses
Association (ANA)
a. Gives direction for those entering the nursing profession about their ethical
accountability, sets a nursing standard for ethical practice, and informs the
consumer about nursing’s ethical standards
PowerPoint Lecture Slides
• Professional Code of Ethics
• The Code of Ethics for Nurses with Interpretive Statements
II. Ethical Decision-Making Frameworks
A. Influence ability to respond to ethical dilemma:
1. Nurse’s perception of his or her level of influence within the health care setting
2. Level of clinical expertise and competence
3. Degree of ethical concern
4. Past experience with ethics education
B. Questions to reflect on in ethical decision making
1. Who should make the choice?
2. What are the possible options or courses of action?
3. What are the available alternatives?
4. What are the consequences, both desirable and undesirable, of all possible options?
5. Which rules, obligations, and values should direct choices?
6. What are the desired goals and outcomes?
C. MORAL model
1. M Massage the dilemma: identify and define issues in the dilemma and consider the
opinions and value systems of the major players
2. O Outline the options: examine all options fully, including the less realistic and
conflicting ones; make pros and cons for all options
3. R Resolve the dilemma: using basic ethical principles, decide the best option based
on the views of all those concerned in the dilemma
4. A Act by applying the chosen option
5. L Look back and evaluate the entire process: including the ability of all those
involved to follow through on final option
PowerPoint Lecture Slides
• What Influences Your Ability to Respond to an Ethical Dilemma?
• Ethical Decision-Making Questions
• MORAL Model
III. Advocacy as a Nursing Role
A. Advocacy has its roots in the legal profession and concerns the active support of a
cause or issue that has importance
B. Nurses advocate for the legal rights of patients and for the ethical concerns of
patients and peers
C. Three models of advocacy employed in clinical practice settings:
1. Rights protection model (or autonomy model): nurses advocate for the legal and
ethical rights of the patient; actions taken promote the patient’s best interest
2. Values-based decision model: nurse assists the patient by discussing his or her needs
and desires and helps the patient make choices that are most consistent with the
patient’s values, lifestyle, and desires
3. Respect for persons model (patient-advocate model): centers on inherent human
dignity and the respect that is owed all persons
D. American jurisprudence system repeatedly enacts the role of nurses as patient
advocates through multiple court decisions (Baby Doe v. (Confidential) Hospital
(2007))
PowerPoint Lecture Slides
• Advocacy as a Nursing Role
IV. Moral Distress
A. Moral stress occurs when faced with situations in which two ethical principles
compete
B. Three categories of moral distress:
1. Moral distress: involved individual knows the ethical course of action to take, but
individual cannot implement the action because of institutional obstacle
2. Moral uncertainty: characterized by an uneasy feeling wherein the individual
questions the right course of action
3. Moral dilemma: characterized by conflicting but morally justifiable courses of action
C. Examples of moral distress:
1. Financial pressures
2. Limited patient care resources
3. Disagreements among family members
4. Limitations provided by health care providers
5. When actions nurses perform violate their personal beliefs
6. Lack of education in nursing ethics
D. Effects of moral distress
1. Initial moral distress: nurses experience frustration, anger, and anxiety as a result of
being prevented from doing what they see as the correct course of action.
2. Reactive moral distress: negative feelings when the nurse is unable to act on their
initial distress. Signs and symptoms include powerlessness, guilt, loss of self-worth,
depression, and more. May cause moral outrage and burnout and inability to
effectively care for patients.
E. Strategies to address moral distress in clinical practice include:
1. Empowering nurses to voice their ethical concerns
2. Educating nurses about moral distress and allowing discussions on the subject
3. Identifying and addressing impediments to delivery of quality nursing care
4. Incorporating conflict resolution and meditation techniques so nurses can bring their
concern to closure
5. Allowing nurses to serve on institution ethics committees
6. Opening communication
7. Encouraging and rewarding collaborative teamwork
F. Personal strategies to combat moral distress:
1. Self-care
2. Assertiveness
3. Collective action
4. Reexamination of nursing ethical values
G. Moral distress can serve to energize a person with a feeling of accomplishment of
professional goals and increased awareness of his or her own beliefs and ability to
handle ethical issues more effectively in the future
PowerPoint Lecture Slides
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Moral Distress—When Two Ethical Principles Compete
Potential Causes of Moral Distress
Initial Moral Distress
Reactive Moral Distress
Empower Nurses to Voice their Ethical Concerns
Personal Strategies to Combat Moral Distress
A Benefit of Moral Distress
V. Therapeutic Jurisprudence
A. Interdisciplinary study of law as a social force
1. Aims to understand law’s impact on an individual’s emotional life and psychological
well-being
2. Similar to ethical behavior, therapeutic jurisprudence challenges nurses to consider
the outcome of one’s actions
3. Acknowledges the fact that “well-being” is one of the many goals of the legal system
and begins to ensure that this goal is integrated when applying legal remedies and
processes
B. Terri Schiavo’s Case
1. A long legal battle to allow the patient to die ensued when she ended up in a
persistent vegetative state following cardiac arrest
2. Principle of therapeutic jurisprudence would have been in reinforcing one of the
basic principles of American law and ethical thought: Self-determination and the
right of autonomy for the individual involved are paramount and take precedence
over what others may have wanted
3. Schiavo case inspired many individuals to seek additional information about durable
powers of attorney of health care, living wills, and other legislative documents that
preserve the autonomy rights of individuals should catastrophe befall them
PowerPoint Lecture Slides
• Therapeutic Jurisprudence
VI. Slippery Slope Arguments
A. An argument that suggests that an action will initiate a chain of events culminating
in an undesirable event later in time without establishing the relevant contingencies
1. Basis for a slippery slope argument has little justification; tends to be more
speculative, and presumes no gray areas
2. E.g., arguing that voluntary euthanasia will lead to active euthanasia of patients who
do not want to voluntarily end their lives
3. Useful because they force health care professionals to think carefully about the full
scope of specific aspects of selected health care interventions and possibilities
4. Using decision-making models to arrive at ethical solutions assists nurses in avoiding
or balancing a slippery slope argument
PowerPoint Lecture Slides
• Slippery Slope Argument
VII. Health Policy
A. Resolving ethical dilemmas
1. Health policy concerns the choices that a society or a part of that society makes in
regard to the health and welfare of its citizens
2. Outlines priorities and the expected roles of individuals within a society, building
consensus and informing the citizens of that society
B. Aspects of policy
1. Generality: it addresses more than one person and more than one set of circumstances
2. Normativity: it formalizes judgments about what course of action is better among
alternatives and the rules by which those alternatives will be determined
3. Scale: policies apply at different levels of an organization or society
4. Policies can supersede policies on lesser levels
5. Policy is always determined by someone
C. Policy is generated:
1. By the workplace; revolving around issues of the workplace
2. Governmental agencies on local, state, or federal level
3. Community groups
4. Efforts of professional organizations at local or national levels
5. Nurses are an important part of policy development and implementation in all
spheres
D. Framework to address policy and the need for new or additional policy in the
clinical setting:
1. What is the problem?
2. Where is the process?
3. How many are affected?
4. What possible solutions could be proposed?
5. What are the ethical arguments involved?
6. At what level is the problem most effectively addressed?
7. Who is in a position to make a policy decision?
8. What are the obstacles to policy interventions?
9. What resources are available?
10. How can I get involved?
11. Framework assists nurses individually and collectively to better educate and
empower their patients and themselves to address health care issues effectively
PowerPoint Lecture Slides
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Health Policy
Aspects of Policy
Ways Policy Is Generated
Framework to Address Policy Needs
Chapter 1
Introduction to
Ethics
I expect to pass through this world but once.
Any good therefore that I can do, or any
kindness I can show to any creature, let me do
it now. Let me not defer it, for I shall not pass
this way again.
—Stephen Grellet
Learning Objectives (1 of 2)
• Explain what ethics is, its importance, and its
application to ethical dilemmas.
• Describe the concepts of morality, codes of
conduct, and moral judgments.
• Understand relevant ethical theories and
principles.
• Describe virtue ethics and values and how they
more clearly describe one’s moral character.
Learning Objectives (2 of 2)
• Understand how religious ethics can affect one’s
moral character.
• Explain the concept of situational ethics and how
changes in circumstances can alter one’s
behavior.
• Understand the importance of reasoning in the
decision-making process.
Good can triumph over evil.
— Author unknown
How we perceive right and wrong
is influenced by what we feed on.
— Author unknown
Words Are “Tools of Thought”
• Knowledge of abstract ethical theories and
principles is required.
• Armed with such knowledge, decision-makers
are able to navigate through the maze of
obstacles to assist in making difficult care
decisions.
What Is Ethics?
• Ethics is the branch of philosophy that seeks to
understand the nature, purposes, justification,
and founding principles of moral rules and the
systems they comprise.
– Deals with values relating to human conduct.
– Focuses on the rightness and wrongness of
actions, as well as the goodness and badness
of motives and ends.
Scope of Ethics
• Microethics
– An individual’s view of right and wrong
• Macroethics
– Global view of right and wrong
Ethics from Various Perspectives
• Ethics is used in different but related ways:
– Philosophical ethics
• Inquiry about ways of life and rules of
conduct
– General pattern or way of life
• Religious ethics
– Set of rules or “moral conduct”
• Professional codes for ethical behavior
Why Study Ethics?
• To make sound judgments, good decisions, and
right/better choices
• To understand the goodness and badness of
motives and ends
Aim above morality. Be not simply good;
be good for something.
— Henry David Thoreau
What Is Morality?
• Morality describes a class of rules held by
society to govern the conduct of its individual
members.
• Implies quality of being in accord with standards
of right and good conduct.
Morals
• Ideas about what is right and wrong.
• Guides to behavior that rational persons put
forward for governing their behavior.
Code of Conduct (1 of 2)
• Generally prescribes standards of conduct,
states principles expressing responsibilities, and
defines the rules expressing duties of
professionals to whom they apply.
Code of Conduct (2 of 2)
• Standards: Guide human conduct by stating
desirable and undesirable traits to be exhibited
or avoided.
• Principles: Describe responsibilities but do not
specify the required conduct.
• Rules: Specify expected conduct; no allowance
for individual judgment.
Moral Judgments
• Judgments concerned with what an individual
