Glossary of RSPT 526 - Ethics

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Created by bramnewman

What is ethics?
- Branch of philosophy which asks how we ought to act
- Often thought to be a feeling but is a rational reflection
What is the aim of ethics?
To arrive at a decision backed by reasoning that must be as good or better than those which support alternative decisions.
What makes issues ethical?
Differences in values
Problems with personal judgements/decision
- Use facts + personal values
- Incorrect change
- Values differ person to person

Western ethical theories
- Consequentialist theories
- Deontological theories
- Justice theories
- Feminist, care & relational theories

Principles of health care ethics

- Autonomy (respect persons’ wishes)
- Non-maleficence (do no harm)
- Beneficence (max benefit, min harm)
- Justice (be fair according to need)
- Care (consider the environment, relationships & impact of our actions on others involved)

- Consequences of an action determine how we ought to act
- Utilitarianism (J.S. Mill) best known consequentialist based theory
- Actions are right, or good, in proportion to the extent to which they promote happiness
Which means...
- Do the greatest good for the greatest number of people
- Moral responsibility of each person is to choose that action which will result in the best set of consequences

Problems with consequentialism
- Not all agree the degree to which consequences are positive or negative
- Basing how to act on overall consequences means that individuals may suffer for the majority
- Help someone because of duty to so, not because of consequences
- Best known duty-based theory (Kant)
- Act according to our reason which tells us that universal principles should be upheld (e.g. tell the truth, treat persons with respect)
- Rules must be universally applied without exception
- Rules must treat persons as ends in themselves and not as a means to some other end.

Problems with deontology
- Is it always right to tell the truth (e.g. Nazi at door)?
- Is it always right to keep one’s promises (e.g. lunch with friend when daughter is ill?)
Justice theories

- We ought to act so as to be fair
- Best known justice theory distributive
justice (J. Rawls)
- Assumes policy-makers are rational egoists (i.e. maximize own advantage & think through the consequences of their decisions before making them)
- Assumes decision-makers are behind a ‘veil of ignorance’ (i.e. person does not know their lot in life; rich/poor; healthy/ill)
- Person must frame policies under these assumptions and will have to live under these policies in whatever state he/she comes into society
- Concludes policy-maker will set policy to look after the most needy, dependent & least well-off
- Contends policies made from behind a think ‘veil of ignorance’ are fairer

Feminist theories
- Feminist ethics, ethics of care and relational autonomy (e.g. Margaret U Walker; Sue Sherwin)
- Brings the experience of women into ethics
- A belief that we ought to consider power relationships, the role of emotion, the subjective in moral reasoning and enquire about other relationships experienced before we act

Care ethics
- Branch of ethical thought & decision making which incorporates and values the notion of ‘care’ in health care
- Includes looking at all of the different persons and relationships involved and providing support for them during an ethical decision making process
- ‘Bottom’ up ethical approach supported by feminist ethics

Problems with feminist theories
- Generally cannot be used alone
- Explains power relationships etc. but does not tell us what actions we should take
Problems with principle approach

- No rational way of ordering principles
- Little or no attention to process and
relationship building
- Therefore:
- NB to know why we are overriding a principle
- Rational reflection,values clarification, attention to relationships and process are key to making ethical decisions

Ethical decision-making framework
10 steps
1. Identify the issue of concern
2. Gather the relevant information
3. Frame concerns in terms of question to be answered
4. Identify your personal values
5. Identify all options from most to least intrusive
6. Use ethics resources to evaluate alternatives
7. Propose possible resolutions
8. Consider the law
9. Documentation
10. Implementation & evaluation

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