Frameworks for

II.b.1

Ethical Decision-making

Mary Grace M. Paayas, MAN, PhD

AY 2021-22 First Sem

Nov 8-13, 2021
 Learning objectives
At the end of oral interaction among classmates
and teacher, the learners will be able to:
distinguish situations that demand
ethical decisions

propose solutions to problems of ethical

concerns based on ethical frameworks

appraise the rightness/goodness or

wrongfulness of actions/options to take; and

summarize the ethical frameworks as

applied to given scenarios/cases
 Outline
WHY learn these frameworks?

Moral Issues faced by nurses

Ethical frameworks for

decision-making
 Why learn these frameworks?

Guide daily life situations

why? Ethics is concerned with

doing the right thing which
is NOT always clear.

Address situations that

entail conflicting needs,
wants, and goals.
 Why learn these frameworks?

Aghamohammadi et al 2021

1. adherence to professional
why? commitments,
2. preserving patient dignity, and
3. respect to colleagues

...lead to better nursing

decisions.
 Why learn these frameworks?

van Bruchem-Visser et al et al 2020

Ethical frameworks are meant to

assist healthcare professionals who
why?
face morally complex decisions in
older patients.

these frameworks should

contain a step-by-step plan,
moral values, and an approach
to balancing
moral values.
Moral issues faced by nurses 2. Moral uncertainty

1. Moral indifference
Moral issues faced by nurses 4. Moral outrage

3. Moral distress
 the most difficult of all moral issues
Moral issues faced by nurses

5. Moral or ethical dilemmas

Ethical frameworks
for decision-making

BEST possible
decisions =
OUTCOMES &
PROCESS
 If a structured approach to problem-solving is
An used, data gathering is adequate, and we
analyze multiple alternatives, even with a poor
important outcome, the nurse should accept that the best
note possible decision was made at that time with
the information and resources available.
Marquis and Huston (2017)
The Moral Decision-
Making Model Massage the Dilemma

Options

Review the Options

Affirm Position and Act

Look Back
 Ethical frameworks GUIDE individuals
solve ethical problems

Individual values

Right or wrong? Or no right answers?

Self-awareness - vital leadership role

 Ethical Tools

Effective in problem-solving
and prevent ethical failure

Critical Thinking
 1. UTILITARIANISM
Four Commonly used
Ethical Frameworks

teleological or
consequentialist theory

greatest good for the

greatest number

end justifies the means

 Four Commonly used Ethical Frameworks

2. DUTY-BASED
REASONING
DEONTOLOGICAL ethical theory

duty to do something or to refrain

from doing something
 Four Commonly used Ethical Frameworks

3. RIGHTS-BASED
REASONING
Individual's basic entitlement

Rights different from needs,

wants, or desires
 Four Commonly used Ethical Frameworks

4. INTUITIONISM

What the decision-maker

believes is right

Potential for subjectivity and bias

 Recently used Ethical Framework

RELATIVISM
What the decision-maker
believes - according to value
system or culture

UNIVERSALISM
Ethical decision-making
does not vary
"Relativity applies to physics,
not ethics."

Albert Einstein
(1879-1955)
Physicist and Nobel
Laureate
"Ethics must begin at the top of an organization. It is a
leadership issue and the chief executive must set the
example." - Edward Hennessy (1933 - ),
Philanthropist and Retired Chairman and CEO of AlliedSignal Inc
Thank you