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59 Cards in this Set
- Front
- Back
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Integrity from latin "integer" meaning? |
intact |
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4 Aspects of Integrity: |
Moral Autonomy Fidelity to Promise Steadfastness Wholeness |
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person lacking integrity is stuck at what level of moral judgement? |
pre-reflective |
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person who strives for integrity.. |
searches out and clarifies own values on own |
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Second aspect of integrity: Fidelity to Promise |
we make and keep our commitments (promises) to each other |
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example of promise-breaking in nursing: |
ignoring core values like autonomy, beneficence, non-maleficence, and confidentiality |
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Third Aspect of Integrity: Steadfastness |
Maintaining our considered values and principles during both calm and turbulent times |
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Steadfastness does not imply __ |
Closed-mindedness |
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Fourth Aspect of Integrity: Wholeness/integration |
Integrating various parts of our lives, including relationships with others, under guidance of the values and principles we have promised for ourselves Consistency and continuity across various dimensions of our lives Intrinsically personal |
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Integrity expressed in (positive/negative?) duties |
positive |
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Integrity threatened in practice by? |
Finding practices that conflict with personal values or what you know to be best practice |
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Moral integrity is incompatible with: |
dogmatism, hubris, duplicity, inauthenticity, unquestioning obedience |
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dogmatism = |
close-mindedness |
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hubris = |
excessive pride or self-confidence |
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Care ethics development = |
Carol Gilligan's criticism of Kohlberg's moral development theory |
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Kohlberg's stages: |
Pre-conventional: fear of punishment, satisfy own desires Conventional: desire to please others, follow social rules Post-conventional: independent use of reason and universal moral principles |
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stage are = |
heirarchical |
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linked to Thomas and Waluchow's stages which are: |
expressive pre-reflective reflective |
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Gilligan's critique and findings: |
Kohlberg only experimented with males Gilligan used males and females and if agree with Kohlberg's theory, females score lower Rejected that women are less morally developed than men |
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Females exhibit a ___-focus when making moral decisions that is less likely to be present in males |
CARE |
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"Justice ethic" = |
focused on autonomy, principle-weighing and rule following. |
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"Care ethic" = |
Emphasizes care and kindness Emphasizes not abstract rules that apply always and everywhere but on the context of the situation and the network of individuals connected by the issue Values autonomy less than relatedness /w others and sensitivity and concern for their needs |
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Gilligan's Care ethics also rejects: |
Idea of moral rules (ex Categorical Imperative) that apply always and everywhere Idea that distinct voices of women on moral issues are second-class - care ethics has equal status as traditional ethics |
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Objections to Care Ethics: |
(like Virtue Ethics) gives indeterminate judgements in particular situations (unhelpful) Reinforces cliches about gender roles (women do the caring, men do really important work) Gilligan argued that care and justice ethics were separate, but care ethics must involve a certain amount of moral reflection (reflective judgements don't rule out care-based approach) |
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A concern that Feminist ethics deals with: |
that traditional ethical theories are male-dominated and miss important things |
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Feminist ethics power dynamics affect other groups as well and is sensitive to: |
racism, elitism, ableism, speciesism etc. |
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In ethical situation, a feminist ethics approach asks (3): |
who has the power? who is most vulnerable? how are cultural and institutional prejudices active and affecting the vulnerable? |
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in healthcare context feminist ethics is sensitive to latent power imbalance between: |
nurses and physicians |
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Unique element of feminist ethics, no other theory emphasizes? |
Moral significance of power dynamics |
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Focus on power dynamics does what to Feminist Ethics? |
tends to make FE analysis political |
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Two types of contextual factors that are morally significant: |
Local contextual factors, ex: power imbalances in medical situations Broader contextual factors, ex: social & political institutions, beliefs, and practices that create moral dilemmas and structure the available options for resolutions |
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"Gender, Feminism and Death" Susan Wolf effects gender might have in connection with MAiD: (4) |
Empirical difference in women dying by MAiD compared to men Difference in reasons women request MAiD Difference in physician's decisions about whether to grant or refuse Difference in public debate |
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"Gender, Feminism and Death" Susan Wolfe Gendered reasons why women may be driven to pursue MAiD more than men: (5) |
-Being at greater risk for inadequate pain relief -Being at greater risk for depression -Being unable to secure satisfactory care from physicians -Being poor -A fear of burdening family members |
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"Gender, Feminism and Death" Susan Wolfe Gendered reasons why physicians may grant request for MAiD: (2) |
-Physician may be clouded by gender in assessing a female patient's request -'help' request is obliteration, temptation to enact both parts of the ambivalence in single act may be great |
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"Gender, Feminism and Death" Susan Wolfe Female requestor of MAiD may have choices severely restrained by: (3) |
Prior and surrounding failures in intimate relationships Resources to cope with illness and pain Adequacy of care being offered by the same physician receiving the request |
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Objections to Feminist Ethics: (2) |
A strength but also a weakness that FE is political: risks dismissal and alienation from those who do not share the politics Very applicable in situations with power imbalance, but less applicable in other moral dilemmas |
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first and only Canadian ethical theory: |
Relational ethics |
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Relational ethics created by ___ as a reaction to ___ |
created by nurses as a reaction to traditional ethical theory |
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Main point of Relational ethics: |
idea that everyone is always and everywhere embedded in a series of overlapping and inter-related relationships with an ethical content |
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Contractual (consumer) model of nurse-patient relationship: |
Nurse provides services the patient expects, nothing more or less Patient provides appropriate instructions and info about needs. |
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Patient Advocate model of nurse-patient relationship: |
Nurses protect patient's interests from being usurped by system |
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Limitations of both nurse-patient relationship models: |
Patients and nurses in one-to-one relationships: Fails to show nurses work collaboratively /w health care team Fails to illustrate patients friends and family involved BUT relationship is starting point for ethics |
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Main ethical question for Relational Ethics is not "what should I do?" or "what kind of person should I be?" but __ |
"what relationships and commitments already inform the person that I am in this particular situation?" can still take principled or rule-base approach |
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Truth: from Old English: |
"Trewth" related to veracity from latin "verax" |
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Despite theoretical complexity, everyone has intuitive grasp of truth as: |
truth as the opposite of falsity truth-telling as the opposite of lying |
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like autonomy, truth-telling was once considered a __ priority in health care. Done in service of __ |
a distant priority in HC, done in service of beneficence (patient's own good) |
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Botha autonomy and truthtelling are now seen to be more of a priority than __ |
beneficence |
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Difference between factual truth and truthfulness? |
Factual truth: something that is accurate against the facts Truthfulness: Not intending to mislead |
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Factually true statements are assessed for their __ or __ |
truth or falsity |
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Truthful statements are assessed for their __ |
misleadingness |
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Distinction between telling the truth and being truthful means several ways to depart from truth: |
Lie: saying something we know to be false for the purpose of deceiving another Using gestures, false clues, understatement, exaggeration, manipulation, use of jargon, withholding info, evasion, silence |
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Truth intersects with __ Ethics |
Feminist Ethics. withholding truth from someone - exercise of power over that person "knowledge itself is power" |
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Truth intersects also with utilitarianism because |
Most of the time, it benefits someone to know the truth (utility) |
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Truth intersects with Deontology because |
Kant argued it was our moral duty to tell the truth always and everywhere no matter what |
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Truth intersects with Relational Ethics because |
it is a minimum expectation of many close personal relationships that you tell each other the truth |
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Truth intersects with Virtue Ethics because |
Honesty/truthfulness is a virtue. Vices: dishonesty and brutal honesty/overtruthfulness |
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What circumstances can get us to diverge from the truth? |
-Concern for beneficence and/or non-maleficence -Respect for autonomy -Sensitivity to power differentials |
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Another reason related to scope of practice? |
Sometimes, it is not a nurse's place to tell the truth |
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When it is not a nurse's place to tell the truth? (bc of rules etc.), it can raise issues of __ |
integrity |
