Ethical Decision

Making
What is Ethical Decision
Making?
When faced with an ethical dilemma the
objective is to make a judgment based on
well-reasoned, defensible ethical
principles.
The risk is poor judgment i.e. a low-
quality decision
A low-quality decision can have a wide
range of negative consequences

Two Types of Ethical Choices
Right vs wrong: choosing right from
wrong is the easiest
Right vs right
Situation contains shades of gray i.e. all
alternative have desirable and undesirable
results
Choosing the lesser of two evils
Objective: make a defensible decision
Making Defensible Decisions
First step in ethical decision making is to
recognize that an ethical dilemma exists
defensible decision
Two well-meaning individuals can examine the same
situation and arrive at different courses of action
High-quality ethical decision: based on reason
and can be defended according to ethical
concepts
Ethical decision making is not a science. It is
however a skill -- a survival skill
There are several models based on a
process of steps (vary from 5 to 20 steps).

the easiest ethical decision making models
to use in clinical settings is the MORAL
model (Thiroux, 1977). It was developed
by Thiroux (1977) and then subsequently,
applied to nursing situations.

The Ethical Decision Making
Process
In business, people make decisions differently than at
home
- Organizational pressures
The ethical decision making process in business includes
ethical issue intensity, individual factors, and
organizational factors, such as corporate culture and
opportunity

A framework for Ethical Decision
Making (EDM)
1. Recognize an ethical issue
2. Get the facts
3. Develop options
4. CHOOSE (make a decision)
5. Monitor and modify (Act and assess)


Recognize an Ethical Issue

Is there something wrong personally,
interpersonally, or socially?
Could the conflict, the situation, or the
decision be damaging to people or to the
community?
Does the issue go beyond legal or
institutional concerns?
Get the Facts
What are the relevant facts of the case?

Be sure you have adequate information to support an
intelligent choice. You cant make good decisions if you dont
know the facts.

To determine the facts, first resolve what you know and, then,
what you need to know.
DEVELOP OPTIONS
What are the options for acting? Have all the relevant persons
and groups been consulted?
Evaluate Alternative Actions From Various Ethical
Perspectives.

Which option will produce the most good and do the least
harm?

Utilitarian Approach: The ethical action is the one that will
produce the greatest balance of benefits over harms.

Even if not everyone gets all they want, will everyone's rights
and dignity still be respected?


CHOOSE
Talk to people whose judgment you respect. Seek out
friends and mentors, but remember, once youve gathered
opinions and advice, the ultimate responsibility is still yours.


What would the most ethical person you know do?
Think of the person you know or know of (in real life or
fiction) who has the strongest character and best ethical
judgment. Then ask yourself: what would that person do in
your situation? Think of that person as your decision-making
role model and try to behave the way he or she would.

MONITOR AND MODIFY
Since most hard decisions use imperfect
information and "best effort" predictions, some of
them will inevitably be wrong. Ethical decision-
makers monitor the effects of their choices.

If they are not producing the intended results or
are causing additional unintended and undesirable
results, they re-assess the situation and make new
decisions
4-13
Ethical Decision Making
Factors that influence EDM
1. Codes for Nurses
2. The patients rights
3. Social and cultural attitudes
4. Science and technology
5. Legislation
6. Judicial decisions
7. Funding
8. Personal religious and philosophic viewpoint
Using the Framework to
Improve Ethical Decisions
- It is impossible to objectively determine
right and wrong
- Having a thorough knowledge about how ethical
decisions are made will not solve ethical problems
^ Business ethics involves value judgments and
collective agreement about acceptable patterns of
behavior
- Ethical decision making in business does not rely
strictly on the personal values and morals of
individuals
^ Organizations take on a culture of their own,
which have a significant influence on business
ethics