ETHICAL THEORIES, PRINCIPLES, TERMINOLOGY AND
DECISION-MAKING – Christine Mitchell, RN
1.
Morality:
typically refers to that which we infer people value, based on their
choices and behavior (or should value based on social
expectations). Morality reveals a person’s values or assumptions
about what is good or bad.
2.
Ethics:
a philosophical discipline concerned with human obligations,
duties and responsibilities. Ethics involves a system of thought
that makes consistent decisions case to case.
Ethical decisions can answer the question “why” from consistent
assumptions to consistent conclusions.
3.
Language:
we use everyday words and specialized terms
Everyday terms:
 right/wrong; good/bad; fair/unjust
 duty, obligation, responsibility
 rights, claims, having a “stake” in something
 virtues/vices, justice, principles
Specialized terms:
 Beneficence, non-malieficience
 Metaethics, normative ethics, applied ethics
 Justifiability, obligatory, supererogatory
4.
Domain of Ethics:
Conduct:
Character:
Which Act is Right?
Which Agent is Good? (We look at the virtues of
the caregiver; is s/he a truthteller, kind,
obedient?
Community: Which policy or practice is Fair?
5.
Metaethics:
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Deals with Epistemology:
How do we know something is right?
How do we know a certain conduct is right?
How do we know a certain character is good?
How do we know a certain policy or practice is fair?
Relativism: an act is right if a given society approves of it.
Moral Absolutist theory: some morals transcend society/culture
Ideal observer: an act is right, good, fair if an Ideal Observer
would approve of it. An Ideal Observer must be omniscient (know
all), omnipercipient (capable of feeling all), disinterested,
dispassionate, and consistent
6.
Normative Ethics:
What conduct is right?
Which character is virtuous?
Which community is just?
An ethical dilemma is experienced when duties and responsibilities
come in conflict (for example, a person’s right to make an
autonomous decision and a caregiver’s duty to do no harm)
Duty-based (or virtue based) theories:
Kant: Treat all persons as an ends not a means. Act as if you were
guided by a universal law.
Rawls: Arrange all inequalities so the greatest benefit goes to the
least advantaged.
One should choose the act which would be chosen by a perfectly
virtuous moral agent.
Utilitarianism (ends-based or teleological) theories:
The ends justifies the means; consequences are crucial.
Choose the act that would produce the greatest good for the
greatest number.
Descriptive ethics:
Describes what conduct, character or community persons report
that they believe is right, good, or just.
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Principles involved:
Nonmaleficence – “do no harm”
Beneficence – “do good”
Autonomy – a person’s right to make his/her own decisions
Veracity – truth telling
Fidelity – promise-keeping, loyalty
Truth telling
Distributive justice
Self-improvement or character excellence
7.
Ethical Decision Making
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name the conflict, problem or choice
get all the facts
name all the possible choices
name the consequences for all involved (including staff) for
each choice
identify values and beliefs that are involved
identify all legal consequences
identify who makes what choice
identify previous experience and its impact on members’
current decision making
What can we do?
What should we do?
Why?
Remember: Two different people can come up with different conclusions, both
using consistent ethical reasoning. To make an argument sound, however, each
person’s argument has to be consistent within itself. If conclusions differ
underlying values differ.
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