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Ethics and Global Public Health
Published in Vincent La Placa, Julia Morgan, Social Science Perspectives on Global Public Health, 2023
An understanding of the differences between ethical theories (Utilitarianism, Deontology and Virtue Ethics) and ethical principles (Autonomy, Beneficence, Non maleficence, and Justice) are important to consider action in any given situation, especially within the context of global public health. Ethical theories within global public health provide broad concepts, and understandings of moral reasoning and defensible abstract normative accounts and explanations around individuals and social systems, as well as effects on ethical principles. Ethical principles constitute general judgements to justify ethical prescriptions and evaluations of public health activities, which are often embedded within codes of conduct, and incorporated into broader ‘Ethical Frameworks’, discussed below.
Ethical, professional and legal requirements to involve older adults in decisions about their care
Published in Helen Taylor, Ian Stuart-Hamilton, Assessing the Nursing and Care Needs of Older Adults, 2021
References to ethics may relate to what ought to be ‘inquiry that attempts to answer the question “Which general norms for the guidance and evaluation of conduct are worthy of moral acceptance?”(normative) or how things actually are (descriptive)’15 (p. 4). The Code of Professional Conduct11 outlines the normative code of ethics for nurses. A number of ethical theories provide a framework that may assist in the evaluation of actions and judgements.15 Those considered most influential in moral reasoning might be broadly grouped into two categories, namely consequentialism and deontology.14
Clinical and organizational ethics
Published in Gerard Magill, Lawrence Prybil, Governance Ethics in Healthcare Organizations, 2020
Gerard Magill, Lawrence Prybil
This link between ethical theory and principle that guide moral reasoning and decision-making provides the landscape for connecting clinical and organizational ethics as well-established fields in healthcare. Each area has developed at a very different pace. Clinical ethics has received the most attention.9 The extensive practice of clinical ethics includes many different arenas, such as clinical research ethics,10 transplant ethics,11 and emerging debates over face and limb transplantation.12 In organizational ethics, though receiving less attention, there has been substantial discourse, including on corporate morality and social responsibility,13 as explained in the following analysis.14 In contrast, little attention has been given to governance ethics that deals with the responsibilities of boards of directors in healthcare organizations. However, there has been a noticeable increase in ethics literature on governance issues in healthcare.15 Furthermore, there has been growing attention to ethical issues around governance in general.16
Normative account of Islamic bioethics in end-of-life care
Published in Global Bioethics, 2022
Al-ʿIzz defines the manifestations of ethical value by declaring that the essence of the good is pleasure and happiness, and the essence of evil is pain and sadness (p. 15). He then draws attention to the complex structure of ethical value by maintaining that pure good and pure evil are rare. Typically, moral reasoning entails degrees of goodness and evilness. Al-ʿIzz's approach to the normative analysis of value is similar to al-Rāzī in holding that the morally required choice depends on a consequentialist weighing of good and evil (p. 12). The right thing to do is to maximize the good (i.e. happiness) and minimize evil (i.e. sadness). However, unlike al-Rāzī, there are different forms of normative positions that we can attach to human actions depending on the relevant degrees of good and evil (p. 15). We cannot reduce moral judgements to mere obligatory acts and omissions. The classic divisions of moral judgement (taqsimāt al-ḥukm al-sharʿi) in Islamic legal theory should inform the normative implications that we can attach to ethical value. For instance, pure good leads to obligatory action, pure evil to prohibition, equal expectations of good and evil to permissibility, and so on (pp. 12, 267 et seq.).
Bioethics Consultation and First-Order Moral Reasoning: Leaving Philosophy at the Hospital Doors
Published in The American Journal of Bioethics, 2022
First-order moral reasoning in the clinical setting is contextually different than that which occurs in other social and professional contexts, but it is first-order moral reasoning nonetheless. Moral questions in the clinical setting have no special philosophical salience or significance. They are rarely “general,” in the philosophical sense of that word; they do not concern the moral permissibility of broad categories of actions and they do not turn on metanormative or theoretical considerations about what makes actions right or wrong. Rather, they concern what ought to be done with respect to particular patients in particular contexts: should we discharge Mr. Holmes, despite his profound cognitive deficits and lack of suitable housing? Should I continue to offer dialysis to Ms. Ahmed, given her worsening condition and some of her utterances before she deteriorated? Who should make the decision for Ms. Bell about whether she will be admitted to a nursing home against her will? CBC is constituted by direct, case-level engagement by professional bioethicists with clinicians (and patients, families, surrogates, and so on) on questions such as these. CBC requires ethicists sometimes to guide or support the first-order moral reasoning of clinicians, sometimes to engage in that reasoning themselves, and sometimes both.
My Story is Traumatic, You Probably Would Not Understand
Published in The American Journal of Bioethics, 2022
The healthcare ethics consultant (HEC) holds a widely described role in the modern American hospital. S/he may practice within a clinical discipline and be trained in bioethics, or be a trained philosopher, chaplain, social worker, or behavioral health specialist. Regardless of such training, the consultant provides a variety of roles in service to the hospital, the staff, and the patients and families that are cared for within its walls. While always regarded as a facilitator, at times the HEC is an explicit problem solver, a convener, an educator, a listener and constructor of narrative, or a mediator. Well delineated in 2000 by the Society for Health and Human Values Task Force-Society for Bioethics Consultation Task Force on Standards of Bioethics Consultation (Aulisio, Arnold, and Youngner 2000) the HEC is to retain ethical assessment skills, process skills, and interpersonal skills. The consultant is also to hold and use knowledge in nine specific areas including “moral reasoning and ethical theory, bioethical issues and concepts, health care systems, clinical context, knowledge of the local health care institution in which consultation is done, the local health care institution’s relevant policies, beliefs and perspectives of patient and staff population, relevant codes of ethics and professional conduct and guidelines of accrediting organizations, and relevant health law” (Aulisio, Arnold, and Youngner 2000, 62).