Ethics In Healthcare Administration

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Why study Ethics?
- Need it as part of your base for sucessful practice - Healthcare is always changing and challenging - Answers not always black and white - The community expects much from you
Name the Big Seven
St. Thomas Aquinas (1225-1274)        Martin Buber Immanuel Kant (1724-1804)               Lawrence Kohlberg John Stuart Mill (1806-1873)               Victor Frankl (1905- John Rawls (1921-2002)                                                                1907)
Who were the Big Seven that were involved in the Global Issues in Ethics
Aquinas Kant Mill Rawls  
Who were the Big Seven in Personal Ethical Issues?
Buber Kohlberg Frankl
List four facts of St. Thomas Aquinas (1225-1274)
- Natural Law - God is rational and created the world rationally - Humans can reason - Humans capable of choosng good over evil
What is Good? (According to St. Thomas Aquinas (1225-1274))
- That which preserves life and the human race - Advance truth - Allows people to live in community - Happiness is not to be found in worldly behaviors or values - Happiness and goodness in seeking wisdom
What happens if evil is choosen over good? (According to St. Thomas Aquinas (1225-1274))
when man chooses to oppose God’s Will and sins, it is asthough a hole is made in a umbrella.This ‘hole’ allows or permits Satan to come in and execute his plans.  Choosing evil is a choice and every choice has a consequence.
Cost factors for Health Care Systems? (According to St. Thomas Aquinas (1225-1274))
- Prescription drugs and technology - Chronic disease - Aging of the population - Administrative costs
What is your obligationto those who do not make rational choices? (According to St. Thomas Aquinas (1225-1274))
The distinctively modern notion of rights is invoked to specify the most fundamental demands of the common good . . . . The duty to promote the common good, therefore, entails the duty to protect the human rights of all.  Emphasis here is on the way individual persons benefit from the enhancement of the common good.
Can you limit health care based on life decisions? (According to St. Thomas Aquinas (1225-1274))
yes - (CPR), (breathing machine), Antibiotics, Tube feeding, (DNR) order are all options on whether to extend your life to live or not to live
List 6 acknowledgements of Immanuel Kant (1724-1804)
- Deontology or duty-based ethics - Everything in society has relative value - Only true good will - All humans beings have worth - People are not just tools to archive societal or organization goals - Catergorical imperative
Define Natural Law
rules of conduct supposedly inherent in the relations between human beings and discoverable by reason; law based upon man's innate moral sense
All People are of value no matter how they contribute to the bottom line Who said this statement?
Immanuel Kant (1724-1804)
Categorical imperative helps with decisions Who said this statement?
Immanuel Kant (1724-1804)
What Big Seven is this Application? - Examine policies and see how they are applied - Does gives you tools and questions to ask - Pure Katian Pracitce is not practical in health care
Immanuel Kant (1724-1804)
Define Catergorical Imperative:
a moral obligation or command that is unconditionally and universally binding
Define Kantian practice:
reason is the means by which the phenomena of experience are translated into understanding, marks the beginning of idealism; put forward a system of ethics based on the categorical imperative.
Name 4 ideals of John Stuart Mill (1806-1873)
- Influential in American Health Care Ethics - Utilitarianism impacts policy development - Good = produces utility (benefit) and/or avoids harm - people can be a means to an end
Define Utilitarianism:
a doctrine that the useful is the good and that the determining consideration of right conduct should be the usefulness of its consequences ; specifically : a theory that the aim of action should be the largest possible balance of pleasure over pain or the greatest happiness of the greatest number
Define Utilitarian:
good character, spirit, or quality
Name two types of Utility
1. Act Utility 2. Rule Utility
Define Act Utility:
Each decision based on its own merit
Define Rule Utility:
consequences help to form rules and the rules are then used for decisions.
Name 5 ideals of John Rawls (1921-2002)
- Social Justice - Theory based on protecting self interests - Used idea of original position - Protect those in lesser position - Advantaged have a responsibility
Name the Big Seven of this Application. - Public health and other organizations based on this - America is judged by how it treats the least well off - Causes ethics concerns balancing mission and margin
John Rawls (1921-2002)
Name Martin Buber 5 ideals.
- Ethic is about relationships and form a hierarchy I-I I-It I-You I-Thou
I-I  is viewed as
like farther like son
I-It    is viewed as
(I) military lead for people "who are the "it" - I-It is charterize as morally wrong
I-You   is viewed as
the equal are recognized by principle of values - patients are charaterized in the I-You
I-Thou  is viewed as
the highlest realtionship, the  most maturist. - increase dollar in patients - unconditional love for a patient
Name the Big Seven based on this application of Ideals - How do you think about employees in your organization - Are they I-It or - Are they at least I-You What do patients want?
Martin Buber
Define the Ethical Developement Stage Theory
Pre Moral: Level 1 - Avoid punishment                    Level 2 - Personal Rewards   Extremally Controlled Morals: Level 3 - Please People                                                 Level 4 - law is obeyed   Principle Moral: Level 5 - common rights                              Level 6 - universal rights and laws
Name Lawrence Kohlberg (1927-1987) Ethical Development Stage Theory 3 categories
- Pre Moral - Externally Controlled Morals - Principled Morals
What Big Seven Application is this - Not everyone thinks about ethics in the same way - Helps understand people and what they do - Analyze your own decisions - Check your role in society's eyes
Lawrence Kohlberg (1927-1987)
Name the 4 Ideals of Viktor Frankl (1905-1997)
- You are MIND/BODY/SPIRIT and UNIQUE - Finding meaning in life and work is key - The existential vacuum happens - Conscience is key to your choices
Who Application decribe this BIG Seven? - Goes back to ethic roots - Check the meaning of your choices - Accepts responsiblity for the what you choose - Existential vacuum increase health care costs
Viktor Frankl (1905-1997)
List 5 Ethic Definitions:
1. Ethics is a way to study moral behavior 2. It is more than obeying the law 3. Normative or organizational ethics 4. Professional ethics 5. Personal ethics
Based on the idea of self rule or self determination means
that there is freedom from other's control and the capability to make choices
The freedom to comply or not to comply is the concerned of what...
the treatment by the overall system