Embed Size (px)
Citation preview
VIRTUE THEORYRels 300 / Nurs 330
17 Sep 2015
COURSE RESOURCES:• Start at my homepage: http://people.stfx.ca/bappleby/ • Click on the Teddy Bear to go to our course homepage:
http://people.stfx.ca/bappleby/300.2015/course.info/300.index.htm
• Choose our 1st term readings and class schedule: http://people.stfx.ca/bappleby/300.2015/course.info/1st.schedule.htm
• Class notes, presentation schedules, due dates are all linked into this 1st term schedule page
• It gets updated every week with new class notes and current notices
300/330 appleby 2
HEALTH CARE ETHICS
(CRN 46634) RELS 300:10
(CRN 48090) NURS 330:10
6 credits
September 2015
to April 2016
Dr. Brenda Appleby
Nicholson Tower #410
867-2436; [email protected]
Office Hours:
Mon 11:00 to 1:00
Wed 11:00 to 1:00
Thurs 1:00 to 3:00
Wednesdays & Thursdays
8:45 to 10:00
COURSE OUTLINE, click here
CLASS SCHEDULE and READINGS,
1st term; 2nd term
ASSIGNMENTS and COURSE EVALUATION,
click here
ASSIGNMENT GUIDELINES:
coming soon
QUIZVirtue Ethics
What is a virtue?
Virtue = a strength of character that promotes human well-being (self and others) often in a social context
Vice = a weakness of character that undermines human well-being (self and others) often in a social context
“A virtue is an admirable character trait or a
disposition to habitually act in a manner that
benefits ourselves and others.
“The actions of virtuous people stem from a
respect and concern for the well-being of
themselves and others.”Brannigan & Boss, 2001
300/330 appleby 4
The Florence Nightingale Pledge
I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.
http://www.nursingworld.org/FunctionalMenuCategories/AboutANA/WhereWeComeFrom/FlorenceNightingalePledge.aspx
300/330 appleby 5
Virtue in Aristotle (384-322BCE)
Virtue is a state of character that undergirds excellence in the human person
Virtue in any endeavour lies in the MEAN [p.27]
(the middle ground between not enough and too much)
• e.g., in a dangerous situation, the person of virtue behaves in a manner that lies between reckless endangerment and fearful inaction
Such a virtue might be
COURAGE or CONFIDENCE
300/330 appleby 6
What else can be said about virtue?
Aristotle says that virtues move a person toward a GOAL or an AIM that is inherently valuable For Aristotle, everything that exists has a natural goal or
purpose
“it is by the excellence of the eye that we see well”
Virtuous actions move a person towards fulfillment of a natural goal This perspective is called TELEOLOGY
Telos = end in the sense of purpose or goal
The highest human purpose or end, according to Aristotle, is HAPPINESS
300/330 appleby 7
What does he mean by happiness?
• Not just pleasure (as in utilitarianism)
For Aristotle, happiness as the ultimate value refers to living well, acting well, and contributing to
human flourishing (or well-being)• Happiness is “a way of being that requires us to live life
fully and actively, in accordance with what reason tells us is the proper purpose of human beings” (p.22)
• Happiness is the telos (end or purpose) of the human person
• this telos can be discerned by the essential aspect of human persons, by reason or rationality
300/330 appleby 8
Virtues are “habitual patterns”• Virtues, such as patience, are learned• They only become evident as persons exhibit behaviour,
in a predictable and characteristic way, that is even-tempered, perseverent, and considerate of others
• Further, generosity, for example, cannot be satisfied by giving a certain sum of money to a particular charity in order to get a tax deduction• Charitable giving is only “generous” if the person gives
with an attitude of sharing, without ties or expectations
300/330 appleby 9
Virtue Ethics asks these questions
• What kind of person should I be? What character traits do I value and want to develop?
• What kind of community do I want to foster? • Family; student body; colleagues; educational or medical institution
• How can I promote human well-being, or human flourishing, within the context of my life-span?
• What leads to consistency or integrity within my own experiences of perceptions, feelings and actions?
300/330 appleby 10
The virtuous health care professional
1. The good colleague
2. The good caregiver
3. The good personThink of a nurse or nursing professor that you admire;
someone whose advice you would value; someone you regard as a good role model.
Describe the characteristics that you admire. What is it about this person that you appreciate most?
Discuss in 2’s or 3’s
300/330 appleby 11
1. The good colleague is a person who contributes to human well-being by
2. The good caregiver is someone who supports human flourishing by
3. Characteristics that promote well-being in oneself and others include
300/330 appleby 12
Aristotle’s Virtue Theory is a form of“Natural Law” theory
1. RATIONALITY Morality is grounded in
the human capacity for reasoning / intelligence
Humans are free and autonomous Make own choices &
carry them out
2. TELEOLOGY Natural law is embedded
in the nature of the universe
Everything in the universe has its own natural purpose or end discovered, not
created, by people
300/330 appleby 13
“Natural Law” has 2 main components or elements:RATIONALITY and TELEOLOGY
Virtue is a state of character that undergirds excellence in the human person
Aristotle believes that excellent ends, goals or purposes can be discerned by all rational creatures
When natural law is adopted within a religious framework, the belief is that the telos of human existence is rooted in God
God created universe and persons
God’s purposes are inscribed in nature
God’s moral law rooted in creation
300/330 appleby 14
Saint Thomas Aquinas
• Saint Thomas Aquinas taught that human persons have the capacity to use reason to discern good and evil
“Human beings act morally when they live in such a way as to satisfy in a consistent and harmonious way those needs basic to human life and common to all human beings…the
natural law is our human sharing in God’s own wisdom about what kind of living will best fulfill the nature which the
Creator has given us…” (Ashley & O’Rourke)
300/330 appleby 15
Examples of “natural law”moral norms
The natural purpose or goal of sexual intercourse is to fertilize an egg leading to conception, implantation, gestation and birth• Contraceptives prevent fertilization, conception and
implantation• Using contraceptives frustrates the natural telos or goal
of the sexual act
→ contraception is immoral
→ it is wrong to engage in sexual intercourse without being open to new life
300/330 appleby 16
Parental love
Children should be conceived within the unity of love, sexual intimacy and parenting within a marriage
• forms of assisted reproduction which separate conception from sexual intimacy, involving donor gametes or surrogate gestation, violate the spousal commitment to unity which is essential to the well-being of children
→ assisted reproduction is immoral
300/330 appleby 17
Catholic Moral Theology
= natural law + faith + teachings of the Church• Natural law is rooted in God’s creation• Every creature has goals or purposes that are
ordained by God• God’s law is eternal and unchanging• All human persons are capable of discerning God’s
natural law – through their rationality• Conscience of the faithful is formed by knowing and
following this revelation, guided & interpreted by the Church
300/330 appleby 18
300/330 appleby 19
Virtues
Take a look at the following excerpts from the summary of the Canadian Nurses Association Code of Ethics for Registered Nurses.
Rephrase each of the 7 headings so that it relates to a character trait or virtue.
http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf
300/330 appleby 20
CNA: Code of Ethics for Registered Nurses
This code is organized around seven primary values that are central to ethical nursing practice:
[values = “standards or qualities that are esteemed, desired, considered important or have worth or merit
(Fry & Johnstone, 2002)]
1. Safe, competent and ethical careNurses value the ability to provide safe, competent and ethical care… to the people they serve.
300/330 appleby 21
2. Health and well-beingNurses value health promotion and well-being and assisting persons to achieve their optimum level of health...
3. Informed decision-makingNurses respect and promote the autonomy of persons and help them to express their health needs and values…
4. DignityNurses recognize and respect the inherent worth of each person...
300/330 appleby 22
5. Privacy and confidentialityNurses safeguard information learned in the context of a professional relationship…
6. JusticeNurses uphold principles of equity and fairness…
7. AccountabilityNurses… act in a manner consistent with their professional responsibilities...
300/330 appleby 23
A 46-yr-old man ……comes to a clinic for a routine physical check-
up needed for insurance purposes. His doctor suspects the man has a form of cancer likely to cause him to die within 6 months.
Chemotherapy may prolong life by a few extra months, but will have side effects the physician does not think warranted in this case. In addition, she believes that such therapy should be reserved for patients with a chance for recovery or remission.
The patient expresses no concerns about his health. He expects to take a short vacation in a week.
300/330 appleby 24
The physician has several decisions to makeShould she tell the patient what she suspects?
Should she withhold this information?
If the doctor decides to reveal her concern:• Should she wait until the patient returns from
his vacation?• Should she mention the possibility of
chemotherapy and her reasons for not recommending it?
• Should she recommend chemo even though she believes it would not be warranted?
300/330 appleby 25
Further Discussion:
1. What would the virtue ethicist advise the doctor to do? … for what reasons?
2. What advice would the deontologist have? … and why?
3. What would the utilitarian have to say about the dilemma?
4. What would you do, and why?
300/330 appleby 26
Who do you work well with?
On a sheet of paper• Write your name
If you wish, you may add the name of someone with whom you would like to work in a group.
If there is someone with whom you already know you don’t work well, you may add the name of that person in [brackets]
I will try to put you in a group which includes your preferred person and excludes the person indicated in [brackets].
