Chapter 3: Prototypes of ethical problems

identifying clinical issues

• choice is completely grounded in medical practice

• provides clarity for what it is recommended for the best patient outcomes

identifying legal issues

• laws provide guidance in this realm

• provide clarity for what is right and wrong in the eyes of the state

prototypes of ethical problems have three things in common

• A- A mortal agent

• C- A course of action

• O- an outcome

A=Moral agent

• acts on behalf of client for the morally right course of action

• takes responsibility for his/her action

• reason versus emotion—is emotion a productive addition?

• locus of authority and shared agency

what is the best definition of how a health professional acts as a moral agent?

1. a person with more than one loyalty (a double agent)

2. a person who has the moral or legal capacity to make decision s and be held responsible for them

3. a person who plans schedules

C=Course of action

• a course of action arrived at based upon:

  • moral agents analysis of issue

  • evaluation of possible resolutions

  • selection based upon best judgement of best resolution

  • decision to ACT upon that resolution

O=the outcome

result of that course of action that was chosen and acted upon

• GOAL- a caring response achieved

two prototypes

• moral distress: confronting barriers to moral agency

• two courses diverging

type A barrier

• moral agent—knows what to do

• reimbursement constraints

• conflict with organizational policies

• pressure for productivity, lack of admin support

type b barrier

• moral agent—knows something is wrong

• don’t know what to do

• new situation

• how to remove barrier—need more info

• ask questions—talk to colleagues

diverging courses

• justice seeking—ethical dilemma

• allocation of resources

• supply, demand and equitable treatment

  • organ transplants