Worldview

Personal Philosophy of Professional Ethics

The Student will develop a written personal statement of their philosophy of ethics as a health care professional. The student will articulate the ethical basis on which they make moral judgments and conduct their behavior as a health care professional. The statement will include guiding principles and values that the student uses to make critical decisions and resolve ethic dilemmas. Although brevity and conciseness are laudable, the statement should be at least one page or more in length providing a clear statement of philosophy yet avoiding repetitious ambiguity.

Worldview

Conflicting world views?

“I am aware that no one….is neutral on such emotionally charged issues. None of us can tolerate the notion that our worldview may be based on a false premise and, thus, our whole life headed in the wrong direction.”

Dr. Armand M. Nicholi Jr.

Read not to contradict…but weigh and consider.

Sir Francis Bacon

Seek first understand, then to be understood.

Steven Covey

“Most of us make one of two basic assumptions:

we view the universe as a result of random events and life in this planet is a matter of chance;

Or we assume an Intelligence beyond the universe who gives the universe order, and life meaning.”

Dr. Armand M. Nicholi Jr.

The basis for an approach to ethics

• Worldview establishes the foundation that individuals rely on to form their approach to ethics. There are two fundamental worldviews from which ethics and values manifest in behavior and decision-making:– A belief that humans are created beings

accountable to a creator.– A belief that humans evolved from the result

of a chance event.

Worldview.

“Every individual bases his thoughts, decisions and actions on a worldview.”

“Because worldviews are pertinent to every person’s life—the way we think and the way we act—and because virtually all worldviews promise salvation or utopia, the study of worldviews is of critical importance.”

David Noebel

“Our worldview informs our personal, social, and political lives. It influences how we perceive ourselves, how we relate to others, how we adjust to adversity, and what we understand our purpose to be.”

Dr. Armand M. Nicholi Jr.

“Our worldview helps determine our values, our ethics, and our capacity for happiness. It helps us understand

where we come from, our heritage; who we are, our identity; why we exist on this planet, our purpose;what drives us, our motivation; and where we are going, our destiny.”

Dr. Armand M. Nicholi Jr.

“Nothing short of a great Civil War of Values rages today throughout North America. Two sides with vastly differing and incompatible worldviews are locked in a bitter conflict that permeates every level of society.” James Dobson and Gary Bauer

“The spiritual worldview, rooted primarily in ancient Israel, with it emphasis on moral truth and right conduct and its motto of Thus saith the Lord;

..The materialist or ‘scientific’ worldview, rooted in ancient Greece, with its emphasis on reason and acquisition of knowledge and it motto What Says Nature?”

Dr. Armand M. Nicholi Jr.

The Roots of Two Worldviews.

“To be more precise, it is a battle between worldviews, On one side is the Christian worldview. On the other is the Humanist worldview divided into three easily definable branches: Secular Humanism, Marxism/Leninism, and Cosmic Humanism or the New Age movement.”

David Noebel

The Unbelievers Bill of Rights The freedoms of thought and expression count

among our most fundamental and cherished rights, and promote both individual welfare and the common good in a democratic state. Historically, however, unbelievers such as secular humanists, atheists, agnostics, rationalists, and freethinkers have faced prejudice, intolerance, and discrimination for their opinions and discoveries.

In the firm conviction that the principle of Church-State separation guarantees the equal rights of the religious and non-religious, we the Campus Freethought Alliance, on this 12th Day of July, 1998, hereby present the following Bill of Rights for Unbelievers.

Unbelievers shall have the right to:

1.Think freely and autonomously, express their views forthrightly, and debate or criticize any and all ideas without fear of censure, recrimination, or public ostracism.

2.Be free from discrimination and persecution in the workplace, business transactions, and public accommodations.

3.Exercise freedom of conscience in any situation where the same right would be extended to believers on religious grounds alone.

4.Hold any public office, in accordance with the constitutional principle that there shall be no religious test for such office.

The Unbelievers Bill of Rights (Con’t)

5.Abstain from religious oaths and pledges, including pledges of allegiance, oaths of office, and oaths administered in a court of law, until such time as these are secularized or replaced by non-discriminatory affirmations.

6.Empower members of their community to perform legally-binding ceremonies, such as marriage.

7.Raise and nurture their children in a secular environment, and not be disadvantaged in adoption or custody proceedings because of their unbelief.

8.Conduct business and commerce on any day of their choosing, without interference from laws or regulations recognizing religious days of prayer, rest, or celebration.

The Unbelievers Bill of Rights (Con’t)

9.Enjoy freedom from taxation supporting the government employment of clergy, and access to secular counseling equivalent to that provided by chaplains.

10.Declare conscientious objection to serving in the armed forces under any circumstance in which the religious may do so.

11.Live as citizens of a democracy free from religious language and imagery in currency, public schools and buildings, and government documents and business.

“Secular humanists should be aware of a new book recently published…..By Tim Lahaye and DavidNoebel…The main theses of LaHaye and Noebel are, first, that secular humanism is a "religion."….Secular humanists should be apprehensive about this vicious indictment. Let us hope that it is not thebeginning of a major new assault, and that it will not be used by the Religious Right or their cohorts in the Bush administration and the conservative media to restrict not only the rights and freedom of secular humanists but of all Americans.”

Another Assault From the Religious Right by Paul Kurtz

Marxism/Leninism

“…law is based squarely on the assumptions that God does not exist and man is an evolving animal.”“…law carries the burden of biological evolution, class warfare, and its own demise. The victory of communism brings with it the end of all class conflicts, the elimination of private property, and paradise on earth.”

Noebel

“capital ethics is based on private property, as is the law in which that ethics is enacted.” Selsam

“Just as it is impossible to find eternal moral principles in the form of commandments and maxims, it is impossible to find eternal justice embodied in statutes and legal codes. Just as a maxim becomes obsolete through changing conditions, so does a principle of legal right require reinterpretation in each new epoch, and, in periods of far-reaching social reconstruction, complete overthrow and replacement by a new principle meeting new situations and needs.” Selsam

Cosmic Humanism“New Age”

Ethical perspective based on theological pantheism and philosophical monism.

“Free will is simply the enactment of the realization that you are God, a realization that you are divine: free will is making everything accessible to you.”“It [is] not possible to judge another’s truth.”

Shirley MacLaine

“Autonomous human beings can create and invent. And they can change their minds, repudiating values they once held.”

Gawain

Cosmic Humanism“New Age”

“we must establish a world system where international law, courts, and enforcement are a reality.” Ferencz & Keyes

All authority resides within the individual

“As each of us connects with our inner spiritual awareness, we learn that the creative power of the universe is within us. We also learn that we can create our own reality and take responsibility for for doing so.” Gawain

“In the beginning was the Word, and the Word was with God, and the Word was God.”

John 1: 1“To cut off Law from its ethical sources is to strike a terrible blow at the rule of law.” Russell Kirk

“The fundamental basis of this nation’s law was given to Moses on the Mount. The fundamental basis of our Bill of Rights comes from the teachings which we get from Exodus and St. Matthew, from Isaiah and St. Paul. I don’t think we emphasize that enough these days. If we don’t have the proper fundamental moral background, we will finally wind up with a totalitarian government which does not believe in rights for anybody except the state.” Harry S. Truman

HAS 4400Legal Aspects of Health Care

Ethical Principles and Approaches

Dr. Burton

Theories of Moral Obligation

• Utilitarian and Other Teleological Theories– Choosing the alternative that produces the

greatest balance of good over evil for members of a moral reference group.

• Deontological Theories– A duty-based theory

Utilitarianism

• Three questions are left unanswered:– Who is to be included in the moral reference

group?– What is to count as good or bad?– What sort of alternative is to be considered?

Source: Graber 1989

Moral Reference Group

• Egoism

• Racism

• Sexism

• Nationalism

• One’s patients

• Utilitarianism “all sentient beings” (human?)

Theories of Value

• Subjective Preference– Maximize satisfaction of preferences and

minimize frustration.

• Hedonism– Pleasure is good, pain is bad.

• Pluralism– Four fundamental intrinsic goods

• Pleasure• Knowledge• Virtue• Justice

Act versus Rule

• Should a standard be applied to individual concrete actions or more generally in formulating policies for action in all situations of a certain type?

Kant’s Deontological Theory

Maintained that it is absolutely and always wrong to treat persons “merely as a means and not at the same time as an end in themselves.”

Absolute duties:It is wrong to kill an innocent person.

It is wrong to tell a lie.

It is wrong to do physical harm to an innocent person.

Ross’s Prima Facie Duties

• Fidelity

• Reparation

• Gratitude

• Justice

• Beneficence

• Self-Improvement

• Nonmaleficence

Beauchamp and Childress(Four basic principles)

AutonomyFree to make choices

NonmaleficenceDo no harm

BeneficenceDoing good

JusticeStrive for equality in welfare and opportunity

Making ethical decisionsEdmund Erde

• A methodology

1. Characterize the dilemma as fully as possible

2. Keeping the nature of morality in mind, discard those constituents that arise as a result of inclinations and prejudices.

3. If step 2 does not suffice to solve the problem, consider fully the characterized case in the light of the available moral theories.

Common Rationalizations

• “It’s not really illegal or immoral.”

• “It’s in my (or the organization’s) best interest.”

• “No one will find out.”

• “Since it helps the organization, the organization will condone it and protect me.”

Exhibit 5-7 Three views on ethics.

Ethical questionsEthical questions

TheUtilitarian

View

TheRightsView

TheJusticeView

Does it providethe greatest goodfor the greatest

number?

Does it providethe greatest goodfor the greatest

number?

Does it respectthe rights of the

individualaffected?

Is it fairand equitable?

Is it fairand equitable?

Times are changing. Individual rights and social justiceare challenges which will require supervisors to base ethical standards on nonutilitarian criteria.

A guide for ethical behavior.Questions to ask yourself.

1. How did this problem occur in the first place?2. Would you define the problem differently if you stood on the other

side of the fence?3. To whom and to what do you give your loyalty as a person and as a

member of your organization/4. What is your intention in making this decision?5. What is the potential for your intentions to be misunderstood by

others in the organization?6. How does your intention compare with the probable result?7. Whom could your decision injure?8. Can you discuss the problem with affected parties before you make

the decision?9. Are you confident that your position will be as valid over a long

period of time as it seems now.10. Could you disclose your decision to your boss or your immediate

family?11. How would you feel if your decision was described, in detail, on the

front page of your local newspaper?

*There

is no

right way to do a

wrong thing

*

Values Clarification Process

Choosing Values

Prizing Values

Acting on Values

The Five P’s of Ethical Power

Perspective

Purpose

Patience

PridePersistence

Purpose

• Objective or Intention

• “ongoing”

• Living by your word

• Congruence – “being right with life”

• Your epitaph?

PridePride

NOT Big I,

little you.

Self-worth vs Worthless

No one can make you feel inferior without your permission

People with humility don’t think less of themselves..

They just think about themselves less

*

*

Patience

Nice guys may appear to finish

last,but usually they are

running in a different race

Persistence

*Never!Never!Never!Never!

Give up!*

•Nothing can take the place of Persistence• Talent will not: nothing is more common than unsuccessful men with great talent•Genius will not unrewarded genius is almost a proverb•Education will not; the world is full of educated derelicts.•Persistence and determination alone are omnipotent.

Perspective

*Every problemcan be solved

if you takesome quiet time

to reflect,seek guidance, and put things

into Perspective.

*

Ethical dilemmas.

“I don’t care how you get results—just get them.!”

How can you get acceptable bottom-line results, stay competitive, and at the same time, be committed to ethical practices?

“If you are always confrontedwith easy choices,

you don’t buildCHARACTER”

“If you are always confrontedwith easy choices,

you don’t buildCHARACTER”

*If

WeTake Care

In theBeginning,

The EndWill

Take careIf

Itself*

Blanchard and Peale’s“Ethics Check”

Ethics Check1. Is it legal?

2. Is it balanced?

3. How will it make me feel about myself?

ConsiderWill I be violating either civil

law or company policy?Is it fair to all concerned in the

short term as well as the long term?

Does it promote win-win relationship?

Would I feel good if my decision were published in the news paper?

Would I feel good if my family knows about my decision?