Chapter 5: Ethical Applications of Informatics

Principlism

arose as societies became more heterogeneous and members began experiencing a diversity of incompatible beliefs and values; it emerged as a foundation for ethical decision making. Principles were expansive enough to be shared by all rational individuals, regardless of their background and individual beliefs

casuist approach to ethical decision making

grew out of the call for more concrete methods of examining ethical dilemmas. Casuistry is a case-based ethical reasoning method that analyzes the facts of a case in a sound, logical, and ordered or structured manner.

nonmaleficence

"do no harm"

E-Health Code of Ethics (eHealth code, n.d.), which includes eight standards for the ethical development of health-related Internet sites

(1) candor, (2) honesty, (3) quality, (4) informed consent, (5) privacy, (6) professionalism, (7) responsible partnering, and (8) accountability.

ETHICAL MODEL FOR ETHICAL DECISION MAKING

Examine the ethical dilemma (conflicting values exist). Thoroughly comprehend the possible alternatives available. Hypothesize ethical arguments. Investigate, compare, and evaluate the arguments for each alternative. Choose the alternative you would recommend. Act on your chosen alternative. Look at the ethical dilemma and examine the outcomes while reflecting on the ethical decision.

Two of the most influential moral and medical authors, Pellegrino and Thomasma (1993)

They argue that moral events are composed of four elements (the agent, the act, the circumstances, and the consequences), and state that a variety of theories must be interrelated to account for different facets of moral judgment

Ethics

a process of systematically examining varying viewpoints related to moral questions of right and wrong

The Husted bioethical decision-making model

centers on the healthcare professional's implicit agreement with the patient or client (Husted & Husted, 1995). It is based on six contemporary bioethical standards: (1) autonomy, (2) freedom, (3) veracity, (4) privacy, (5) beneficence, and (6) fidelity.

The consensus-based approach to bioethics was proposed by Martin (1999

claims that American bioethics harbors a variety of ethical methods that emphasize different ethical factors, including principles, circumstances, character, interpersonal needs, and personal meaning. Each method reflects an important aspect of ethical experience, adds to the others, and enriches the ethical imagination.

The Hippocratic tradition

emerged from relatively homogenous societies where beliefs were similar and most societal members shared common values. The emphasis was on duty, virtue, and gentlemanly conduct.

Virtue ethicists

emphasize the ideal situation and attempt to identify and define ideals. Virtue ethics dates back to Plato and Socrates -According to this view, the cause of any moral weakness is not a matter of character flaws but rather a matter of ignorance

virtue ethics approach

emphasizes the virtuous character of individuals who make the choices. A virtue is any characteristic or disposition desired in others or oneself.

Beneficence

refers to actions performed that contribute to the welfare of others. Two principles underlie beneficence: Positive beneficence requires the provision of benefits, and utility requires that benefits and drawbacks be balanced. One must avoid negative beneficence, which occurs when constraints are placed on activities that, even though they might not be unjust, could in some situations cause detriment or harm to others.

Justice

refers to fair, equitable, and appropriate treatment in light of what is due or owed to a person. Distributive justice refers to fair, equitable, and appropriate distribution in society determined by justified norms that structure the terms of social cooperation.

Ethical decision making

refers to the process of making informed choices about ethical dilemmas based on a set of standards differentiating right from wrong

Care ethics

responsiveness to the needs of others that dictates providing care, preventing harm, and maintaining relationships

Virtue ethics

suggests that individuals use power to bring about human benefit. One must consider the needs of others and the responsibility to meet those needs

Autonomy

the individual's freedom from controlling interferences by others and from personal limitations that prevent meaningful choices, such as adequate understanding. Two conditions are essential for autonomy: liberty, meaning the independence from controlling influences, and the individual's capacity for intentional action.

Bioethics

the study and formulation of healthcare ethics. Bioethics takes on relevant ethical problems experienced by healthcare providers in the provision of care to individuals and groups

Aristotle's (350 BC) Nicomachean principles also contribute to virtue ethics

virtues are connected to will and motive because the intention is what determines if one is or is not acting virtuously. Ethical considerations, according to his eudaemonistic principles, address the question, "What is it to be an excellent person?" For Aristotle, this ultimately means acting in a temperate manner according to a rational mean between extreme possibilities.