Beyond Personal & Professional Decision Making The Ethics of Caring Beyond Personal & Professional Decision Making

Barbara Gordon & Molly Dobson What is ethics? Ethics refers to well based standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues. Ethics refers to the study and development of one's ethical standards Is legal the same as ethical? What, then, is ethics? Ethics is two things. First, ethics refers to well based standards of right and wrong that prescribe what humans ought to do, usually in terms of rights, obligations, benefits to society, fairness, or specific virtues. Ethics, for example, refers to those standards that impose the reasonable obligations to refrain from rape, stealing, murder, assault, slander, and fraud. Ethical standards also include those that enjoin virtues of honesty, compassion, and loyalty. And, ethical standards include standards relating to rights, such as the right to life, the right to freedom from injury, and the right to privacy. Such standards are adequate standards of ethics because they are supported by consistent and well founded reasons. Secondly, ethics refers to the study and development of one's ethical standards. As mentioned above, feelings, laws, and social norms can deviate from what is ethical. So it is necessary to constantly examine one's standards to ensure that they are reasonable and well-founded. Ethics also means, then, the continuous effort of studying our own moral beliefs and our moral conduct, and striving to ensure that we, and the institutions we help to shape, live up to standards that are reasonable and solidly-based. Barbara Gordon & Molly Dobson

Barbara Gordon & Molly Dobson What is ethics? The enterprise of disciplined reflection on moral intuitions and moral choices. Moral values are examined What ought to be done in a given situation. Ethical principles form moral choices as persons act as moral agents. Various Professional disciplines have individual Codes of Ethics Barbara Gordon & Molly Dobson

Ethics in the Service Environment The Health Care & Human Service Environment hosts many professional disciplines. Each discipline’s codes of ethics have similar principles and they are generally not in conflict but supportive and mutual. Quality in the human service and healthcare service environment does not only include technical and service quality, but also ethical quality. Barbara Gordon & Molly Dobson

Barbara Gordon & Molly Dobson Code of Ethics Individual/Personal value system Personal Standards – Respect, Trust and Confidence Professional/Discipline Code of Ethics Based on various ethical theories Used as tool to define and understand crisis in decision making and resolve differences. Barbara Gordon & Molly Dobson

Guiding Principles in Ethics Integrity Objectivity Professional Confidence Confidentiality Professional Behavior Technical Standards Source: Advancing Government Accountability Barbara Gordon & Molly Dobson

The Healthcare/Human Service Environment “In human service/healthcare the person’s good is achieved across a spectrum of biomedical, spiritual, functional, and emotional needs. Thus, the provider addresses the physical, psychological, functional, emotional and societal needs of individuals, families, and communities. Often, ethical dilemmas arise because of the necessity for making choices in how to meet these human needs. Ethical principles & theories both contribute to systematic reasoning to achieve the good in decision making.” Barbara Gordon & Molly Dobson

The Healthcare/Human Service Environment Clinical ethics versus institutional ethics Value structure of an organization Does not just depend on leadership Ethics must be inherent in the organizational culture. Holistic systems approach. Barbara Gordon & Molly Dobson

Organizational Culture “In any attempt to change the values of an organization, whether it is through the education of its participants in moral principles, or the imposition of leadership committed to higher ethical principles, the contents of the existing organizational culture must be dealt with directly for positive change to occur. Ignoring culture in attempting to refocus the values orientation of an organization is similar to ignoring causes and treating symptoms.” Mary Cipriano Silva, Ph.D., RN, FAAN Barbara Gordon & Molly Dobson

Organizational Culture Values and ethics are not only central to organizational culture but also to positive organizational performance. Institutions have ethical lives and characteristics just as their individual members do. Must disengage behaviors and practices that compromise the organizational culture or causes the organization to become ethically deviant. Barbara Gordon & Molly Dobson

Organizational Culture: Building an Ethics Infrastructure Conduct a formal process to clarify and articulate the organization's values and link them to the mission and vision. Facilitate communication and learning about ethics and ethical issues, including values clarification and reflection on their link to practice. Create structures that encourage and support the culture. Create processes to monitor and offer feedback on ethical performance. Barbara Gordon & Molly Dobson

Organizational Culture: Building an Ethics Infrastructure To prevent deviant organizational structures, human service professionals should consider: extending their horizons and that of their staff beyond their own discipline and attend business classes and seminars on organizational ethics, read business journals and books on ethics and organizational structure, understand that hidden behind many decisions they make is an ethical issue waiting to be explored, and Barbara Gordon & Molly Dobson

Organizational Culture: Building an Ethics Infrastructure Healthcare and human service providers who exist within an environment with positive and effective ethical culture will typically not get caught in the cross fire of administration, rules, regulations, policies and practices, and/or funding limitations that prevent people from receiving the type of care that is available. This type of environment will protect and defend the human dignity of the professional and re-humanize the health or human service that is being provide. Barbara Gordon & Molly Dobson

Making and Ethical Decision Recognize the Ethical Issue Get the Facts Relevant Facts Individuals and groups with an important stake in decision What are the options for acting? Evaluate Alternative Actions Make a Decision and Test It Act and Reflect the Outcomes Barbara Gordon & Molly Dobson

Approaches to Ethical Business Decision-Making Utilitarian -Action that will result in the greatest good for greatest numbers. Moral Rights – Moral principles, regardless of consequences. At times simply right or wrong. Universalism- 1) Should decision apply to all and 2) Are you willing to have rule applied to you? Cost-Benefit – Balance the costs and benefits vs. not taking any action. Source: Managementhelp.org Barbara Gordon & Molly Dobson

Resources Code of Ethics Websites http://www.managementhelp.org/ethics/ethxgde.htm   http://www.babicm.org/code-of-ethics.php#manager http://www.socialworkers.org/practice/standards/sw_case_mgmt.asp http://ethics.iit.edu/codes/coe/nat.org.human.services.1996.html http://www.greystoneprograms.org/code_of_ethics.htm http://www.agacgfm.org http://www.entrepreneur.com Barbara Gordon & Molly Dobson