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EILEEN E. MORRISON
A Practical Approach
For Decision Makers
SECOND EDITION
© 2010 Jones and Bartlett Publishers, LLC
Class One:
Ethics Theories
© 2010 Jones and Bartlett Publishers, LLC
Agenda
Welcome and traditions
 Syllabus and online site review
 Definitions of ethics
 Introduction to the global four
 Homework
 Summary
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© 2010 Jones and Bartlett Publishers, LLC
Class Traditions
Begin the tradition of communities.
 Divide into communities and seating
areas.
 Shake the hand of your community
members.
 Tell me about your community.
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Review of Syllabus and Online
This course touches all of the other
courses you will study.
 Review the syllabus: where are we going?
 Review the online site.
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© 2010 Jones and Bartlett Publishers, LLC
Why Study Ethics?
You need it as part of your base for
successful practice.
 Health care is always changing and
challenging.
 Answers not always black and white.
 The community expects much from you.
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Ethics Definitions
Ethics is a way to study moral behavior.
 It is more than obeying the law.
 There are different types of the ethics
such as
 Normative or organizational ethics.
 Professional ethics.
 Personal ethics.
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Welcome to the Global Four
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Global Issues in Ethics
– Aquinas
– Kant
– Mill
– Rawls
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St. Thomas Aquinas (12251274)
His theory is called natural law.
 God is rational and created the world
rationally.
 Humans can reason, therefore are
 Capable of choosing good over evil.
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St. Thomas Aquinas (12251274)
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Aristotle and Christian theology influenced
him.
He asked questions to develop his theory.
God is rational and created the world
rationally.
Humans can think/reason and have the
potential to choose good over evil.
Do we always do this? The gift of free will?
Need to listen to our conscience.
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What is Good?
Humans should strive for the highest
good-- seeking wisdom and knowing God.
 For Aquinas, good preserves life and the
human race, allows us to act prudently so
we can live in community, & seek the
truth.
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Happiness is not in…
Pursuing our passionate appetites such as
eating, drinking, sex, power.
 We are to use temperance in these things,
so that we can enjoy them without being
ruled by them.
 To be ethical, we must allow others to
gain their best human potential.
 We must practice the cardinal virtues
(prudence, temperance, courage, justice)
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Application: Stop and Talk
What happens if evil is chosen over good?
 Cost factors for the health care system?
 What is your obligation to those who do
not make rational choices?
 Can you limit health care based on life
decisions?
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© 2010 Jones and Bartlett Publishers, LLC
Immanuel Kant (1724-1804)
His theory is deontology or duty-based ethics.
Everything in society has relative value.
The only true good is good will.
All human beings have worth.
People are not just tools to achieve societal or
organization goals.
 Categorical imperative helps make decisions.
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Application: Stop and Talk
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All people are valuable no matter how they
contribute to the bottom line.
Categorical imperative helps with decisions.
Examine application of Kant to policies.
Pure Kantian practice is not always practical in
health care, but it does give you tools and
questions.
What questions would you ask yourself?
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John Stuart Mill (1806-1873)
He is influential in American health care ethics.
 Utilitarianism impacts policy development.
 Good=produces utility (benefit) and/or avoids
harm.
 People can be a means to an end, but the end
must be___.
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Types of Utility
Act Utility
– Each decision based on its own merit.
 Rule Utility
– Consequences help to form rules.
– Rules are then used for decisions.
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Applications: Stop and Talk
What are the limitations of utilitarianism?
 How can it help you make decisions?
 How can it help with policies?
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John Rawls (1921-2002)
What is a just society?
 Rawls sets up hypothetical concepts called the
original position and veil of ignorance.
 If the concepts were true, we would create rules
that to live in a just society.
 These rules would lead to a social contract.
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John Rawls
Social contract includes equal basic rights. What
do you think these should be?
 It also includes protecting those in lesser
positions (in your self interest).
 The advantaged have a responsibility (difference
principle).
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Application: Stop and Talk
Public health and other organizations
based on social justice.
 America is judged by how it treats the
least well off—Examples?
 Political issues around social justice?
 His theory causes ethics concerns with
balancing mission and margin; huge issue
for health care.
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© 2010 Jones and Bartlett Publishers, LLC
In summary…
What does the word ethics mean to you?
 How does knowing about the Big 8 help
you understand ethics?
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© 2010 Jones and Bartlett Publishers, LLC