Theories of Ethical Reasoning

8/6/2019 Theories of Ethical Reasoning

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THEORIES OF ETHICAL REASONING

OBJECTIVES

At the end of the lecture the student should be able

to :

Define ethics ( in Nursing Practice)

Discuss the ethical reasoning (Teleological,Deontological, Feminist and Virtue ethics).


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REFERENCES

Thomson, I, E., Melia, K. M. Kath,M., Boyd, K.,

M., (2003) Nursing Ethics 4 th ed., USA ,

Philadelphia : Elsevier Science Limited.

Crisp J., & Taylor C., (2005) Potter & Perrys

Fundamentals ofNursing, [2nded.], Australia.

Elsevier Sciences Ltd.


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Presentation

Lecture presented by Ms Uma K., Lal

P.P.D Strand.


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WHAT IS ETHICS?

In general ,ethics ,from the Greek ethos means thespirit of a community. It refers to the formalcooperative Endeavour of a moral community to

define its values ,the necessary conditions, practicalrequirements, and protective rules which will ensureits well-being and the flourishing of its members.

An ethic' refers to the belief and value system of anymoral community or the formal code of practice of acooperate body, or profession .


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Applied ethics in nursing practice

Application of ethics in nursing means that

you are able to act responsibly ,appropriately

and effectively in various situations being able

to provide a clear ,coherent and reasoned

justification for your decisions and actions,

with reference to commonly accepted

standards.


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Applied ethics

This application requires the following skills:

Know the basic principles which express our

fundamental values

and from which we derive practical moral values.


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Applied ethics

Competence in practical problem solving and

decision making skills required for dealing

with moral problems.

Discretion in formulating sound ethical

policies and choosing relevant decision

procedures for use in different types of

situations.


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Applied ethics

Sound habits and stable dispositions

(competencies) to ensure that one actseffectively as a responsible moral agent


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Ethical reasoning's-Teleological

According to teleological theory,

actions can be judged right and or good

only on the basis of the consequencesthey produce focuses on ends ,goals

and consequences.


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Teleological theory

Utilitarianism-most popular teleological theory which is

concerned with the general welfare of people as a whole

, rather than individual. It views the world in terms of the

collective and overall welfare and interest of people,

promoting universal point of view that one persons.


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Teleological theory

interest can not count as being superior to the

interest of

another ,just because they are personal interest.

(Singer,1979; Smart andW

illiams ,1973) .


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DEONTOLOGICAL

According to deontological ethics duty is the

basis of all moral action. It asserts that some

acts are obligatory (duty bound) regardless of

their consequences eg duty to always tell the

truth even when doing so might have horrible

consequences.


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SO HOW DOWE KNOWWHAT OUR DUTY

IS?

Deontological theory derives its values from religious

ethics. According to this view, it is Gods command

that determines our moral duties eg it is Gods

command that thou shall not kill , thou shall notsteal and so on.

This kind of conduct that accords with these

commands is morally praiseworthy (right &justified)

because it is commanded by God (Frankena,1973).


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What our duty is?

Another deontological ethics which influence

decision making in health care is that

Jehovahs witnesses refuse life saving blood

transfusion on the grounds that God prohibits

taking blood- to accept blood would mean

that they are violating Gods command.


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FEMINIST ETHICS

Defined as the examination of all sorts ethical and

bioethical issues from the perspective of feminist

theory (Little,1996).

It is `an attempt to uncover the ways in whichconceptions of gender distort peoples view of the

world and to articulate the ways in which these

distortions, which are hurtful to all are particularly

constraining to women (Little, 1996).


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It involves a new way of thinking

about, asking questions about

and responding to ethical issuesin the world (Little,1996;

Walker,1998).


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Feminist ethics

Feminist ethics has been particularly critical of

mainstream ethics on the grounds that :

It is too abstract to be used effectively in theeveryday practical world.

It pays too much attention to upholding

abstract principles and rules rather than

promoting quality relationships between

people.


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Feminist ethics

Concerns of dominant notably white middle

class able bodied heterosexual males who

tend to lean to the right of the political

spectrum at the expense of more vulnerable

and often marginalized populations e.g.

women , children, people who are not white

,people with disabilities, lesbians andhomosexual men ,and so on.


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Moral Values

Moral values are virtues which commonly feature in

in Feminist ethics.

Nursing ethics has a number of features in commonwith Feminist ethics and has much to gain by

considering Feminist theory perspective.19


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COMMON FEATURES OF FEMINIST ETHICS

Moral values of :

Love

Caring

Friendship

Compassion

Empathy

Mutuality

Kindness


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Common features of feminist ethics

Nurse theorist have critised together with thefeminist theorists the traditional and conventionalapproaches to ethics in regards to its application ofabstract principles and rules.

Nursing ethics is not a subcategory of feminist ethicsbut stands as a justified role differentiated ethic inits own right.


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VIRTUE ETHICS

Virtue ethics is based on attitudes that show highmoral standards .

This is shown by such moral virtues as:

Compassion Care

Kindness

Empathy

Sympathy


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Virtue Ethics

Altruism ( The fact of caring about the needsand happiness of other people more thanyour own).

Generosity

Respectfulness

Trustworthiness

Personal integrity Wisdom


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Virtue Theory

Virtue theorists claim that without the

character logical excellence of virtue a person

could robot like ,obey every moral rule andlead the perfectly moral life but on doing


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Virtue Theory

so would be acting more like a perfectly

programmed computer than a morally

responsible human being (Pence,1991).


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Virtue theory

There is a sense in which being moral involves

much more than merely following rules.

Pence (1991) stated that we need to know

much more about the outer shell of behavior

to make such judgments


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Virtue theory

We need to know what kind of person is

involved, how the person thinks of other

people.

How he or she thinks of his or her own

character.


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Virtue theory

How the person feels about the past actions.

How the person feels about the actions not done.

So virtue ethic is particularly relevant to nursing and

to nursing ethics since virtuous conduct is closely

linked to therapeutic healing behaviors and thepromotion of human health and wellbeing.


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Virtue theory

Emphasizes that the quality of action

produced is affected by the integrity andcompetence of the moral agent, e.g. if the

agent is corrupt , then the action is likely to

be corrupt .


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Virtue theory

If the moral agent is incompetent in either a

practical or a moral sense than the action is

likely to be


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less satisfactory e.g. if:

you lack the skill or competence to perform aparticular procedure e.g. to insert a catheter

or a nasogastric tube then it would be morally

irresponsible and unjust to patients to subject

them to your incompetence.


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Virtue theory

If you lack any or all of the basic intellectual or

moral virtues than the quality of your action is

likely to be compromised in terms of;


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scientific knowledge ,technical skills and

experience intelligence, discriminating

judgment and practical wisdom, honesty ,self

discipline, courage ,justice and fairness and

personal wisdom.


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Dilemma

A situation in which a difficult choice has to

be made :

between two (2) equally attractive or

undesirable options.


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Dilemma

In ethics , a moral dilemma is actual

irresolvable clash of competing principles or

duties.


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So what actually is dilemma?

Dilemma in Greek language means double

argument with conflicting assumptions.

Examples a specific situation in which achoice has to be made between alternatives

that are both undesirable or a situation

involving a real irresolvable clash of principles

or duties where there are no rules(precedents) to follow.


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Some every day dilemmas

A student has promised her classmates that

she will write up their group project , which

must be handed in to their tutor the next

morning. Few minutes after she had started

to write, she received a telephone call from

her fiance that his younger brother had a

motor vehicle accident and is admitted tointensive care unit and asking to see her right

away for her assistance.


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Process of Moral Decision Making

Step 1- Assess the situation and gather all

information relevant to the case ; Ask what are the relevant facts of the case?

Step 2- Diagnose the moral problem ;

Ask what is the nature of the problem in this

case?


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Step 3 Set moral goals and plan of course of

action aimed at achieving a morally just

outcome;

Ask How best can the clients best

interests(wellbeing &welfare) be maximized in

this case?


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Step 4 Implement the plan of action

This could involve range of actions reporting

the matter to the supervisor /manager/involvement of an institutional

ethics committee for advice


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Step 5- Evaluate the outcome of the plan of

action implemented.

Ask Has the desired moral outcome been

achieved in this case.


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Group activity

1. Get into your own groups

2. Describe and present a moral dilemma thatyou may have experienced either in your own

personal lives or in your nursing care during

your clinical placements.


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THANK YOU

Thank you for attentive listening and active participation.

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Theories of Ethical Reasoning