Topic 1: Ethical Theories, Principles, and Standards - Ch 1 Intro to Ethics

Question 1

What are the four basic principles of healthcare ethics?

Answer 1

Beneficence
Nonmaleficence
Autonomy
Justice

Question 2

What is “ethics”?

Answer 2

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

encompasses the decision-making process of determining ultimate actions—that is, answering the questions What should I do? and Is it the right thing to do?

is concerned with human conduct as it ought to be, as opposed to what it actually is

Question 3

Microethics

Answer 3

involves an individual’s view of what is right and wrong based on one’s personal life teachings, traditions, and experiences.

Question 4

Macroethics

Answer 4

involves a more global view of right and wrong.

Question 5

What are the 3 distinct ways ethics are used?

Answer 5

1. philosophical ethics - involves inquiry about ways of life and rules of conduct
2. general pattern or way of life - such as religious ethics
3. set of rules - conduct or “moral code” (e.g., professional codes for ethical behavior)

Question 6

Bioethics

Answer 6

addresses a diversity of issues that include the nature of life and death, what sort of life is worth living, how we distinguish between assisted suicide and murder, how we should treat people who are especially vulnerable, and the responsibilities that we have toward other human beings

Question 7

Morality

Answer 7

a class of rules held by society to govern the conduct of its individual members

is a code of conduct

requires us to reach a decision as to the rightness or wrongness of an action

Question 8

Morals

Answer 8

ideas about what is right and what is wrong

are deeply ingrained in culture and religion and are often part of its identity

should not be confused with religious or cultural habits or customs

That which is considered morally right can vary from nation to nation, culture to culture, and religion to religion.

There is no universal morality that is recognized by all people in all cultures at all times

Question 9

code of conduct

Answer 9

prescribes standards of conduct, states principles expressing responsibilities, and defines the rules expressing duties of professionals to whom they apply

Wikipedia describes a code of conduct as a “set of rules outlining the social norms, religious rules and responsibilities of, and or proper practices for, an individual, party or organization. Related concepts include ethical, honor, moral codes and religious laws.”

Question 10

Standards

Answer 10

e.g., honesty, respect for others, conscientiousness - are used to guide human conduct by stating desirable traits to be exhibited and undesirable ones (dishonesty, deceitfulness, self-interest) to be avoided

Question 11

Principles

Answer 11

responsibilities that do not specify what the required conduct should be.

Professionals need to make a judgment about what is desirable in a particular situation based on accepted principles.

Question 12

Rules

Answer 12

specify specific conduct; they do not allow for individual professional judgment.

Question 13

Moral judgments

Answer 13

those judgments concerned with what an individual or group believes to be the right or proper behavior in a given situation.

Making a moral judgment is being able to select an option from among choices.

A lack of conformity can result in moral disapproval and possibly ridicule or censure of one’s character.

Question 14

Laws

Answer 14

created to set boundaries for societal behavior.

They are enforced to ensure that the expected behavior happens.

Question 15

Can morality be legislated?

Answer 15

Yes.

You can’t not legislate morality.

Question 16

Moral dilemmas

Answer 16

often arise when values, rights, duties, and loyalties conflict

Question 17

theories and principles of ethics

Answer 17

introduce order into the way people think about life

They are the foundations of ethical analysis that provide guidance in the decision-making process.

Question 18

Ethical theories

Answer 18

help caregivers determine the outcome of alternative choices, when following their duties to others, in order to reach the best ethical decision under the circumstances.

Question 19

Meta-Ethics

Answer 19

the study of the origin and meaning of ethical concepts

seeks to understand ethical terms and theories and their application

attempts to discover the origin or cause of right and wrong

Question 20

Normative Ethics

Answer 20

prescriptive in that it attempts to determine what moral standards should be followed so that human behavior and conduct may be morally right.

primarily concerned with establishing standards or norms for conduct and is commonly associated with investigating how one ought to act.

One of the central questions of modern normative ethics is whether human actions are to be judged right or wrong solely according to their consequences.

Question 21

Descriptive Ethics

Answer 21

also known as comparative ethics

is the study of what people believe to be right and wrong and why they believe it.

describes how people act

Question 22

Difference between normative and descriptive ethics?

Answer 22

Normative prescribes how people ought to act, vs descriptive describes how they DO act.

Question 23

Applied Ethics

Answer 23

the philosophical search (within western philosophy) for right and wrong within controversial scenarios

the application of normative theories to practical moral problems, such as abortion, euthanasia, and assisted suicide

Question 24

Consequential Ethics

Answer 24

emphasizes that the morally right action is whatever action leads to the maximum balance of good over evil.

theories that judge actions by their consequences

Revolve around the premise that the rightness or wrongness of an action depends on the consequences or effects of an action.

based on the view that the value of an action derives solely from the value of its consequences

goal of a consequentialist is to achieve the greatest good for the greatest number

ends justify the means

Question 25

Utilitarian Ethics

Answer 25

involves the concept that the moral worth of an action is determined solely by its contribution to overall usefulness commonly holds that the proper course of an action is one that maximizes utility, commonly defined as maximizing happiness and reducing suffering describes doing the greatest good for the greatest number of people form of consequential ethics - moral worth of an action is determined by its outcome, and, thus, the ends justify the means

Question 26

Deontological Ethics

Answer 26

“doing your duty.” commonly attributed to the German philosopher Immanuel Kant. He believed that although doing the right thing is good, it might not always lead to or increase the good and right thing sought after focuses on one’s duties to others and others’ rights includes telling the truth and keeping your promises often referred to as duty-based ethics involves ethical analysis according to a moral code or rules, religious or secular Deon is derived from the Greek word meaning “duty.” heavy on obligation, in the sense that a person who follows this ethical paradigm believes that the highest virtue comes from doing what you are supposed to do

Question 27

Nonconsequential Ethics

Answer 27

denies that the consequences of an action are the only criteria for determining the morality of an action the rightness or wrongness of an action is based on properties intrinsic to the action, not on its consequences believes right or wrong depends on the intention, not the outcome good intentions They accept the fact that sometimes good intentions can lead to bad outcomes. Focus more on character as to whether someone is a good person or not

Question 28

Ethical Relativism

Answer 28

morality is relative to the norms of the culture where one lives right or wrong depends on the moral norms of the society in which it is practiced A particular action by an individual may be morally right in one society or culture and wrong in another

Question 29

Ethical principles

Answer 29

universal rules of conduct, derived from ethical theories that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued assist caregivers in making choices based on moral principles that have been identified as standards considered meaningful when addressing health care

Question 30

Autonomy

Answer 30

involves recognizing the right of a person to make one’s own decisions is not an absolute principle actions of one person must not infringe upon the rights of another

Question 31

Are their laws related to autonomy?

Answer 31

Yes, Respect for autonomy has been recognized in the Fourteenth Amendment to the Constitution of the United States. The law upholds an individual’s right to make healthcare decisions Patients can refuse treatment, refuse to take medications, and refuse invasive procedures regardless of the benefits that may be derived from them. They have a right to have their decisions adhered to by family members who may disagree simply because they are unable to let go.

Question 32

What can affect a persons ability to make autonomous decisions?

Answer 32

one’s disabilities, mental status, maturity, or incapacity to make decisions

Question 33

What can help in cases where a person is unable to make an autonomous decision?

Answer 33

one’s autonomous wishes may be carried out through an advance directive and/or an appointed healthcare agent

Question 34

Beneficence

Answer 34

the principle of doing good, demonstrating kindness, showing compassion, and helping others In the healthcare setting, caregivers demonstrate beneficence by providing benefits and balancing benefits against risks requires one to do good

Question 35

Paternalism

Answer 35

a form of beneficence People sometimes believe that they know what is best for another and make decisions that they believe are in that person’s best interests may involve withholding information can occur because of one’s age, cognitive ability, and level of dependency

Question 36

Can paternalism violate a patient’s rights to self-determination?

Answer 36

Yes, A patient’s rights to self-determination are compromised when a third party imposes their wishes upon those of another person.

Question 37

Centers for Medicare and Medicaid Services Memorandum - CPR Policies

Answer 37

Memorandum Summary: 1. Must provide CPR to patients who have cardiac arrest in accordance to their advance directives or in the absence of advance directives or a Do Not Resuscitate (DNR) order. CPR-certified staff must be available at all times. 2. Facilities must not establish and implement facility-wide no-CPR policies. 3. Surveyor Implications - Surveyors should ascertain that facility policies related to emergency response require staff to initiate CPR as appropriate and that records do not reflect instances where CPR was not initiated by staff even though the resident requested CPR or had not formulated advance directives

Question 38

Medical paternalism

Answer 38

involves physicians unwittingly making decisions for patients who are capable of making their own choices can influence a patient’s healthcare decision simply by selectively telling the patient what he or she prefers based on personal beliefs This directly violates patient autonomy

Question 39

Employment-related paternalism

Answer 39

at it's best - a shared and cooperative style of management in which the employer recognizes and considers employee rights when making decisions in the workplace at it's worst - occurs when the employer’s style of management becomes more authoritarian, sometimes arbitrary, and unpredictable

Question 40

Are there laws that protect employees decisions related to employment paternalism?

Answer 40

Yes! Under Title VII of the Civil Rights Act of 1964, the courts and the Equal Employment Opportunity Commission (EEOC) reject such paternalism, demanding that the applicant alone decide whether to pursue (and accept) a job that poses risks related to his or her sex, race, color, religion, or national origin.

Question 41

Nonmaleficence

Answer 41

an ethical principle that requires caregivers to avoid causing patients harm “first, do no harm.” Physicians today still swear by the code of Hippocrates, pledging to do no harm.

Question 42

Can telling the truth cause harm?

Answer 42

yes.

Question 43

What is the Tuskegee Syphilis Experiment?

Answer 43

designed to analyze the natural progression of untreated syphilis in African American men participants were not warned during the study that penicillin was available as the cure for syphilis They believed that they were receiving adequate care and unknowingly suffered unnecessarily

Question 44

Was the Tuskegee Syphilis Experiment morally or ethically right or wrong? Why?

Answer 44

Yes, to both. Nonmaleficence requires a person to do no harm. This study purposefully withheld information causing harm to the subjects.

Question 45

Is letting a patient die the same as killing them?

Answer 45

No. Killing a patient is never justified, whereas letting a patient die by removing respirators (for example) can be right.

Question 46

Justice

Answer 46

the obligation to be fair in the distribution of benefits and risks demands that persons in similar circumstances be treated similarly Justice involves how people are treated when their interests compete with one another

Question 47

When is a person considered to be treated justly?

Answer 47

A person is treated justly when he or she receives what is due, is deserved, or can legitimately be claimed.

Question 48

Distributive justice

Answer 48

a principle requiring that all persons be treated equally and fairly

Question 49

What is a common issue with providing justice related to healthcare?

Answer 49

There are not enough funds to go around. This causes less funding for diseases that are less common.

Question 50

Virtue ethics

Answer 50

focuses on the inherent character of a person rather than on the specific actions he or she performs

Question 51

A virtue

Answer 51

is a positive trait of moral excellence. are those characteristics that differentiate good people from bad people. such as courage, honesty, and justice

Question 52

What is a morally virtuous person?

Answer 52

one who does the good and right thing by habit, not merely based on a set of rules of conduct

Question 53

Values

Answer 53

standards of conduct used for judging the goodness or badness of some action are rooted in customs and habits of a culture the standards by which we measure the goodness in our lives.

Question 54

moral value

Answer 54

the relative worth placed on some virtuous behavior

Question 55

Intrinsic value

Answer 55

something that has value in and of itself (e.g., happiness)

Question 56

Instrumental value

Answer 56

something that helps to give value to something else (e.g., money is valuable for what it can buy)

Question 57

Can values change?

Answer 57

Yes. As needs change a persons values may change.

Question 58

What are abstract virtues?

Answer 58

a persons principals.

Question 59

Are virtues and values used interchangeably in healthcare?

Answer 59

yes.

Question 60

Pillars of Moral Strength

Answer 60

describes a virtuous person Courage Wisdom Temperance Commitment Compassion Conscientiousness Discernment Fairness Fidelity Freedom Honesty Integrity Kindness Respect Hopefulness Tolerance