Ethical decision-making. Kitty Uys (Ph.D) Michal Harty (Ph.D) (012)
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1 Ethical decision-making Kitty Uys (Ph.D) Michal Harty (Ph.D) (012)
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3 Ethics is Standards of behaviour that tell us how human beings ought to act in the many situations in which they find themselves - as friends, parents, children, citizens, business people, teachers, professionals, and so on.
4 Ethics has popularly been named moral values or community standards In a professional setting ethics is better understood as standards set by the profession Professional bodies have their own Code of ethics
5 Five Approaches of Ethical Standards The Utilitarian Approach The ethical action is the one that produces the greatest good and does the least harm for all stakeholders e.g. clients, colleagues, the community. The utilitarian approach deals with consequences; it tries both to increase the good done and to reduce the harm done.
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7 The Rights Approach The ethical action is the one that best protects and respects the moral rights of those affected. Humans have the ability to choose what they do with their lives. They have a right to be treated as ends and not merely puppets where the end justifies the means. Choices about e.g. what kind of life to lead, to be told the truth, not to be injured, to a degree of privacy.
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9 The Fairness or Justice Approach Ethical actions should treat all human beings equally, or if unequally, then fairly based on some standard that is defensible. E.g. people are paid more based on their greater contribution to the organization, and we say that is fair.
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11 The Common Good Approach This approach suggests that the interactions with your community are the basis of ethical reasoning. Respect and compassion for all others, especially the vulnerable, are requirements of such reasoning. This approach draws attention to marginalized groups such as PwD.
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13 The Virtue Approach Virtues are dispositions and habits that enable us to act according to the highest potential of our character. Honesty, courage, compassion, generosity, tolerance, love, fidelity, integrity, fairness, self-control, and prudence are all examples of virtues. Virtue ethics asks of any action, "What kind of person will I become if I do this?" or "Is this action consistent with my acting at my best?"
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15 5 Approaches of Ethical Standards The utilitarian approach The rights approach The fairness or justice approach Which option will produce the most good and do the least harm? Which option best respects the rights of all stakeholders? Which option treats people equally or proportionately? The common good approach The virtue approach Which option best serves the community as a whole, not just some members? Which option leads me to act as the sort of person I want to be?
16 We may not agree on the content of some of these specific approaches. We may not agree to the same set of human and civil rights. We may not agree on what constitutes the common good. We may not agree on what is a good and what is a harmful action
17 Therefore it is more important to focus on how to make the right decisions, given a specific situation. Having a method for ethical decision making is essential.
18 A Framework for Ethical Decision Making
19 Scenario 1 Margi, at the age of three, has been going to nursery school for four months. The nursery school employs a multi-professional team, including OT, SLP & PT. The teacher has observed that Margi is either unresponsive or slow to react. As the result of a few months of observation, the teacher suspects that Margi may have a hearing loss and suggests to the family that they seek professional input. But the mother responded that she couldn t relay this information to the father because of his own chronic health problems. What would you do if you were the teacher?
20 Is there a choice between good and bad? Are there effectiveness, efficiency or legal implications? Could the decision be damaging for any of the stakeholders? Recognize an Ethical Issue Get the Facts What subjective and objective information is available? Do I know enough to make a decision? Who are the stakeholders? Were all stakeholder consulted? What are the options for action? Which option will produce the most good and do the least harm? Which option best respects the rights of all stakeholders? Which option treats people equally or proportionately? Which option best serves the community as a whole, not just some members? Which option leads me to act as the sort of person I want to be? Evaluate Alternative Actions Make a Decision and Act Which option do you feel addresses the situation best? Which options agrees best with previous decisions made? If I told someone I respect, or told a television audience, which option I have chosen, what would they say? How can my decision be implemented with great care and attention to the concerns of all stakeholders? How did my decision turn out? What have I learned from this specific situation? Reflect on the Outcome
21 Facts Objective information : Ethical Decision Making Report Form Options Ethical considerations Therapeutic considerations List: Good Rights Equality Community Personal Effective Efficient Subjective information : Stakeholders Consulted Not Consulted Implementation steps: Reflection on outcome:
22 Facts Objective information : -Multi-professional team -Margi s age 3 (Free medical care) -Pre-school -Teacher is concerned -Teacher has spoken to mother Subjective information -Hearing loss?? -Report on behavioural issues -Mother says she could not talk to father -Mother says father has health issues
23 Stakeholders Consulted Not Consulted Teacher yes Margi Mother Father Multi-professional team No No No No
24 Options Ethical considerations Therapeutic considerations List Good Right Equality Community Personal Effective Efficient 1. Re-confront the mother and get her consent 2. Get the team and the parent together and negotiate 3. Organise with the local clinic/hospital to screen the whole school for hearing problems 4. If there is financial problems at home, you can convince the parents to take her to the local clinic/hospital for a hearing test, seeing that she still has free medical available? x x x? x??
25 Options Ethical considerations Therapeutic considerations List Good Right Equality Community Personal Effective Efficient 1. Reconfront the mother and get her consent? 2. Get the team and the parent together and negotiate 3. Organise with the local clinic/hospital to screen the whole school for hearing problems 4. If there is financial problems at home, you can convince the parents to take her to the local clinic/hospital for a hearing test, seeing that she still has free medical available x x x? x?? Implementation steps:
26 Reflection on outcome
27 Thank you (012)
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