Ethical decision-making

Kitty Uys (Ph.D)

Michal Harty (Ph.D)
[email protected]
(012) 420 2001
www.caac.up.ac.za
 Ethics is …
• Standards of behaviour that tell us how
human beings ought to act in the many
situations in which they find themselves -
as friends, parents, children, citizens,
business people, teachers, professionals,
and so on.
• Ethics has popularly been named “moral
values” or “community standards”
• In a professional setting ethics is better
understood as “standards set by the
profession”
• Professional bodies have their
own “Code of ethics”
 Five Approaches of Ethical
Standards
The Utilitarian Approach
• The ethical action is the one that
produces the greatest good and
does the least harm for all
stakeholders e.g. clients, colleagues,
the community.
• The utilitarian approach deals with
consequences; it tries both to
increase the good done and to
reduce the harm done.
The Rights Approach
• The ethical action is the one that best protects and respects
the moral rights of those affected.
• Humans have the ability to choose what they do with their
lives.
• They have a right to be treated as ends and not merely
puppets where the end justifies the means.
• Choices about e.g. what kind of life to lead, to be told the
truth, not to be injured, to a degree of privacy.
The Fairness or Justice Approach
• Ethical actions should treat all human beings equally, or
if unequally, then fairly based on some standard that is
defensible.
• E.g. people are paid more based on their greater
contribution to the organization, and we say that is fair.
The Common Good Approach
• This approach suggests that the interactions with your
community are the basis of ethical reasoning.
• Respect and compassion for all others, especially the
vulnerable, are requirements of such reasoning.
• This approach draws attention to marginalized groups
such as PwD.
The Virtue Approach
• Virtues are dispositions and habits that enable us to act
according to the highest potential of our character.
• Honesty, courage, compassion, generosity, tolerance,
love, fidelity, integrity, fairness, self-control, and
prudence are all examples of virtues.
• Virtue ethics asks of any action, "What kind of person will
I become if I do this?" or "Is this action consistent with
my acting at my best?"
 5 Approaches of Ethical Standards
The utilitarian Which option will produce the most good and do
approach the least harm?

The rights Which option best respects the rights of all

approach stakeholders?

The fairness or Which option treats people equally or

justice approach proportionately?

The common good Which option best serves the community as a

approach whole, not just some members?

The virtue Which option leads me to act as the sort of

approach person I want to be?
• We may not agree on the
content of some of these
specific approaches.
• We may not agree to the
same set of human and
civil rights.
• We may not agree on
what constitutes the
common good.
• We may not agree on
what is a good and what
is a harmful action
• Therefore it is more important to focus
on how to make the right decisions,
given a specific situation.

• Having a method for ethical decision

making is essential.
 A Framework for
Ethical Decision Making
Scenario 1

‘Margi, at the age of three, has been going to nursery

school for four months. The nursery school employs a
multi-professional team, including OT, SLP & PT. The
teacher has observed that Margi is either unresponsive
or slow to react. As the result of a few months of
observation, the teacher suspects that Margi may have a
hearing loss and suggests to the family that they seek
professional input. But the mother responded that she
couldn’t relay this information to the father because of
his own chronic health problems.
What would you do if you were the teacher?’
 Get the Make a
Facts Which option will Decision
produce the most and Act How can my
Is there a What good and do the Which option decision be
choice subjective and least harm? do you feel implemented
between objective
“good” and addresses the with great care
information is Which option best
“bad”? situation best? and attention
available? respects the rights
to the
of all
Which options concerns of all
Are there Do I know stakeholders?
agrees best stakeholders?
effectiveness, enough to
Which option treats with previous
efficiency or make a
people equally or decisions How did my
legal decision?
proportionately? made? decision turn
implications?
Who are the out?
Which option best
Could the stakeholders? serves the If I told
decision be community someone I What have I
damaging for Were all as a whole, not just respect, or told learned from
any of the stakeholder some members? a television this specific
stakeholders? consulted? audience, situation?
Which option leads which option I
me to act as the sort have chosen,
What are the
of person I want to
options for what would
be? Reflect on
Recognize action? Evaluate they say?
the
an Ethical Alternative Outcome
Issue Actions
 Ethical Decision Making Report Form
Facts Therapeutic
Options Ethical considerations
Objective information : considerations
List: Good Rights Equality Community Personal Effective Efficient

Subjective information :

Stakeholders Consulted Not Consulted Implementation steps:

Reflection on outcome:
Facts
Objective information :
-Multi-professional team
-Margi’s age 3 (Free medical care)
-Pre-school
-Teacher is concerned
-Teacher has spoken to mother

Subjective information
-Hearing loss??
-Report on behavioural issues
-Mother says she could not talk to father
-Mother says father has health issues
 Stakeholders Consulted Not Consulted

Teacher yes

Margi No

Mother No

Father No

Multi-professional No
team
 Therapeutic
Ethical
Options considera-
considerations
tions

List Good Right Equality Community Personal Effective Efficient

1. Re-confront the mother and get her ?

consent
2. Get the team and the parent together x x x ?
and negotiate

3. Organise with the local clinic/hospital x ?

to screen the whole school for hearing
problems
4. If there is financial problems at home, ?
you can convince the parents to take
her to the local clinic/hospital for a
hearing test, seeing that she still has
free medical available
 Therapeutic
Ethical
Options considera-
considerations
tions
List Good Right Equality Community Personal Effective Efficient
1. Reconfront the mother and get her consent ?
2. Get the team and the parent together and x x x ?
negotiate
3. Organise with the local clinic/hospital to screen the x ?
whole school for hearing problems
4. If there is financial problems at home, you can ?
convince the parents to take her to the local
clinic/hospital for a hearing test, seeing that she still
has free medical available

Implementation steps:
Reflection on outcome
 Thank you
[email protected]
(012) 420 2001
www.caac.up.ac.za