Week 2: Ethical decision making in healthcare Flashcards
(141 cards)
1
Q
Definition
The component of the Ethical Grid that addresses moral obligations such as truth-telling, doing good, and minimizing harm.
A
Define
Deontological Layer
2
Q
Define
Deontological Layer
A
The component of the Ethical Grid that addresses moral obligations such as truth-telling, doing good, and minimizing harm.
3
Q
Definition
A decision-making tool created by Seedhouse that uses a four-layer diagram to systematically analyze ethical issues, considering autonomy, deontological obligations, consequentialist outcomes, and external considerations.
A
Define
The Ethical Grid
4
Q
Define
Consensus Building
A
Approaching moral conflicts democratically and involving all relevant parties in discussions to reach a common understanding.
5
Q
Define
International Council of Nurses (ICN) Code of Ethics
A
Guidance for nurses’ professional roles, duties, and responsibilities; a set of moral values and principles updated regularly to address current issues.
6
Q
Definition
Affirms nurses’ and midwives’ right to refuse participation based on strongly held religious, moral, or ethical beliefs, requiring clear communication and documentation.
A
Define
Australian Nursing and Midwifery Federation (ANMF) Statement
7
Q
Define
Cultural Perception
A
Recognizing how cultural background influences moral decisions and perceptions of “good.”
8
Q
Definition
Outcome-Based Approaches
A
Evaluating the potential harms and benefits of each course of action and choosing the one with the best overall consequences.
9
Q
Define
Conscientious Objection
A
A refusal by a healthcare professional to provide or participate in a treatment based on personal values, moral concerns, or beliefs.
10
Q
Define
Self-Knowledge
A
Awareness of personal motives and biases, and understanding how these might influence decision-making.
11
Q
Definition
The right of patients to make their own health care decisions, including the refusal of treatments.
A
Define
Patient Autonomy
12
Q
Definition
The principle of self-determination and non-interference, allowing individuals to make their own decisions and control what happens to them.
A
Define
Autonomy
13
Q
Define
Consequentialist Layer
A
The component of the Ethical Grid that focuses on identifying the most beneficial outcomes of a decision.
14
Q
Definition
Approaching moral conflicts democratically and involving all relevant parties in discussions to reach a common understanding.
A
Define
Consensus Building
15
Q
Definition
The principle of “above all, do no harm,” requiring that actions do not cause undue harm to patients and necessitating justification of actions that may cause harm.
A
Define
Non-Maleficence
16
Q
Define
Beneficence
A
The principle of “above all, do good,” motivating actions that benefit patients, while balancing short-term benefits against potential long-term harm.
17
Q
Definition
Differences in moral judgments and conclusions resulting from varying interpretations of information and evidence.
A
Define
Moral Disagreement
18
Q
Definition
Guidance for nurses’ professional roles, duties, and responsibilities; a set of moral values and principles updated regularly to address current issues.
A
Define
International Council of Nurses (ICN) Code of Ethics
19
Q
Definition
A decision-making model emphasizing self-awareness, reflection, and the role of emotions and life experience.
A
Define
Johnston’s Model
20
Q
Definition
Two meanings: fairness (treating people equally and giving them what they deserve) and equal distribution (distribution of resources and prioritization in emergency situations).
A
Define
Justice
21
Q
Define
Knowledge of Theories
A
Understanding and applying ethical theories to specific situations.
22
Q
Definition
A refusal by a healthcare professional to provide or participate in a treatment based on personal values, moral concerns, or beliefs.
A
Define
Conscientious Objection
23
Q
Define
Character-Based Approaches
A
Considering whether decisions align with personal or organizational values and what a virtuous person would do.
24
Q
Definition
The component of the Ethical Grid that focuses on identifying the most beneficial outcomes of a decision.
A
Define
Consequentialist Layer
25
# Definition
A situation where a choice must be made between two or more conflicting moral principles, with no clear right or wrong response, requiring careful evaluation of all alternatives.
# Define
Ethical Dilemma
26
# Definition
Evaluating the potential harms and benefits of each course of action and choosing the one with the best overall consequences.
Outcome-Based Approaches
27
# Definition
Awareness of personal motives and biases, and understanding how these might influence decision-making.
# Define
Self-Knowledge
28
# Define
Moral Disagreement
Differences in moral judgments and conclusions resulting from varying interpretations of information and evidence.
29
# Define
Johnston’s Model
A decision-making model emphasizing self-awareness, reflection, and the role of emotions and life experience.
30
# Definition
The process of making judgments about what is right or wrong, involving systematic assessment and consideration of personal biases, cultural influences, and moral implications.
# Define
Moral Decision-Making
31
# Definition
Focuses on adherence to rules, principles, and duties, including following best practice guidelines and legal obligations.
# Define
Deontological Approach
32
# Define
Justice
Two meanings: fairness (treating people equally and giving them what they deserve) and equal distribution (distribution of resources and prioritization in emergency situations).
33
# Define
Ethical Principlism
An approach to ethics involving the application of four major principles: Autonomy, Non-Maleficence, Beneficence, and Justice.
34
# Define
Non-Maleficence
The principle of "above all, do no harm," requiring that actions do not cause undue harm to patients and necessitating justification of actions that may cause harm.
35
# Define
Moral Decision-Making
The process of making judgments about what is right or wrong, involving systematic assessment and consideration of personal biases, cultural influences, and moral implications.
36
# Define
Deontological Approach
Focuses on adherence to rules, principles, and duties, including following best practice guidelines and legal obligations.
37
# Define
External Considerations
The outermost layer of the Ethical Grid, including factors such as the law, others' wishes, codes of practice, and available resources.
38
# Definition
An approach to ethics involving the application of four major principles: Autonomy, Non-Maleficence, Beneficence, and Justice.
# Define
Ethical Principlism
39
# Define
Autonomy
The principle of self-determination and non-interference, allowing individuals to make their own decisions and control what happens to them.
40
# Define
Ethical Dilemma
A situation where a choice must be made between two or more conflicting moral principles, with no clear right or wrong response, requiring careful evaluation of all alternatives.
41
# Definition
The innermost layer of the Ethical Grid emphasizing the creation and respect of autonomy and the equal respect of persons' needs.
# Define
Autonomy/Respect Layer
42
# Definition
Ensuring all relevant information is considered and adherence to principles, codes of practice, or laws.
# Define
Process-Based Approaches
43
# Define
Process-Based Approaches
Ensuring all relevant information is considered and adherence to principles, codes of practice, or laws.
44
# Definition
Specific ethical standards for those working in Catholic health or aged care facilities, particularly regarding end-of-life care.
# Define
Catholic Health Australia (CHA) Code of Ethical Standards
45
# Define
The DECIDE Model
A structured approach to ethical decision-making consisting of: 1) Define the problem, 2) Establish the criteria, 3) Consider all alternatives, 4) Identify the best alternative, 5) Develop and implement a plan of action, 6) Evaluate and monitor the solution.
46
# Define
Decide Model
A decision-making model involving: 1) Assessing the situation, 2) Diagnosing the moral problem, 3) Setting moral goals, 4) Implementing the course of action, 5) Evaluating outcomes.
47
# Definition
Considering whether decisions align with personal or organizational values and what a virtuous person would do.
# Define
Character-Based Approaches
48
# Definition
The principle of "above all, do good," motivating actions that benefit patients, while balancing short-term benefits against potential long-term harm.
# Define
Beneficence
49
# Define
Catholic Health Australia (CHA) Code of Ethical Standards
Specific ethical standards for those working in Catholic health or aged care facilities, particularly regarding end-of-life care.
50
# Definition
Understanding and applying ethical theories to specific situations.
# Define
Knowledge of Theories
51
# Definition
A structured approach to ethical decision-making consisting of: 1) Define the problem, 2) Establish the criteria, 3) Consider all alternatives, 4) Identify the best alternative, 5) Develop and implement a plan of action, 6) Evaluate and monitor the solution.
# Define
The DECIDE Model
52
# Definition
An ethical theory focusing on four primary principles in biomedical ethics: Autonomy, Non-Maleficence, Beneficence, and Justice.
# Define
Principlism
53
# Definition
A decision-making model involving: 1) Assessing the situation, 2) Diagnosing the moral problem, 3) Setting moral goals, 4) Implementing the course of action, 5) Evaluating outcomes.
# Define
Decide Model
54
# Definition
Recognizing how cultural background influences moral decisions and perceptions of "good."
# Define
Cultural Perception
55
# Define
The Ethical Grid
A decision-making tool created by Seedhouse that uses a four-layer diagram to systematically analyze ethical issues, considering autonomy, deontological obligations, consequentialist outcomes, and external considerations.
56
# Definition
The outermost layer of the Ethical Grid, including factors such as the law, others' wishes, codes of practice, and available resources.
# Define
External Considerations
57
# Define
Principlism
An ethical theory focusing on four primary principles in biomedical ethics: Autonomy, Non-Maleficence, Beneficence, and Justice.
58
# Define
Autonomy/Respect Layer
The innermost layer of the Ethical Grid emphasizing the creation and respect of autonomy and the equal respect of persons' needs.
59
# Define
Australian Nursing and Midwifery Federation (ANMF) Statement
Affirms nurses' and midwives' right to refuse participation based on strongly held religious, moral, or ethical beliefs, requiring clear communication and documentation.
60
# Define
Patient Autonomy
The right of patients to make their own health care decisions, including the refusal of treatments.
61
What are the four principles of biomedical ethics outlined by Beauchamp and Childress?
Respect for autonomy, non-maleficence, beneficence, and justice.
62
What does the principle of non-maleficence require from healthcare professionals?
It requires that they do not intentionally create harm or injury to the patient, either through acts of commission or omission.
63
What is the main focus of the principle of beneficence in healthcare?
The focus is on taking positive steps to benefit the patient and to remove harm.
64
What does the 'Autonomy/Respect Layer' of the Ethical Grid emphasize?
It emphasizes creating and respecting autonomy, respecting persons equally, and serving their needs.
65
How does the principle of justice apply to healthcare?
It involves the fair distribution of goods and services, ensuring that people receive what they are due.
66
What is the purpose of the 'Deontological Layer' in the Ethical Grid?
It addresses moral obligations such as telling the truth, doing good, and minimizing harm.
67
What does the 'Consequentialist Layer' of the Ethical Grid focus on?
It focuses on identifying the most beneficial outcomes.
68
List the six activities involved in the DECIDE model for ethical decision-making.
Define the problem, establish the criteria, consider all the alternatives, identify the best alternative, develop and implement a plan of action, evaluate and monitor the solution.
69
What is an ethical dilemma?
It is a situation where a choice must be made between two conflicting moral principles, with no clear right or wrong response.
70
In what contexts can the Ethical Grid be used?
It can be used for clinical case analysis, personal and public reflection, discussion, and justification of ethical issues in healthcare.
71
How does the DECIDE model help in ethical decision-making?
It provides a structured approach to defining problems, establishing criteria, considering alternatives, and evaluating solutions to ensure ethical decisions.
72
What are some criteria for distributive justice mentioned in the document?
Equal share, need, effort, contribution, merit, and free-market exchanges.
73
What does the term 'Ethical Principlism' refer to?
It refers to the use of four core principles (autonomy, non-maleficence, beneficence, and justice) as a framework for moral reasoning in healthcare.
74
What does Seedhouse’s 'Ethical Grid' aim to do?
It aims to systematically analyze ethical issues by considering multiple layers, including autonomy, moral obligations, beneficial outcomes, and external considerations.
75
What should be considered when evaluating the best ethical alternative in decision-making?
Ethical principles, potential outcomes, and the elimination of unethical options.
76
What does DECIDE stand for?
D = define the problem
E = establish the criteria
C = consider all the alternatives
I = identify the best alternative
D = develop and implement a plan of action
E = evaluate and monitor the solution and feedback when necessary
77
What is the blue layer called?
Autonomy/respect layer
78
What is the pink layer called?
Deontological layer
79
What is the green layer called?
Consequentialist layer
80
What is the gray layer called?
External considerations
81
What does the principle of autonomy involve in healthcare?
Respecting patients' rights to make their own decisions about their treatment and providing them with necessary information for informed consent.
82
What is the core idea behind the principle of non-maleficence?
The principle of "above all, do no harm," which requires healthcare practitioners to ensure their actions do not cause undue harm to patients.
83
What are the two meanings of justice in healthcare?
Justice as fairness (treating people equally and giving them what they deserve) and justice as equal distribution (fair allocation of resources and prioritization).
84
How does the principle of beneficence guide nurses' actions?
It motivates nurses to act in ways that benefit patients, even if it may sometimes conflict with patients' wishes.
85
What is the purpose of the International Council of Nurses (ICN) Code of Ethics?
To provide guidance for nurses' professional roles, duties, and responsibilities, serving as a set of moral values and guiding principles.
86
What is emphasized in the ICN Code of Ethics regarding nurses and practice?
Professional development, evidence-based practice, work-life balance, personal growth, and collaboration.
87
What are the four principal elements of the ICN Code of Ethics?
Nurses and Patients, Nurses and Practice, Nurses and the Profession, Nurses and Global Health.
88
What specific ethical standards does the Catholic Health Australia (CHA) Code address?
It provides standards particularly related to end-of-life care and is updated to reflect current legislation and practices.
89
What is the first step in the Decide Model for moral decision-making?
Assess the situation.
90
What does Johnston’s Model emphasize in decision-making?
Self-awareness, reflection, and the role of emotions and life experience.
91
What is one key element for effective moral decision-making?
Self-Knowledge—awareness of personal motives and biases.
92
How does cultural perception influence moral decision-making?
It affects how individuals perceive and make judgments about what is considered "good" or right.
93
What is the role of the Nurses and Global Health element in the ICN Code of Ethics?
It involves participation in human rights efforts, global health crises response, support for ethical use of technology, and advocacy for global health issues.
94
In moral decision-making, what should be done after identifying the problem and possible actions?
Consider personal biases and cultural influences.
95
What does the principle of justice as equal distribution involve?
It involves the fair allocation of resources and prioritization, especially in emergency situations.
96
What does the principle of beneficence require from healthcare practitioners?
To act in ways that benefit the patient and prevent or remove harm.
97
What should be done to evaluate outcomes in the Decide Model?
Assess the effectiveness and impact of the chosen course of action and make necessary adjustments.
97
What does the ICN Code of Ethics say about nurses and the profession?
Nurses should be involved in teaching, research, policy development, and advocate for better workplace conditions and public health.
98
Why is self-awareness important in moral decision-making?
It helps recognize personal biases and influences, which can guide better decision-making and avoid situations that may impair professional judgment.
99
How can awareness of challenges or distress affect decision-making?
It can guide you to step away from situations that might compromise your professional judgment.
100
What role does reason play in moral decision-making?
Rational thinking is crucial, though it is often influenced by emotions and intuition.
101
How does intuition impact moral decision-making?
Gut feelings or instincts play a role, but it is important to understand their basis and not rely solely on immediate reactions.
102
What influence do life experiences have on decision-making?
Past experiences shape perspectives and can affect how moral issues are viewed, evolving over time.
103
How can emotional stress affect decision-making?
Decisions made under emotional stress may differ from those made with more time for reflection.
104
Why is it important to examine intuition in moral decisions?
Instinctual responses may not always align with well-considered decisions, so understanding why certain decisions feel right or wrong is crucial.
105
How can life experiences change perspectives on moral issues?
They influence and evolve perspectives over time due to new experiences, learning, or societal changes.
106
What does adaptability in moral views involve?
Being open to evolving moral views and considering new information and perspectives as decision-making is dynamic.
107
What causes moral disagreement?
Different interpretations of information and contradictory evidence can lead to varying conclusions.
108
Why is an accurate understanding of facts important in decision-making?
It ensures objective decision-making and helps avoid distorted conclusions from unreliable sources.
109
How should ethical principles be balanced in decision-making?
Principles such as autonomy, justice, beneficence, and non-maleficence should be considered together, rather than emphasizing one over others.
110
What is the role of open-mindedness in handling moral disagreement?
Being open to multiple viewpoints and engaging in discussions can lead to a more nuanced understanding.
111
How can consensus building help in moral conflicts?
It involves including all relevant parties in discussions, aiming for respectful dialogue, and avoiding dismissing differing viewpoints.
112
What is the benefit of showing curiosity in moral disagreements?
It helps understand differing values and perspectives, even if you don’t agree with them.
113
What should be considered in character-based approaches to decision-making?
Whether decisions align with personal or organizational values and what a virtuous person would do in the situation.
114
What are process-based approaches to ethical decision-making?
Ensuring all relevant information is considered and checking for adherence to fundamental principles, codes of practice, or laws.
115
What do outcome-based approaches evaluate?
The potential harms and benefits of each course of action to determine which produces the best overall consequences.
116
How should moral rights be balanced in decision-making?
Assess the moral rights of all parties involved and ensure actions respect these rights without unfair discrimination unless justified.
117
Why consider the common good and moral virtues in decision-making?
To determine if decisions advance the common good, set a precedent, and support moral virtues and character development.
118
What is the deontological approach to ethical decision-making?
It focuses on adherence to rules, principles, and duties, such as following best practice guidelines, legal obligations, ethical standards, and considering financial and environmental impacts.
119
How should conscientious objection be approached in healthcare?
It must be based on personal values or moral concerns and not on convenience. It requires sound moral reasoning, and patient safety must be ensured by arranging alternative care.
120
What does the ANMF statement say about conscientious objection?
Nurses and midwives can refuse participation based on strong religious, moral, or ethical beliefs, but personal convenience is not a valid reason. Clear communication and documentation are essential.
121
Mr. P is a 49-year-old male with motor neurone disease (MND), decreased mobility, impaired swallowing, and was prescribed a modified diet due to dysphasia and dysphagia. He wished to consume normal foods and thin fluids, specifically requesting a cold beer and fresh strawberries, despite understanding the risks.
What ethical principles are to be considered in Mr. P's case?
Autonomy: Balancing the patient’s right to make decisions with the responsibility to follow best practices.
Beneficence: Ensuring the patient’s quality of life and comfort, considering his terminal condition and wishes.
Justice: Ensuring fairness and avoiding discrimination based on disability or terminal illness.
122
What should healthcare professionals reflect on regarding professional and personal obligations?
They face conflicts between their professional duties and personal moral beliefs, requiring careful balancing of both.
123
Why is documentation and communication crucial in ethical decision-making?
It ensures clarity and adherence to ethical standards, involving all relevant stakeholders in decision-making.
124
What rights do competent patients have concerning medical interventions?
They have the right to refuse medical interventions, including artificial nutritional hydration, even if it hastens death.
125
What does the World Health Organization’s code emphasize about patient choices?
It highlights the right of competent patients to refuse treatments, emphasizing respect for patient choices even in difficult circumstances.
126
Mr. J, a 62-year-old patient with end-stage renal disease, requests to discontinue his dialysis treatments despite knowing that it will lead to a rapid decline in his health. He wants to spend his remaining time with family and without medical interventions.
What ethical principles are at stake in Mr. J’s decision?
Autonomy: Mr. J’s right to make his own decisions about his treatment and end-of-life care.
Beneficence: The healthcare provider’s duty to act in the patient’s best interest, considering the potential benefits of continued treatment.
Non-Maleficence: The principle of doing no harm, including considering whether continuing dialysis might prolong suffering.
Justice: Fairness in providing care and respecting the patient’s choices, even if they conflict with medical recommendations.
127
Ms. A, a 35-year-old woman in labor, refuses a cesarean section despite medical advice that it is necessary to prevent potential complications for her and her baby. She prefers a natural birth and insists on continuing with the vaginal delivery.
Which ethical principles need to be addressed in Ms. A's situation?
Autonomy: Ms. A’s right to make decisions about her own childbirth, including refusal of a cesarean section.
Beneficence: The healthcare provider’s responsibility to promote the well-being of both Ms. A and her baby.
Non-Maleficence: Ensuring that Ms. A’s refusal does not lead to unnecessary harm to herself or her baby.
Justice: Balancing respect for Ms. A’s choices with the duty to provide safe and effective care.
128
Dr. S, a healthcare provider, has a personal objection to administering blood transfusions due to religious beliefs. A patient in critical condition requires a transfusion to survive, but Dr. S is asked to perform the procedure.
What ethical considerations should be evaluated regarding Dr. S's conscientious objection?
Autonomy: Dr. S’s right to follow personal moral and religious beliefs.
Beneficence: The need to act in the patient’s best interest, which includes providing necessary medical interventions to save a life.
Non-Maleficence: Ensuring that the patient is not harmed by the refusal of care.
Justice: Ensuring that the patient receives timely and appropriate care despite Dr. S’s personal objections, including arranging alternative care.
129
Which ethical principle emphasizes the importance of allowing patients to make their own informed decisions about their healthcare?
A) Beneficence
B) Non-Maleficence
C) Justice
D) Autonomy
D) Autonomy
130
A nurse administers medication to a patient based on the belief that it will improve their condition, even though the patient has refused it. Which ethical principle is primarily being challenged?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
A) Autonomy
131
In a situation where a healthcare provider must choose between allocating limited resources to a high-risk patient or a patient with a higher chance of recovery, which ethical principle is most relevant?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
D) Justice
132
A doctor decides to withhold a potentially beneficial treatment because it involves significant risk to the patient. Which ethical principle is guiding this decision?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
C) Non-Maleficence
133
When considering whether to implement a new healthcare policy that will benefit some patients but disadvantage others, which principle requires careful evaluation of fairness and equity?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
D) Justice
134
A patient with a terminal illness requests to discontinue all treatments and spend their remaining time at home. Which principle supports the patient’s right to make this choice?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
A) Autonomy
135
A healthcare provider chooses to follow established clinical guidelines to ensure the best possible outcome for patients, even if it means not accommodating every individual preference. Which principle is this decision aligned with?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
B) Beneficence
136
A hospital must decide how to allocate its limited resources between different departments. Which ethical principle is most concerned with ensuring resources are distributed fairly among patients?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
D) Justice
137
A nurse is concerned that a particular intervention might harm the patient, even though it is likely to be beneficial. Which principle should guide the nurse’s decision in this scenario?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
C) Non-Maleficence
138
When a patient expresses a wish to refuse a life-saving treatment, and the healthcare team respects this decision despite the potential negative outcome, which principle is being upheld?
A) Autonomy
B) Beneficence
C) Non-Maleficence
D) Justice
A) Autonomy
139
How does the four major ethical principles apply to the following case study:
*Jane is a Yorta Yorta woman who was diagnosed with breast cancer three years ago. After a mastectomy and chemotherapy, she experienced a brief remission but recently learned the cancer has recurred in her lungs. Jane’s doctor advised her and her family
that treatment will likely be unsuccessful and, although it may offer a few more months of life, Jane’s quality of life will rapidly deteriorate. The doctor recommends palliative care at home with comfort measures only, including oxygen and opioid pain relief. Despite symptoms of pain Jane refuses pain medication, stating she does not want to experience the effects of feeling sleepy and missing precious time with her family. Her husband is distraught and asks the nurse if there is a way to administer pain medication
without Jane knowing.*
**Autonomy** is paramount in this case; Jane has the right to refuse pain medication based on her personal values and goals.
**Beneficence** guides the healthcare team to offer appropriate palliative care to improve her quality of life, but must consider her preferences.
**Non-Maleficence** prohibits administering medication without Jane’s knowledge, as it would be unethical and harmful.
**Justice** requires that Jane’s rights and choices are respected, ensuring that she is treated fairly and with dignity.
140
How does the four major ethical principles apply to the following case study:
*A research team at the university invites students to participate in some groundbreaking research that could significantly improve how care is delivered in the acute setting. Participation involves a half hour interview with the research team. The university has offered to “compensate” students for their time in the form of a visa gift card (that can be used at any location a Visa card can be used). The researchers have stipulated that medical students will get $100, nursing students will get $50. The interview questions are the same and will take the same amount of time to be
answered.*
**Autonomy** is respected as long as participation is voluntary and students are fully informed about the study and compensation.
**Beneficence** is upheld by the research’s potential to improve care delivery, but the fairness in compensation needs to be considered to ensure that it does not negatively impact the perceived benefits.
**Non-Maleficence** requires avoiding any negative impact on students’ perceptions or feelings of unfairness. Unequal compensation could potentially harm participants’ trust or feelings of being valued.
**Justice** is a major concern in this case, as different compensation amounts for the same participation could be viewed as unfair. Equal compensation would better adhere to the principle of justice, ensuring fairness and respect for all participants.
