ETHICS MIDTERM KANT'S MORALITY AND FREEDOM According to Kantian Philosophy, FREEDOM is a concept which involved in the moral domain. Kantian Freedom is closely linked to the notion of autonomy meaning "law itself; thus freedom falls obedience to a law that I created myself" "To act freely is to act autonomously. To act autonomously is to actc according to a law I give myself. When I act according to the laws of the natute, demands of social convention, when I pursue pleasure and comfort, I am not acting freely. To act freely is not tocsimply choose a means to a given end.To act freely is to choosecthe end itself, for its own sake." KANTIAN NOTION OF FREEDOM Contrasts of Kant's Notion of Moral Law 1. DUTY vs INCLINATION (morality) only the motive of duty, acting according to the law I give myself confers moral worth to an action. Any other motive, while possibly commendable, cannot give and an action moral worth Scenario 1: Duty vs Inclination A nurse, Maria, is working in a hospital She Is assigned to care for a difficult patient, Mr. Johnson, who is known for being rude and demanding. Maria feels a strong inclination to ignore Mr. Johnson's requests and provide minimal care due to his behavior. However, according to her duty as a nurse, Maria knows she must provide the same level of care to all patients regardless of their behavior. Scenario 2: Duty and inclination in accordance to Emmanuel Kant's Morality Sara, a Muslim American nurse, is working in a hospital where there is a shortage of staff. One day, she finds out that her colleague, Lisa, a Hindu Indian nurse, made a medication error that harmed a patient. Sara knows that according to her duty as a nurse, she should report the error to the authorities. However, Sara also feels a strong inclination to protect Lisa, as they are good friends, and she fears that reporting the error may harm Lisa's career. Scenario 3: Nurse Johnson is assigned to administer medication to patients in a hospital. One day, while on duty, she notices that one of her patients is in severe pain and requires immediate attention. However, Nurse Johnson is feeling exhausted and overwhelmed due to working long hours without a break. Despite knowing her duty to provide timely care to the patient, Nurse Johnson decides to take a break and relax for a while, prioritizing her inclination to rest over her duty to attend to the patient's needs. 2. AUTONOMY vs HETERONOMY (freedom) I am only free when my will is determined autonomously, governed by the law I give myself Being Scenario 1: Autonomy vs. Heteronomy Sarah, a high school student, is given the freedom to choose her extracurricular activities. She decides to join the debate club because she enjoys public speaking and critical thinking. Her parents support her decision but let her make the choice independently. Sarah feels empowered and motivated by her ability to make her own decisions In contrast, Sarah's friend Emily is pressured by her parents to join the school choir despite not having much interest in singing. Her parents believe that being part of the choir will improve Emily's confidence and social skills. Emily feels obligated to obey her parents' wishes, even though she would prefer to explore other activities. Scenario 2 David, a college student, is faced with a difficult decides on about whether to cheat on an upcoming exam. Despite feeling overwhelmed by the pressure to perform well, David chooses not to cheat because he believes it is morally wrong. On the other hand, David's classmate, Tom, decides to cheat on the exam after being persuaded by his friends who argue that everyone else is doing it and that the consequences are minimal. 3. Categorical vs Hypothetical Imperatives (reason) Kant acknowledges two ways in which reason can command the will, two imperatives. Hypothetical Imperatives uses instrumental reason: " If i want X, I must do Y" Hypothetical Imperatives is always conditional. Categorical Imperatives is non-conditional. Situation 1 [categorical] A student wants to pass their exam. If the student wants to pass the exam, they must study diligently Scenario 2 [hypothetical] A person wants to lose weight. If the person wants to lose weight, they must exercise regularly and eat healthily. Scenario 3 [categorical] A nurse encounters a patient in the hospital who requires immediate medical attention. However, the nurse is unsure if she should assist the patient because it is her break time, and she wants to relax. Scenario 4 [ categorical] A nurse is assigned to administer medication to a patient However, the nurse mistakenly believes that she can skip certain safety protocols to save time. ROLE OF FREEDOM IN MORALITY Morality refers to the cultivation of virtue Virtue: the development of character traits so that choosing the good becomes the matter of habit But in order to be truly Virtues, a person must be set free to cultivate such virtue, or not. FREEDOM: THE FOUNDATION OF MORAL ACT Freedom is humans' greates quality, a reflection of our creator. The power rooted in: Reason and Will To Act or Not To Act To Do This or That To Perform Out of Responsibility Good and Evil are forged out from freedom. And that as a person reaches a higher level of freedom, he becomes more capable of higher levels of morality. However, the sinful person becomes a slave. The concept of Freedom is a central premise in Religious Morality, and Secular Culture greatly exalts freedom. FREEDOM AND FREE WILL Freedom is rooted in "reason and will", "to act or not to act", "to do this or that", and to perform deliberate actions on one's own responsibility is a premise in religious morality (i.e. Catholics). Since our secular culture greatly exalts freedom. Freewill "the power of acting without of the constraint necessity or fate" -Oxford Dictionary "the notional capacity or ability to choose between different possible courses of action unimpeded. Free will is closely linked to the concepts of moral responsibility, praise, culpability, sin, and other judgements which apply only to actions that are freely chosen." -Philosophical notion FREEDOM FREEWILL Refers to the ability to act according to one’s own will, without coercion or constraint. Often associated with external circumstances, such as legal rights or societal norms Can be limited by external factors, such as laws, regulations, or societal expectations. Implies, the absence of external restrictions on one’s actions Refers to the philosophical concept that individuals have the ability to choose their actions freely. Often associated with internal mental states, such as intentions, desires, and beliefs. Implies the ability to make choice that are not determined by external factors alone. Raises questions about determinism, the idea that all events, including human actions, are ultimately determined by causes to external to the will Reason and Will Difference Similarity Reason -the ability to think, understand, and form judgement based on logic -is often associated with intellect and rationality -more objective and impartial -faculty of the mind - Both involve conscious process and can be influenced by various factors - Both play a role in decision-making and guiding behavior Will -ability to make conscious choices -desire and motivation -more of an intentional process -influenced by emotions and desires Faculty of the soul/spirit -Both are considered important aspects of human nature in many philosophical and psychological theories FREEWILL AGAINST ALL ODDS "if man has freewill, then are we truly free?" Freewill in Philosophy VS Freewill in the Scientific Notion Freedom, Freewill and Chaos Freewill in the Scientific Notion Chaos Theory (Physics and Quantum Mechanics) interdisciplinary area of scientific study and branch of mathematics focused on underlying patterns and deterministic laws of dynamical systems that are highly sensitive to initial conditions, and were once thought to have completely random states of disorder and irregularities. Chaos Theory (Psychology) is a theory that explains events that seem unforeseeable and erratic on their surface but are controlled by deterministic explanations. The chaos theory definition is applied to nonlinear systems that are significantly impacted by the circumstances of their starting position. The theory explains that extremely small changes in the initial circumstances of a situation can result in extreme differences later on. Chaos Theory (Leyman's) describes the qualities of the point at which stability moves to instability or order moves to disorder. CHAOS THEORY: Butterfly Effect "one small occurrence can influence a much larger complex system" evokes the idea that a small butterfly flapping its wings could, hypothetically, cause a typhoon. Or it could not - the mind-boggling part of the butterfly effect is that it's virtually impossible to predict whether a small system will lead to chaotic behavior ETHICAL THEORIES I. Consequentalism Il. Moral Subjectivism III. Ethnocentricism IV. Social Contract Theory V. Feminist Ethics VI. Situation Ethics Vil.Divine Command Theory VIII. Natural Law Theory IX. Rawl's Theory of Justice X. Ethical Nursing Theories REASON AND IMPARTIALITY Reason and Impartiality are not absolute to a particular group of people, while Morality is absolute. REASON the capacity for consciously making sense of things, establishing and verifying facts, applying logic, changing or justifying practices, intitutions, and beliefs bassed on new or existing information (Kompridis, 2000) CONSEQUENTIALISM: Only the consequenecs, or outcomes, of actions matter morally. Acts are deemed to be morally right (or wrong) solely on the basis of their consequeces. e.g.: Lying (considered wrong) Consequentialism: "If lying is may help save a person's life, then lying is deemed to be the right thing to do." theoretical flaw: difficult; no one can predict the future; objectionable Principles of Consequentialism 1. Whether an act is right or wrong depends only on the results of that act; 2. The better consequences an act produces, the better or more right that act. MORAL SUBJECTIVISM Right and Wrong is determined by what YOU, the subject just happens to think or "FEEL" is right or wrong Theories under Moral Subjectivism A. Simple Subjectivism B. Individualist Subjectivism C. Moral Relativism D. Ideal Observer E. Ethical Egoism F. Utilitarianism G. Teleotonlogy H. Deontology I. Virtue Ethics A. Simple Subjectivism view that ethical statements reflect sentiments, personal preferences and feelings rather than objective facts B. Individual Subjectivism Individualist, a view put forward by Protagoras, saying that "there are as many distinct scales of good and evil as there are individuals in the world." Egoism, maintains that every human being ought to pursue what is in his or her self-interest inclusively. C. Moral Relativism or Ethical Relativism, view that "for a thing to be right, it must be approved by society", leading to the conclusion of different things are right for people in the different societies and different time periods D. Ideal Observer view that 'what is right is determined by the attidtudes that a hypothetical ideal observer"(a being who is perfectly rational, imaginative, and informed) E. Ethical Egoism Right and wrong is determined by what is in your self-interest. Or is it immoral to act contrary to your self-interest based on Psychological Egoism, that WE by nature, act selfishly. Egocentricism and Sociocentrism E1. Egocentricism -the common tendency to consider one's personal opinion. - "an egocentric thinker thinks or does not recognized or even entertain any other opinion; thinks that their opinion alone matters, and all other opinions fare less compared to his own" E2. Sociocentrism - when an entire community (not just an individual) or social group imposes its own worldview and thinks of it as an unquestionable. e.g Religious groups (Islam, Christians, and Jewish) Political Factions Postcolonial Mentality F. Utilitarianism a theory that holds that the best way to make moral decision is to look at the potential consequences of each available choices, then pick the option that either does most to increase happiness or does to increase suffering. G. Teleontology refers to the philosophical study of the nature and essence of teleology, which is the study of purpose or goal-directedness in nature. can be understood as the study of the purpose or ultimate goals behind things, particularly in the context of healthcare and nursing. It involves examining why certain healthcare practices are carried out and what they aim to achieve for the well-being of patients. H. Deleontology or Deontological Ethics is an approach that focuses on the rightness or wrongness of actions themselves, as opposed to the rightness or wrongness of the consequence of those actions I. Virtue Ethics is an excellent trait of character. Is a disposition, well entrenched in its possessor. emphasizes an individual's character as the key element of ethical element of ethical thinking. States that only good people can make good moral decision. Therefore, the best way to be moral is to constantly seek to improve oneself. Virtue ethics encourages nurses to embody virtues like empathy and kindness, which guide their actions and decisions Examples Compassionate Care: A nurse provides emotional support and comfort to a grieving family, demonstrating empathy and compassion. Honest Communication: A nurse is truthful and transparent in communication with patients and families, reflecting honesty as a virtue. Advocacy: A nurse advocates for a patient's needs, showing fairness and a commitment to justice. I1. Eudaimonism holds that the proper goal of human life is eudamonia (which can be variously translated as "happiness") and that this goal can be achieved by a lifetime of practicing arête (the virtues), in one's everyday activities, subject to the exercise of phronesis (practical wisdom) or dilemmas which might aruse. I2. Ethics of Care developed by Annette Baier (1987), is focused upon feminine mentality,wherein it is to exemplified by women such as: taking care of others, patience, ability to nurture, and self sacrifice, etc. I3. The Theory of Natural believe that every person is endowed with certain inalienable rights, such as right to life, right to property, right to liberty. Kant's Good Will and Sense of Duty to act out of sense of moral "obligation" or "duty" ETHNOCENTRISM -is the belief in the inherent superiority of one's own ethnic group or culture. It involves judging other cultures based on the standards and values of one's own culture, often leading to a biased perspective where one's own culture is seen as the "norm" or the standard by which all other cultures are measured. Ethnocentrism can result in prejudice, discrimination, and misunderstanding towards other cultures. Implications for Nursing Practice Cultural Imposition: Nurses may unintentionally impose their own cultural beliefs on patients, which can lead to misunderstandings and conflicts. For example, a nurse might assume that a patient's reluctance to accept a particular treatment is due to ignorance rather than cultural beliefs Barriers to Communication: Ethnocentrism can create barriers in communication between nurses and patients. When nurses view their cultural norms as superior, they may struggle to understand the perspectives of patients from different backgrounds, leading to ineffective communication and reduced trust. Impact on Patient Compliance: Patients who perceive that their cultural beliefs are not respected may be less likely to comply with medical advice or treatment plans. This non-compliance can result in poorer health outcomes and increased healthcare disparities among ethnocultural groups IV. SOCIAL CONTRACT THEORY posits that moral obligations arise from agreements among individuals in society. It suggests that ethical rules are those that rational individuals would agree to for mutual benefit. Application in Nursing in nursing, social contract theory can inform professional codes of conduct and ethical standards that nurses agree to uphold. Examples Professional Codes: Nurses adhere to professional codes that outline ethical responsibilities, such as respecting patient rights and maintaining professional boundaries. Teamwork: Nurses work collaboratively with other healthcare professionals based on agreed-upon roles and responsibilities. Patient Rights: Nurses respect and advocate for patient rights such as the right to refuse treatment, as part of their professional obligations. V. FEMINIST ETHICS a complex set of interrelated perspectives that emphasize interpersonal concerns such as caring, interdependence, and the ethical requirements of particular relationships. Such concerns are traditionally identified with women, but Feminist Ethics should not be thought of as a theory only for women. Feminist ethics can guide care that prioritizes empathy, nurturing, and the well-being of patients and their families. Examples Holistic Care: Nurses provide care that considers the emotional and social needs of patients, not just their physical health. Supportive Relationships: Nurses foster supportive relationships with patients and their families, emphasizing care and empathy Advocacy for Vulnerable Groups: Nurses advocate for the rights and needs of vulnerable patient groups, reflecting a commitment to social justice. VI. SITUATION ETHICS argues that ethical decisions should be made based on the unique circumstances of each situation, rather than adhering to fixed rules. Sițuation ethics can guide decisions that require flexibility and adaptation to individual patient needs. Examples: Emergency Situations: In emergency situations, nurses mayneed to act quickly without following standard protocols, prioritizing immediate patient needs. Cultural Sensitivity: Nurses adapt care practices to respect the cultural beliefs and values of diverse patients. End-of-Life Care: Nurses make decisions about end-of-life care based on the specific needs and wishes of the patient and their family. VII. DIVINE COMMAND THEORY (DCT) is a metaethical theory that posits that moral values and obligations are grounded in the commands of God. According to this theory, actions are morally right if they align with God's commands and morally wrong if they contradict them. This perspective asserts that morality is not based on human reasoning or societal norms but is derived from divine authority. Is higher than human act Key Features of DCT 1.God's Sovereignty: DCT emphasizes that God's will is the ultimate foundation for all moral principles. What God commands is inherently good, while what He forbids is inherently bad. 2. Objective Moral Standards: The theory asserts that moral truths exist independently of human opinions or cultural contexts. These truths are rooted in divine commands. 3. Moral Simplicity: Actions can be categorized as right or wrong based on their alignment with God's commands, making moral decision-making straightforward according to this framework. 4. Religious Texts as Guidance: Ethical guidance is derived from sacred texts, such as the Bible or the Qur'an, which provide the commandments and principles that followers are expected to uphold. 5. Absolute Moral Laws: Since God's commands are seen as unchanging, the moral laws derived from them are also considered fixed and universal. 6. Limitations on Autonomy: Adherents to DCT may find their personal freedoms constrained by divine dictates, emphasizing obedience to religious laws over individual preferences. Applications of DCT in Nursing: Guiding Ethical Decisions Nurses who subscribe to DCT may use their understanding of divine commands to guide their ethical decisions in clinical settings