Download Ethics and Decision Making

Ethics & Decision-Making
Dr Dónal O’Mathúna
[email protected]
700 7808
What is ethics?
What is ethics?
• Ethics: from Greek ethikos (moral
character), related to ethos (custom).
• Morality: In Latin, ethikos was translated as
mores (character, proper behaviour in
society); plural: mores, customs.
• Virtue: from Anglo-French, vertu (moral
life and conduct, moral excellence)
• Ethics is the systematic study of concepts,
principles and theories that address issues of right
and wrong. Examines arguments, actions and
character qualities.
• Morality refers to the broader traditions of right
and wrong, good and bad, in society and culture.
• Virtue describes personal
characteristics that impact
ethical behaviour: courage,
honesty, fidelity, etc.
• Ethics differs from laws and codes, but they
are all interrelated.
• Ethics builds and evaluates arguments about
ethical issues and situations to establish
principles of right behaviour.
• The terms ‘ethics’ and ‘morality’ are used
interchangeably.
• Ethics is a branch of philosophy.
Ethics as philosophy
• Ethics builds & scrutinizes arguments about right
and wrong behaviour
• Ethics seeks to determine valid principles (e.g.
never take innocent human life) & the relationship
between principles and actions (e.g. does saving a
life in some situations constitute a valid reason for
breaking a promise?)
• Ethical decision-making ‘is a complicated
process of using all of one’s faculties—
intellect, emotions, and imagination—to
evaluate a particular situation and determine
how to act.’
Hawkins 2002 in Stories Matter p76
Dónal O’ Mathúna, “The Place of
Dignity in Everyday Ethics,”
Journal of Christian Nursing 28.1
(January-March 2011): 12-18
Using cases in ethics
• Cases are stories or descriptions of situations
in which people disagree about core ethical
values.
1. Examine the facts of the case
•
•
•
•
Do you understand all the terminology?
Are all terms being used in the same way?
Are there communication problems?
What ‘facts’ are missing? Have they been
overlooked, ignored or deliberately left out?
2. Identify the ethical issues
• Why is there a conflict?
• Are there a number of different ethical
issues?
• Are there other issues that are not ethical?
– e.g. any misunderstandings?
– any hurt feelings?
– any relational issues?
3. Examine all the ethical issues
• Are some more significant than others?
• Are some more pressing than others?
• Do different people differ in which needs to
be resolved first?
– e.g. which treatment simplifies to whether to
treat or not
• Decide on how to approach the issues.
4. Examine each ethical issue
• What ethical principles and values are
central?
• Is one ethical principle in conflict with
another?
– e.g. autonomy versus justice
• Are different interpretations of an ethical
principle involved?
– e.g. beneficence includes or excludes suicide
5. Consider other cases
• Try to find other cases that bring light to
this one because of their similarities or
differences.
6. Consider alternative options
• Is there another option that has not been
considered?
• Have we asked someone else who might
have a different perspective?
• Is an ethics committee available?
7. Test consistency
• If we do this here, what will it mean in
another situation where …?
• Would I want others to know that this is
what I recommended here?
• Would I want this to be done in my case?
8. Decide, act … and reflect
• Decisions need to be reviewed.
To tell or not to tell
• What makes this an ethical issue?
• What reasons would you give to support
your view on what should happen?
• What other information is needed?
• Make assumptions explicit & examine
them.
• What alternatives may exist?
• Get input from other sources.
• The ethical issue can be what to do, but also
how to do it.
• What are the time factors?
• Organise the issues.
• What are the general principles?
• What if this approach was taken in similar
cases?
• Look for other related issues: legal,
financial, family, social, etc.
• Who is responsible for the final decision?
What does ethics offer?
Embryonic stem cell research
religion
Scientific
freedom
harm
law
suffering
patients
embryo
playing God
rights
cure
s
person
philosophy
death
autonomy
ethics
Embryonic Stem Cell Research
Ye
s
No
patients’
rights
embryo’s
rights
human
suffering
human
dignity
common
ground
action
action
If you are faced with a dilemma on what is the
right thing to do, moral philosophy will not
find a decision for you. What it can do is
remove some confusions and clarify some
obscurities, so that the options stand out more
plainly.
DD Raphael, Moral Philosophy, p.10.
Ethics can…
• Provide direction towards better answers and away
from worse ones.
• Help clarify various positions held on controversial
issues.
• Make explicit values and norms in healthcare (and
thereby improve services??).
• Engage our mental, emotional and relational
dimensions to consider those aspects of practice.
• Guide us as we grapple with some of the deeper
implications of healthcare.