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ETHICS IN HEALTHCARE
CTE Online
Shelby County ATC
Health Science
MEET THE BIG 8
Aquinas
 Kant
 Mill
 Rawls
 Aristotle
 Buber
 Kohlberg
 Frankl

SAINT THOMAS AQUINAS (1225-1274)
Theory: Natural Law
 God is rational and created the world rationally.
 Humans can reason, therefore are capable of
choosing good over evil.
 Influences: Aristotle and Christian theology
 Asked a lot of questions to develop theories
 Gift of Free Will
 Why do we do things?
 The need to listen to conscience.

WHAT IS GOOD?
Humans
should strive for the
highest good—seeking wisdom
and knowing God.
For Aquinas, good preservers life
and the human race, allows us to
act prudently so we can live in
community, and seek the truth
HAPPINESS
 Pursuing
our passionate appetites such as
eating, drinking, physical relations,
power.
 We are to use restraint 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).
STOP AND TALK
Can
you limit health care based
on life decisions?
What are the cost factors for the
health care system?
What is the healthcare
obligation to those who do not
make rational choices?
IMMANUEL KANT (1724-1804)
 Theory:
deontology (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.
STOP AND TALK
Are
all people valuable no
matter how they contribute
to the bottom line?
Why would a pure Kantian
practice be practical in
healthcare?
JOHN STUART MILL (1806-1873)
 Theory:
Utilitarianism produces
utility (benefit) and/or avoids harm.
 Influential in American healthcare
ethics.
 People can be a means to an end, but
the end must be __________.
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.
STOP AND TALK
What
are the limitations of
utilitarianism?
How can it help you make
decisions?
How can it help you make
policies?
JOHN RAWLS (1921-2002)
Theories: original position and veil of ignorance.
 If the concepts were true, we would create rules
to live in a just society.
 What is a just society?
 These rules would lead to social contract.


Social contract = equal basic rights including
protecting those in lesser positions (in your self
interest). The advantaged have the responsibility to
carry out this mandate.
STOP AND TALK
Societies
are judged by how it
treats the least well off? How
would America be judged?
His theories cause ethics
concerns in healthcare because
they ask for a balance of mission
and profit. How do you see this
in hospitals?
ARISTOTLE (384 BC – 322 BC)

Virtue Ethics





What makes a good person
Practical wisdom and eudaimonia.
A character trait that you are willing to ACT on
Includes thinking emotions, choices, values
If you have virtue, you will act on it even when it is
difficult.
PRACTICAL WISDOM OR PHRONESIS
Practical
Wisdom means you
think about how and why to
act.
 The
ability to decide what is
best for a situation.
 Rational thought is achieved
by experience AND education.
EUDAIMONIA
Happiness
or flourishing.
Only possible with humans.
Living a life devoted to
virtues and not just to
external rewards such as
money or pleasure.
STOP AND TALK
What
kind of employees do you
want to hire?
What are the benefits of
eudaimonia?
MARTIN BUBER (1878-1956)
 Ethics
is about relationships and
forms a hierarchy
 I-I—person does not exist.
 I-IT—people as property.
 I-YOU—people are whole and have
ideas
 I-THOU—highest moral
relationship; agape.
STOP AND TALK
What
would happen if you
treated people as I-YOU?
I-IT?
LAWRENCE KOHLBERB (1927-1987)
 Ethical
Development Stage
Theory


Pre moral (before moral reasoning) or
Pre Conventional, its about YOU.
Level one—avoid punishment
 Level two—personal rewards


Exernally controlled morals (Rules by others)
Level three—please people
 Level four—law is obeyed


Principled morals (Rules by higher authority)
Level five—common rights
 Level six—universal rights and laws

STOP AND TALK
Analyze
your own moral
stages
What is your role in
society's eyes
VICTOR FRANKL (1906-1997)
Search for meaning
 You are Mind/Body/Spirit (noös) and unique in
the universe.
 Finding meaning in life and work is key.
 You have choices but with choice comes
responsibility.
 There is super meaning that knows the answers.
Consequence is key to your choices and keeps you
from the existential vacuum.

STOP AND TALK
Do
you accept
responsibility for your
choices?
APPLICATION TO HEALTH CARE
Think
of the theories we have
just reviewed. How can we use
them in health care?
What does the word ethics mean
to you?
How does knowing about the Big
8 help you understand ethics?