1. © 2010 Jones and Bartlett Publishers, LLC A Practical Approach For Decision Makers SECOND EDITION EILEEN E. MORRISON

2. © 2010 Jones and Bartlett Publishers, LLC Class Two Agenda: The rest of the Big 8: Personal-based Ethics Theorists Application to health care Summary

3. © 2010 Jones and Bartlett Publishers, LLC Virtue Ethics It is the search to define what makes a good person. Comes from Aristotle, Aquinas and even Chinese philosophy. Central ideas: virtue, practical wisdom and eudaimonia.

4. © 2010 Jones and Bartlett Publishers, LLC Virtue Ethics: Virtue What does the word “virtue” mean? Aristotle: it a character trait that you are willing to ACT upon. It includes thinking, emotions, choices, values, etc. If you have virtue, you will act on it even when it is difficult. What virtues should be present in HCMs?

5. © 2010 Jones and Bartlett Publishers, LLC Practical Wisdom or Phronesis Practical wisdom means you think about how and why to act. Aristotle says practical wisdom is the ability to decide what is best for a situation. Rational thought is achieved by experience AND education. Examples?

6. © 2010 Jones and Bartlett Publishers, LLC Virtue Ethics: Eudaimonia Sometimes translated as happiness or flourishing. Only possible with humans. It means living a life devoted to virtues and not just to external rewards such as money or pleasure. Would you hire someone who does not practice eudaimonia?

7. © 2010 Jones and Bartlett Publishers, LLC Application: Stop and Talk What is expected of you as a health care manager? What kind of employees do you want to hire? What are the benefits of eudaimonia?

8. © 2010 Jones and Bartlett Publishers, LLC Martin Buber (1878- 1965) Ethics is about relationships and forms a hierarchy. I-I—person does not exist. I-IT—people as property. I-You—people are whole and have ideas, etc. I-THOU—highest moral relationship; agape.

9. © 2010 Jones and Bartlett Publishers, LLC Application: Stop and Talk How do you think about employees in your organization? Are they I-IT or are they at least I-You? What would happen if you treated people as I-You? What do patients want?

10. © 2010 Jones and Bartlett Publishers, LLC Lawrence Kohlberg (1927- 1987) Ethical Development Stage Theory Pre moral (before moral reasoning) or Pre-Conventional. Its about YOU.  Level one-Avoid punishment  Level two-Personal rewards

11. © 2010 Jones and Bartlett Publishers, LLC Stages Continued Externally controlled morals (Rules by others)  Level three-please people  Level four-law is obeyed Principled morals (Rules by higher authority)  Level five-common rights  Level six-universal rights and laws

12. © 2010 Jones and Bartlett Publishers, LLC Application: Stop and Talk Not everyone thinks about ethics in the same way. Theory helps understand people and why they do things. You can analyze your own decisions. Check your role in society’s eyes.

13. © 2010 Jones and Bartlett Publishers, LLC Viktor Frankl (1905-1997) Frankl’s work is based on search for meaning. You are Mind/Body/Spirit (noös) and unique in the universe. Finding meaning in life and work is key.

14. © 2010 Jones and Bartlett Publishers, LLC Viktor Frankl (1905-1997) You have choices but with choice comes responsibility. The existential vacuum happens; why? There is a super meaning that knows the answers. Conscience is key to your choices and keeps you from the existential vacuum.

15. © 2010 Jones and Bartlett Publishers, LLC Application: Stop and Talk Goes back to ethics roots? Check the meaning of your choices Accept responsibility for what you choose Existential vacuum increases health care costs

16. © 2010 Jones and Bartlett Publishers, LLC Application to Health Care Think about each of the theories we have just reviewed. How can we used actually use them in health care? Debrief Conclusions?