Ethical Decision Making

Front 1

Moral problems

Back 1

-include intricate relationships among people with opposing views
-incorporate a mix of values, risks, benefits, and harms
-include solutions that are obscure until the situation unfolds

Front 2

Problem

Back 2

-a discrepancy between the current situation and a desired state
-usually unplanned and often unexpected
-simple or complex, routine or moral

Front 3

Articulate the "current situation" and a practical "desired state":

Back 3

-terminally ill patient with intractable pain
-critically ill person with no health insurance
-alzheimers patient who wants to go home
-narcotic drug abuser who has severe, chronic pain

Front 4

Types of Moral Problems:

Back 4

-moral uncertainty
-moral dilemma
-moral distress
-moral outrage
-moral reckoning

Front 5

Moral uncertainty

Back 5

occurs when one senses that there is a moral problem but:
-is not sure of the morally correct action
-is unsure which moral principles or values apply
-cannot define the moral problem

Front 6

Moral dilemma

Back 6

A dilemma is a problem:
-that requires a choice between two equally unfavorable and mutually exclusive options
-that seems to defy a satisfactory solution
-that occurs when solutions to a problem include conflicting moral claims

Front 7

Moral dilemma presentation:

Back 7

-evidence indicates that an act is morally right, and other evidence indicates that the act is morally wrong, but no evidence is conclusive
-one moral rule supports one course of action, and another moral rule supports another course of action, yet the two are mutually exclusive

Front 8

What are the conflicting moral claims in these situations?

Back 8

-patient seeks an experimental treatment that is likely to cause harm
-an alert elderly patient falls often, so the physician orders physical restraints

Front 9

Moral Distress

Back 9

-"...arises when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action"
-...nurses participate in the action that they have judged to be morally wrong

Front 10

Moral Outrage

Back 10

-occurs when someone else performs an act the nurse believes to be immoral
-Nurses:
1) Do not participate in the act
2)do not believe they are responsible for wrong
3)believe they are powerless to prevent the act

Front 11

Moral reckoning

Back 11

-encompasses moral distress, moral outrage and more
-may last a lifetime
-is a three stage process:
1)stage of ease
2)stage of resolution
3)stage of reflection

Front 12

Intervening factors

Back 12

-intervening factors add to the complexity of ethical problems: uncertainty, context, stakeholders, power imbalance, extraneous variables, other relevant cases, urgency

Front 13

Ethical Decision Making

Back 13

-basic features constitute every type of decision: a problem, alternative solutions, uncertainty, outcome

Front 14

Effective Decision Maker Attributes

Back 14

-moral integrity
-sensitivity, compassion, and caring
-sense of responsibility
-empowerment
-patience and willingness to deliberate

Front 15

Ethical Decision-Making Model

Back 15

-articulate the problem
-gather data and identify conflicting moral claims
-implore strategies
-implement the chosen strategy
-evaluate outcomes