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The number one driver in ethics the role of women

2. The application of moral value = ethics
a. Why we teach it to know your own biases and values and YOUR
3. Human values development
a. Product of sociocultural environment
i. Like religions that will not accept blood products because some
believe that their life force is in their blood and will not take
blood products from someone else because they believe that
they are taking away their life force
b. Reflects the content and process of learning what is right and wrong
within the culture
c. Moral values should be viewed within a cultural perspective
d. Moves from a focus on self, through responding to external forces,
toward being guided by universal considerations
4. Values and Beliefs
a. Our views of life shapes what we value
b. Values derive from beliefs ideas that one held to be fact
c. Beliefs may flow from empirical observations,, logic, traditions, faith, or
other sources
d. Beliefs from ones conception of the world and out framework within
which perceptions occur
e. Together with other mental states, beliefs function as reasons for
5. Methods of fixing belief
a. Peirce proposed 4 basic methods of fixing belief
i. Tenacity obstinately adhering to beliefs already held
ii. Authority doctrines forces on people by repeating them
iii. A priori seeing others perspectives, willful adherence to beliefs
forced by authority is given up
iv. Reasoning based on discovering what is real: it seeks the truth
6. Piagets stages of cognitive development
a. Address hoe the mind works, the development of intellectual capacities
b. Four stages
i. Sensorimotor (birth to 24 mo) hand to mouth
ii. Preoperational (2-7 years) includes preconceptual and intuitive
stages the WHY? Stage
1. Trying to figure out what the truth is here
iii. Concrete operations (7-11 years)
1. It is what it is kind of thinking
iv. Formal operations (11-15 years)
1. This says that you no longer develop cognitively after 15
years do you believe that?? not really
2. No further changes in cognitive ability after age 15
3. Progresses from thoughts dominated by motor activity
and reflex to logical thought applied to concrete and
abstract situations
c. More modern theorists developed a 5th stage
7. Kohlbergs Model

a. Often referred to as the ethic of justice

b. Suggests that choices are based on objective rules and principles and
are made from a stance of separateness
c. Level 1
i. Preconventioanl level egocentric focus includes 2 stages
1. Stage 1
a. Punishment and obedience (obey rules = avoid
2. Stage 2
a. Individual instrumental purpose and exchange
d. Level II
i. Conventional level social conformity includes 2 stages
1. Stage 3
a. Mutual interpersonal expectations, relationships,
and conformity (concern about others)
2. Stage 4
a. Social system and conscience maintenance
(conform to laws out of duty and respect) guilt is
more a motivator than fear of punishment
e. Level III
i. Postconventional and principled level universal moral
principles as its focus includes 2 stages
1. Stage 5
a. Prior rights and social contract or utility (equality,
liberty, justice)
2. Stage 6
a. Universal ethical principles (internalized rules and
8. Gilligans Model
a. Often referred to as the ethic of care
b. The moral imperative is grounded in relationship[p and mutual
c. Choices are contextually bound, requiring strategies that maintain
connections and a striving to hurt no one
d. Studied under Kohlberg and has more of a focus in women and equality
e. Progression of moral thinking goes through 3 phases and 2 transitions
each reflecting greater understanding and reevaluation of
i. Phase 1 concern for survival
ii. Transition from selfishness to responsibility to others
iii. Phase 2 focusing on goodness
iv. Transition from goodness to truth that they are a person too
v. Phase 3 imperative of care (caring for ourselves and other
individuals is paramount)
f. Women must learn to deal with their own interests and the interests
of others. Says that women hesitate to judge because they see the
complexities of relationships
9. Fowlers Stages of Faith Development


Stage 1: Intuitive projective

Stage 2: Mythic-literal
Stage 3: Synthetic-conventional
Stage 4: Individuative-reflective
Stage 5: Conjunctive
Stage 6: Universalizing faith
Is faith important in moral development
Compare and contrast the ethic of justice (Kohlberg), the ethic of care
(Gillian), and stages of faith (Fowler)
b. Helps you see the other person as a person- that they have other
11.Case study pic on ipad
a. Which Kohlberg level?
i. Level II
b. Which Gillian phase?
i. 3
c. As the nurse, what would you tell Moira?
i. Facilitate some sort of support for her.
ii. Whatever decision you chose to make will be the right decision.
And whatever that decision is, we will support and help you.
12.Ethics and nursing
a. It is through the nurse-patient relationship that nurses participate in
ethical decision making
b. By developing a working knowledge of ethical theory, nurses can make
clear and consistent decisions
a. Definition of philosophy: the intense and critical examination of beliefs
and assumptions
i. Offers principles for deciding what actions and qualities are most
ii. Moral theory
1. Provides a framework for cohesive and consistent ethical
reasoning and decision making
2. Two moral theories having greatest influence on
contemporary bioethics and nursing: utilitarianism and
3. Moral philosophy responds with works that include: good
b. Is morality taught?
i. May
c. Ethics is a formal process making logical and consistent decisions,
based upon moral philosophy. The practical application of moral
i. Ethical theories explain values and behavior related to cultural
and moral norms
1. Professional codes of ethics look to govern professional
14.Ehtical theories

a. Naturalism
i. The belief that all people have a tendency to make similar
ethical decisions
1. Most people desire to be happy , experience pleasure, and
avoid pain
2. Sympathy is the motivating factor in moral decision
ii. Discussion on naturalism:
1. A toddler wander into a busy intersection with nor parent
in sight.
b. Rationalism
i. Believe feelings or perceptions, though they may seem similar in
many people. May not actually be similar in all people
1. There are universal truths, independent from humans,
that can be known through the process of reasoning
a. i.e. its always good to help those in need
regardless of the circumstances and the grass is
perceived as green but the actual color may differ
ii. Out of these two school of though
1. Utilitarianism
2. Deontology
c. Is ethics a matter of feeling (naturalism) or reason ( rationalism)?
d. Are individuals free to make ethical choices based upon predictable
human nature (naturalism).
e. Utilitarianism
i. Moral philosophy of healthcare delivery
ii. Also called consequentialism
iii. A type of theological theory
iv. Holds that an action is judged as good or bad in relation to the
consequence, outcome, or end result that it is derived from
v. We look at the outcomes and base our decision on whether the
outcome was positive or negative
vi. Websters dictionary a morally good action that helps the
greatest number of people
vii. Jeremy Bentham (1748-1832) was the father of this philosophy
viii. John Stuart Mill
1. The ends justify the means
2. The greatest happiness principle
ix. 2 types
1. Act utilitarianism people choose actions that will
increase the overall good, even if it violated the rights of
some individuals
2. Rule - absolute
x. When is it permissible to sacrifice the rights of one for th greater
f. Deontology
i. A type or rationalism (sense of duty)
1. Belief that rightness or wrongness of an act depends upon
the nature of the act NOT its consequences

2. Moral rules are absolute and apply to all people

a. Provides clear guidelines for judging right from
3. Kantianism
a. To treat another person as an end it to make his/her
own end your own
g. Virtue ethics
i. Morality depends upon a persons character
ii. A virtuous people will naturally choose the morally right decision
iii. Focal virtues/morally important traits:
1. Compassion
a. An attitude of active regard for anothers welfare
with an imaginative awareness and emotional
response of deep sympathy
2. Discernment
a. Wisdom ; keen insight and good judgment coupled
with the ability to recognize and understand human
3. Trustworthiness
a. Consistent, predictable, honest, reliable,
4. Integrity
a. Ability to follow moral norms consistently over time
b. A person with integrity will display consistency of
convictions, actions, emotions, and is trustworthy
i. Deficiency: hypocrisy, insincerity, and bad