ETHICS IN HEALTHCARECTE Online

Shelby County ATC

Health Science

MEET THE BIG 8

Aquinas Kant Mill Rawls Aristotle Buber Kohlberg Frankl

SAINT THOMAS AQUINAS (1225-1274)

Theory: Natural Law God is rational and created the world

rationally. Humans can reason, therefore are capable of

choosing good over evil. Influences: Aristotle and Christian theology Asked a lot of questions to develop theories Gift of Free Will Why do we do things? The need to listen to conscience.

WHAT IS GOOD?

Humans should strive for the highest good—seeking wisdom and knowing God.

For Aquinas, good preservers life and the human race, allows us to act prudently so we can live in community, and seek the truth

HAPPINESS

Pursuing our passionate appetites such as eating, drinking, physical relations, power.

We are to use restraint in these things, so that we can enjoyenjoy them without being ruledruled by them.

To be ethical, we must allow others to gain their best human potential.

We must practice the cardinal virtues (prudence, temperance, courage, justice).

STOP AND TALK

Can you limit health care based on life decisions?

What are the cost factors for the health care system?

What is the healthcare obligation to those who do not make rational choices?

IMMANUEL KANT (1724-1804)

Theory: deontology (duty-based ethics) Everything in society has relativerelative

value. The only true good is good will. All human beings have worth. People are not just tools to achieve

societal or organization goals. Categorical imperative helps make

decisions.

STOP AND TALK

Are all people valuable no matter how they contribute to the bottom line?

Why would a pure Kantian practice be practical in healthcare?

JOHN STUART MILL (1806-1873)

Theory: Utilitarianism produces utility (benefit) and/or avoids harm.

Influential in American healthcare ethics.

People can be a means to an end, but the end must be __________.

TYPES OF UTILITY

Act UtilityEach decision based on its own merit.

Rule UtilityConsequences help to form rules.

Rules are then used for decisions.

STOP AND TALK

What are the limitations of utilitarianism?

How can it help you make decisions?

How can it help you make policies?

JOHN RAWLS (1921-2002)

Theories: original position and veil of ignorance.

If the concepts were true, we would create rules to live in a just society.

What is a just society? These rules would lead to social contract.

Social contract = equal basic rights including protecting those in lesser positions (in your self interest). The advantaged have the responsibility to carry out this mandate.

STOP AND TALK

Societies are judged by how it treats the least well off? How would America be judged?

His theories cause ethics concerns in healthcare because they ask for a balance of mission and profit. How do you see this in hospitals?

ARISTOTLE (384 BC – 322 BC)

Virtue Ethics What makes a good person Practical wisdom and eudaimonia. A character trait that you are willing to ACT on Includes thinking emotions, choices, values If you have virtue, you will act on it even when it

is difficult.

PRACTICAL WISDOM OR PHRONESIS

Practical Wisdom means you think about how and why to act.The ability to decide what is best for a situation.

Rational thought is achieved by experience AND education.

EUDAIMONIA

Happiness or flourishing.Only possible with humans.

Living a life devoted to virtues and not just to external rewards such as money or pleasure.

STOP AND TALK

What kind of employees do you want to hire?

What are the benefits of eudaimonia?

MARTIN BUBER (1878-1956)

Ethics is about relationships and forms a hierarchy

I-I—person does not exist.I-IT—people as property.I-YOU—people are whole and have

ideasI-THOU—highest moral

relationship; agape.

STOP AND TALK

What would happen if you treated people as I-YOU? I-IT?

LAWRENCE KOHLBERB (1927-1987)

Ethical Development Stage TheoryPre moral (before moral reasoning) or Pre Conventional, its about YOU.

Level one—avoid punishment Level two—personal rewards

Exernally controlled morals (Rules by others) Level three—please people Level four—law is obeyed

Principled morals (Rules by higher authority) Level five—common rights Level six—universal rights and laws

STOP AND TALK

Analyze your own moral stages

What is your role in society's eyes

VICTOR FRANKL (1906-1997)

Search for meaning You are Mind/Body/Spirit (noös) and unique in

the universe. Finding meaning in life and work is key. You have choices but with choice comes

responsibility. There is super meaning that knows the

answers. Consequence is key to your choices and keeps you from the existential vacuum.

STOP AND TALK

Do you accept responsibility for your choices?

APPLICATION TO HEALTH CARE

Think of the theories we have just reviewed. How can we use them in health care?

What does the word ethics mean to you?

How does knowing about the Big 8 help you understand ethics?