INFORMATICS L7 LEC

The philosophical inquiry of the moral dimensions of human conduct

Ethics

Ethics focuses on:

Right versus wrong

Good versus bad

Duties and responsibilities

Justification of decisions

Ethics is not

• Personal preference

• Mere opinion

• Moral development

• Religious doctrine alone

• The law

Three characteristics of Ethics

Fundamental

Universal

Considers all affected parties

No higher standard exists for judging the issue

Fundamental

Participants believe there is a right or wrong answer

Universal

Welfare of everyone involved is considered

Considers all affected parties

Levels of ethical decision-making:

Micro Level

Meso Level

Macro Level

Individual patient-professional interactions

• Eg.: accurate information, patient autonomy, potential harm, professional responsibility

Micro Level

Institutional or organizational decisions

• Eg., fair allocation of limited resources

Meso Level

Professional, societal, or governmental policy decisions

• Eg., balancing individual needs and societal resources

Macro Level

Rules of conduct imposed by society on its members

Law

Rules of conduct or standards by which a particular group in society regulates its actions and sets standards for its members

professional ethics

Our ethical beliefs may on occasion command our ___

Eg., a prison pharmacist who refuses to dispense drugs to be used in legal executions

civil disobedience

Branch of moral philosophy that establishes the criteria for determining what is morally right and wrong

Normative Ethics

Based on their consequences, rather than on any intrinsic features

Consequentialist Theory

2 types of Consequentialist Theory

Beneficence

Nonmaleficence

Do that which promotes a good outcome

Beneficence

Do that which minimizes bad outcomes (more important)

Nonmaleficence

Look more to intrinsic qualities

Deontological (Duty-Driven) Theory

“Four pillars of biomedical ethics” by Beauchamp and Childress:

Respect for autonomy

Nonmaleficence

Beneficence

Justice

(Deantological) The right of the individual to self-rule or to decide on issues that primarily affect self

Respect for autonomy

(Consequentialist) Duty to do no harm

Nonmaleficence

(Consequentialist) Duty to promote good

Beneficence

Relate to fairness and tendering what is due, resource allocation, and providing that to which the individual is entitled

Justice

The physician’s (or any healthcare provider’s) duty is to the patient

Respecting the patient-professional relationship

Related to autonomy; the client has a right to be informed and to freely choose a course of action

Consent

Related to autonomy; individual client’s right to give or refuse consent relative to release of privileged information

Confidentiality

Related to autonomy; right of the individual to control their own affairs without interference from or knowledge of outside parties

Privacy

Duty to the welfare of the individual, particularly within religion-based deontological theories; dignity or sanctity of human life principles

Respect for persons

(Deontological) Obligation to truth telling or honesty

Veracity

(Deontological) Responsibility to be trustworthy and keep promises

Fidelity

Consideration of the other’s point of view

Duty of reciprocity

each party takes on certain responsibilities and gives up certain rights in order to achieve specific good outcomes

(consequentialist theory)

3 parts of Ethics analysis

I. Identification of relevant background information

II. Identification of relevant background information

III. Deliberation, through the use of moral intuition and application of ethical theory, on how to rank/balance the rules and principles pertinent to the case in order to resolve the ethical dilemma

3 parts under Identification of relevant background information

A. Data gathering

B. Consideration of the welfare of all affected parties

C. Respect for the cultural perspectives of these parties

• Details of the issue

• Who is directly involved

• Any conflict in factual understanding among the involved parties

Data gathering

• The healthcare provider

• The direct client

• Other indirect but individual clients (e.g., unborn children)

• Other health professionals (e.g., patient’s physicians)

• Other societal groups (e.g., other patients who might be harmed by an incompetent practitioner)

• Any higher power recognized by the health professional

Consideration of the welfare of all affected parties

• Religious affiliation

• Socioeconomic status

• Political affiliation

• Age category

• Racial or ethnic group

Respect for the cultural perspectives of these parties

• Nonmaleficence

• Beneficence

• Respecting the patient- professional relationship

• Respect for autonomy

• Consent

• Confidentiality

• Privacy

• Respect for persons

• Veracity

• Fidelity

• Justice

Identification and justification of the relevant moral rules and principles (action-guides) pertinent to the case