Module 4 - Ethical Decision Making PPT

ethics aims and attempts

to provide good reasons for our moral choices

to justify our actions that gives ethics it’s distinctive character

Moral/Ethical Dilemma

Our obligations and responsibilities are in conflict

Moral/Ethical Dilemma criteria

Moral reasoning or critical thinking is required

Not just a right or wrong answer - often a variety

Having to choose between 2 consequences which may be undesirable

Moral Weakness

Moral responsibilities and personal inclinations point in different directions

NOT AN ETHICAL DILEMMA

Moral Uncertainty

Question of whether a moral obligation exists

MOST LIKELY AN ETHICAL DILEMMA

Ethical Decision-Making Models

provides a framework for making a decision using principle-based reasoning

Not overnight, it takes time AND practice to be able to solve ethical dilemmas

Weinstein Model - 4

Gather the relevant facts

Identify the values involved

Generate options

Select and justify an option

Darby Model - 7

Identify the Problem

Identify the Ethical Issue (normative principles & moral rules)

Gather Information

Identify Solutions & Alternatives

Establish an Ethical Position

Justify & Defend that Position

Act on the Decision

Six Step Model

Identify the type of ethical problem

Get the story straight: Gather relevant facts

Explore the practical alternatives

Select the course of action: Justify

Implement/Act on the decision: Follow through

Evaluate the process and outcome

Identify the Ethical Dilemma

most critical step in the process

Analyze what’s the challenge and how to solve it

Be specific in identifying the challenge

What are the ethical principles in play?

If the ethical question does not place the ethical principles in conflict it means

it is not a dilemma, but rather a simple question of right and wrong, no need to proceed to the following steps

Gather the Facts

To make an informed decision

ASK what, where, when, why and how questions

Can be factual information on how the situation developed

Information may come from a various sources

Must understand your profession’s code of ethics, standard of care and legal responsibilities

facts can be - step 2

Technical

Social

Psychological

Contextual

Technical Questions

What is the diagnosis/prognosis?

Is the situation reversible?

What is the current standard of care?

What is the usual treatment for this condition?

What is needed to relieve suffering, provide comfort?

What modifications may the medical history require?

Social Questions - 5

What does the patient/client want?

Have realistic options been presented to the patient/client?

Is there a caregiver involved?

Is the patient/client competent to make decisions?

How are financial issues influencing the decision-making process?

Psychological Questions - 3

What are the patient’s beliefs/values?

Are there quality of life issues involved?

Are quality of life issues influencing the decision-making process?

Contextual Factors - 2

Are there “institutional” policies?

Are there legal implications? (Court cases, statutes)

List the Alternatives/Options

Brainstorm to identify as many alternatives or options as possible (even the options that sound unreasonable to YOU)

View the situation from different angles (duties, wants and needs) and from another person’s point of view

HAVE AN OPEN MIND - Sometimes suggestions that appear to be most unlikely may prove to be the best

Apply the Ethical Principles

Autonomy, Confidentiality, Societal Trust, Nonmaleficence, Beneficence, Justice, Veracity, Fidelity

For EACH option, develop a list of pros and cons

Pro column are alternatives that protect the ethical principles

Con column are alternatives that violate the ethical principles

Weigh the negative against the positive options

4. Select Course of Action

Each option must be weighed according to the pros and cons with the fact that the patient’s welfare and interests are put first

Choose an option then justify the option

Actions become easy when we are sure the selected action is justifiable

5. Implement the decision

Act on your decision

You may not be totally comfortable with the final decision, but you will know you explored each possible alternative

The best action are those that show the most ethical scrutiny - may not be the most popular

Face the consequences knowing you chose the most ethical choice possible based on a full situational analysis

6. Evaluate the action

If I had to do it all over again, would I make the same decision?

Did I grow and develop professionally from my decision?

Did this lead to positive changes?

Continued evaluation… it may take time to clearly see the outcome

Welcome all feedback, input and counsel about your decision and action

Evaluation

Pillow Test - Can you sleep with your decision?

Newspaper Test - Would you be comfortable publishing your decision in the paper?

Child Test - Could you explain your decision to a child as an example for them?