Seminar. Leadership and ethics in healthcare

1. LEADERSHIP and ETHICS in HEALTHCARE

HA405-01,
HA405-02
1804C, SEPTEMBER 2018
PROF. STEPHEN J. LEMIRE
[email protected]
AGENDA
1. COURSE ADMINISTRATION
2. ETHICS THEORIES (PART II)
TECH SUPPORT
1-866-522-7747

2. ASSIGNED WORK

PARTICIPATE IN SEMINAR
OR, COMPLETE OPTION 2
READ ASSIGNED ARTICLES
POST DISCUSSION BOARD ENTRY
o RESPOND TO TWO PEERS’, OR MY, POSTS
COMPLETE UNIT 2 ASSIGNMENT ON ETHICIST
o POINTERS ON NEXT TWO SLIDES

3. ASSIGNMENT POINTERS

ORAL PRESENTATION
o MAY BE AUDIO OR VIDEO
3-MINUTE MAXIMUM
FOLLOW THE RUBRIC
o NEXT SLIDE
PROFESSIONAL PRESENTATION

4. RUBRIC

PROVIDE A BRIEF OVERVIEW OF YOUR SELECTED THEORIST. /20
INCLUDE DETAILS OF THEIR THEORY. /20
DEMONSTRATE SIGNIFICANT CONTRIBUTIONS TO THE FIELD OF
HEALTHCARE. /20
SHOW HOW YOUR SELECTED THEORY/THEORIST MAY CONTRIBUTE
TO CURRENT ETHICAL DILEMMAS IN HEALTHCARE. GIVE AT LEAST
ONE EXAMPLE. /20
OFFER AT LEAST THREE CREDIBLE AND SCHOLARLY REFERENCES
TO SUPPORT YOUR ASSERTIONS. /20

5. St. THOMAS AQUINAS (1225-1274)

THEORY OF NATURAL LAW
o GOD CREATED THE WORLD RATIONALLY
HUMANS SHOULD STRIVE FOR THE HIGHEST GOOD
o SEEK WISDOM AND KNOW GOD
GOOD PRESERVES LIFE AND THE HUMAN RACE
o ACT PRUDENTLY TO LIVE IN COMMUNITY AND SEEK THE TRUTH
LISTEN TO OUR CONSCIENCE
o HUMANS CAN THINK/REASON AND HAVE THE POTENTIAL
TO CHOOSE GOOD OVER EVIL
© 2010 Jones and Bartlett Publishers, LLC

6. IMMANUEL KANT (1724-1804)

THEORY OF DEONTOLOGY
o DUTY-BASED ETHICS
o CATEGORICAL IMPERATIVE HELPS MAKE DECISIONS
EVERYTHING IN SOCIETY HAS RELATIVE
o THE ONLY TRUE GOOD IS GOOD WILL
o ALL HUMAN BEINGS HAVE WORTH
o PEOPLE ARE NOT JUST TOOLS TO ACHIEVE
SOCIETAL OR ORGANIZATION GOALS
VALUE
© 2010 Jones and Bartlett Publishers, LLC

7. JOHN STUART MILL (1806-1873)

THEORY OF CONSEQUENTIALISM
o CHOICES BASED ON CONSEQUENCES OF ACTION
o ACTIONS AFFECT DECISIONS IN FAVOR OF ALL PEOPLE
UTILITARIANISM IMPACTS POLICY DEVELOPMENT
o ACT UTILITY - EACH DECISION BASED ON ITS OWN MERIT
o RULE UTILITY - CONSEQUENCES HELP TO FORM RULES
o RULES ARE THEN USED FOR DECISIONS
INFLUENTIAL
IN AMERICAN HEALTH CARE ETHICS !!
© 2010 Jones and Bartlett Publishers, LLC

8. JOHN RAWLS (1921-2002)

BASIS FOR SOCIAL JUSTICE (below)
o HYPOTHETICAL CONCEPTS: ORIGINAL POSITION AND
VEIL OF IGNORANCE
o IF TRUE, WE WOULD CREATE RULES TO LIVE IN A JUST SOCIETY
o THESE RULES WOULD LEAD TO A SOCIAL CONTRACT
SOCIAL CONTRACT INCLUDES EQUAL BASIC RIGHTS
o PROTECT THOSE IN LESSER POSITIONS (IN YOUR SELF INTEREST)
o THE ADVANTAGED HAVE A RESPONSIBILITY (DIFFERENCE PRINCIPLE)
SOCIAL JUSTICE (NOT TO BE CONFUSED WITH “DISTRIBUTIVE JUSTICE”)
o PUBLIC HEALTH AND COMMUNITY AGENCIES
o AMERICA IS JUDGED BY HOW IT TREATS THE LEAST WELL OFF
© 2010 Jones and Bartlett Publishers, LLC

9. DISTRIBUTIVE JUSTICE

HOW SOCIETY DECIDES:
o
o
o
o
WHO GETS WHAT (WHICH DIAGNOSES?)
HOW THEY WILL PAY (ALL FOR FREE?)
WHO WILL PAY IF THEY CANNOT (HOW DECIDED?)
HOW DO WE ENSURE THAT EVERYONE IS TREATED FAIRLY
CONCERNED WITH WHAT IS FAIR OR PERCEIVED TO BE FAIR
PATIENTS EXPECT FAIR, QUICK TREATMENT THAT MEETS THEIR NEEDS

10. ARISTOTLE (384-322 BCE)

THEORY OF VIRTUE
o TO BE ETHICAL, ALLOW OTHERS TO GAIN THEIR
BEST HUMAN POTENTIAL
o PRACTICE THE CARDINAL VIRTUES
(PRUDENCE, TEMPERANCE, COURAGE, JUSTICE) BY BEING MORAL
HAPPINESS IS NOT IN:
o PURSUING OUR PASSIONATE APPETITES SUCH AS EATING,
DRINKING, POWER
o WE ARE TO USE TEMPERANCE IN THESE THINGS, SO THAT WE CAN
ENJOY THEM WITHOUT BEING RULED BY THEM

11. MARTIN BUBER (1878-1965)

HIERARCHY OF RELATIONSHIPS
o HOW PEOPLE INTERACT WITH EACH OTHER
LEVELS
o I-I (CHILD)
o I-IT (LABEL)
o I-YOU (EACH DIFFERENT W/ VALUE)
o I-THOU (INDIVIDUALS W/ VALUE)

12. LAWRENCE KOHLBERG (1927-1987)

THEORY OF MORAL REASONING
o KEY TO DEVELOPMENT AND UNDERSTANDING
OF DECISIONS PEOPLE MAKE
LEVELS:
o I – PRE-MORAL (AVOID PUNISHMENT)
o II – PRE-CONVENTIONAL (“WHAT’S IN IT FOR ME?”)
o III – CONVENTIONAL (“GOOD” PERSON)
o IV – LAW & ORDER (HCAs)
o V AND VI – PRINCIPLED MORAL REASONING
(UNIVERSAL PRINCIPLES)

13. VIKTOR FRANKL (1905-1997)

CONSIDER THE WHOLE PERSON, MIND, BODY, SPIRIT
EVERYONE IS UNIQUE; ENTITLED TO DIGNITY
EVERYONE’S CONSCIENCE LEADS TO A SEARCH FOR MEANING
CHOOSE RESPONSIBLY AND…
CHOOSE THE BEST ACTION POSSIBLE -> CONSEQUENCES