You must use your course ethical decision-making models and frameworks in your analyses/responses — consult Decision Making Model paper below.
CHP 480 Final Assignment
Successfully recognizing, applying, assessing, and balancing the 8-step process of ethical
decision-making, the 10 Universal Values in ethical decision-making, and the eight ethical
decision-making models and their multi-step frameworks addressed in this course as knowledge
to real-world health care ethical dilemmas is a critical part of a health care professionals
practical management and practice skills.
A Health Care News article identified the following top ethical issues in health care:
1.
2.
3.
4.
Balancing health care quality and safety with efficiency
Improving access to care
Addressing end-of-life issues
Allocating limited medications and donor organs [1]
Question 1: Balancing health care quality and safety with efficiency
Many of the challenges facing the healthcare system in the future will be related to the overall
challenge of balancing quality and safety with efficiency. . . [2] This, in turn, raises a real
question about whether the right values are driving our focus in our healthcare system. . . and
whether should efficiency be the driver? [3]
Assignment: Apply the 8-step process of ethical decision-making to determine how a health care
organization can ensure an ethical balancing of health care quality and safety with efficiency.
What Universal Values apply to this issue/goal and why? (List at least 3). What model(s) of
ethical decision-making discussed in this course would be applicable or helpful to a health care
organization in its challenge to perfectly balance the delivery of quality and safe health care
services with the efficiencies required to remain a business? In other words, what model(s) of
ethical decision-making should a healthcare organization provide use (and why) to determine
whether the right values are driving its organizational health care focus? (Describe at least 2).
Analyze the issue/problem using the applicable models multi-step frameworks, and thoroughly,
concisely, and clearly explain why the models provide a valid way for a health care organization
or provider to determine whether its actions or inactions are ethical or unethical. Provide a
healthcare example for each model discussed. What is your recommended approach and why?
Question 2: Improving access to care
Considered by some to be a hallmark of a civilized society and our countrys biggest ethical
issue and considering recent Congressional legislative changes and reviewing federal court
decisions, the ongoing issue of providing everyone with access to basic medical care both
currently and in the future remains an unresolved concern to some.
Assignment. Apply the 8-step process of ethical decision-making to determine how a health care
organization can ethically improve access to health care. What Universal Values apply to this
issue/goal and why? (Describe at least 3). What models of ethical decision-making discussed in
this course would be applicable or helpful to determining whether societys laws and practices
concerning an individuals access to basic medical care are ethical or ethical? In other words,
what model(s) of ethical decision-making should our society and its health care organizations
and providers be using (and why) to determine whether the right values are driving the
provision of basic health care for everyone? (Describe at least 2). Analyze the issue/problem
using the applicable models multi-steps frameworks, and thoroughly, concisely, and clearly
explain why the models provide a valid way for a health care organization or provider to
determine whether its actions or inactions are ethical or unethical. Provide a healthcare example
for each model discussed. What is your recommended approach and why?
Question 3: Addressing end-of-life issues
Its the classic good news; bad news scenario. The good news is advances in science, nutrition,
and health care in the 21st Century have resulted in great leaps in average life expectancy with
people living into their nineties. The sad news is as the population continues to age, there will
be a concurrent increase in health care end-of-life ethical dilemmas including the entire
decision-making process and the financing that pays for end-of-life care.
Assignment: Apply the 8-step process of ethical decision-making to determine how a health care
organization can ethically improve addressing end-of-life issues. What Universal Values apply to
this issue/goal and why? (Describe at least 3). What models of ethical decision-making discussed
in this course would be applicable or helpful to determining whether societys laws and practices
concerning an individuals access to basic medical care are ethical or ethical? In other words,
what model(s) of ethical decision-making should our society and its health care organizations
and providers be using (and why) to determine whether the right values are driving the
provision of basic health care for everyone? (Describe at least 2). Analyze the issue/problem
using the applicable models multi-steps frameworks, and thoroughly, concisely, and clearly
explain why the models provide a valid way for a health care organization or provider to
determine whether its actions or inactions are ethical or unethical. Provide a healthcare example
for each model discussed. What is your recommended approach and why?
Question 4: Allocating limited medications and donor organs
The health care ethical issue is whether there will be sufficient critical medications and donor
organs available in the future to meet everyones needs and, if not, what can be done about
it? In some ways, it is the simple economics of supply and demand. Medications are consumer
products subject to shortages when, due to market forces, there is not enough economic incentive
for manufacturers (especially for generics because there is not much profit in making
them). Organs are different. It is illegal in the U.S. to buy or sell body parts. Organ recipients
must rely solely on the beneficence of donors and even then, there are just not enough livers or
deceased donor organs to meet current medical needs in this country.
Assignment: Apply the 8-step process of ethical decision-making to determine how a health care
organization can ethically improve allocating limited medications and donor organs. What
Universal Values apply to this issue/goal and why? (Describe at least 3). What models of ethical
decision-making discussed in this course would be applicable or helpful to determining whether
societys laws and practices concerning an individuals access to basic medical care are ethical or
ethical? In other words, what model(s) of ethical decision-making should our society and its
health care organizations and providers be using (and why) to determine whether the right
values are driving the provision of basic health care for everyone? (Describe at least 2). Analyze
the issue/problem using the applicable models multi-steps frameworks, and thoroughly,
concisely, and clearly explain why the models provide a valid way for a health care organization
or provider to determine whether its actions or inactions are ethical or unethical. Provide a
healthcare example for each model discussed. What is your recommended approach and why?
Extra Credit Bonus Question (+10)
Succinctly summarize the current state of the U.S. Federal Affordable Care Act following recent
Congressional legislative changes and court challenges.
References:
[1] Health Care News, Five Top Ethical Issues in Healthcare, by Jennifer Larson, contributor,
https://www.amnhealthcare.com/latest-healthcare-news/five-top-ethical-issues-healthcare/
[2] Id.
[3] Id.
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Ethical Decision-Making Models and Frameworks
Name
Course
University
Professor
Date
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1. The 8-Step Process for Ethical Decision-Making
The ability to make ethical decisions is fundamental in a range of professions, including
medicine. The information in the text includes an 8-step model that can be taken as a
predetermined plan for those involved with decision making.
Recognize the Ethical Issues: The first stage is where potential ethical hazards are
spotted. It also involves judging what is on the line and morality behind it.
Gather All the Relevant Facts: When these ethical issues are identified, all relevant
information should be acquired (Wagner 2020). This phase focuses on the need to understand
every element around context and outcomes.
Survey Decision-Making Models: The third step is the assessment of some
decisionmaking models. This also includes understanding of other alternatives and models that
can assist in solving ethical dilemmas.
Evaluate the Relevance of Each Model for the Situation: This is done by describing the
particulars of a certain dilemma and ensuring that your model complies with parameters
underlying ethical questions.
Apply the Appropriate Model to the Situation: The fifth step involves implementing a
chosen framework along with an ethical dilemma. This is a reasonable and logical step.
Make Decisions Based on the Model: The model determines the decision-making. It is
necessary to highlight that this stage pays much attention to the model principles focus.
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Monitor the Results of Those Decisions: The seventh step is controlling the outcome of
decisions. This means assessing whether the selected course of action aligns with desired ethical
outcomes and determining unintended consequences.
Monitor Progress and Repeat the Process as Changes Occur: The last part of the ethical
decision-making process is implemented by monitoring progress and reviewing again whenever
there are changes. This iterative process stays with the ability to respond quickly in defining new
ethical challenges.
2. 10 Universal Values in Ethical Decision-Making
The ten universal values govern healthcare ethics, and each of these is significantly
responsible for influencing the patterns of behavior adopted by health practitioners.
Autonomy: The basic principle of autonomy is respecting people’s health decisions. For
instance, a patient has the right to refuse treatment if it is beneficial.
Beneficence: Beneficence is directed at the need to benefit patients’ well-being. For
example, a healthcare provider could recommend an intervention that maximizes benefits and
minimizes the risk of harm.
Compassion: The true meaning of sympathy and empathy arises from compassion. It
includes patient-centered care, which is the comfort of a distressed person.
Equality of Opportunity: The value that equality of opportunity represents is equality in
healthcare access (van Bruchem-Visser et al., 2020). This can be done by fairly allocating the
available resources to all patients regardless of their socio-economic class.
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Fairness: Healthcare decision-making fairness is founded on impersonality and equality.
For instance, practitioners can choose patients based on medical indicators instead of
favoritism.
Human Dignity: Human dignity is a concept that considers every individual worthy of
respect and treated morally. The right to privacy and confidentiality of a patient is one practical
application of the idea that it is human dignity.
Individual Responsibility: This value highlights the responsibility of medical
professionals for their behavior and decisions. According to this ethical perspective, an individual
should not deny their faults.
Justice: The concept of health fairness is a general idea referring to the fair distribution of
benefits and costs. For instance, rationing arises due to shortages in medical resources for all
groups and categories.
Non-Malfeasance: Malfeasance calls for the absence of harmful activities by the
providers. This stems from the reluctance to do anything that might unintentionally harm
patients.
Truthfulness: The principle of truthfulness emphasizes honesty and transparency in the
health-communicative process. This also means that patients are given the right information
about their cases and treatment.
3. The Rights Model of Ethical Decision-Making
The Rights Model involves a wide scope that brings together morals and legality linked to
human rights. Individual moral privileges go beyond the limits of the law, such as life, freedom,
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and personal safety. On the contrary, legal rights specified in laws of a given jurisdiction may
concur with moral ones but at the same time exceed them; such an intricate relationship between
private freedoms and restrictions established by the state shall arise.
The 5-step framework of the Rights Model unrolls as a structured route, helping
decisionmakers navigate their way through conflicting rights:
1.
Identifying the Rights Involved: The first step is a comprehensive analysis to
identify the rights involved in the ethical dilemma (Lim et al., 2023). This necessitates a wide
understanding of the rights of individuals and society.
2.
Determining the Priority of Conflicting Rights: The model is a subtle
consideration in balancing conflicting rights and, hence, determination between overrides.
According to the above prioritization, a line of events dictates what will come after it.
3.
Evaluating the Moral and Legal Weight of Each Right: This step involves a close
examination of moral and legal issues related to each right identified. Through such
measurements of the cost and effect that every right will have, decision-makers get impressions
regarding what kind of ethical terrain they manage.
4.
Seeking Alternatives that Respect Rights: When rights come in conflict with each
other, this model gives an idea to find potential alternatives that would not threaten preciously
identified rights. The generative stage characterizes the creative approach to obtaining ethical
solutions.
5.
Making a Decision Based on the Evaluation of Rights: The final step is when a
clearly defined action occurs after the assessment of rights has been made precisely (Sambala et
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al., 2020). This ethical move results in the assurance of harmony between prioritized, respectful,
and balanced rights course/action.
Overall, the legitimacy of this validity for the Rights Model is indicated by its strong
morality despite conflicting laws. As such, this model allows for the inclusion of moral and legal
components in a rather complex way that could serve as an excellent point from which to
construct ethical models. Breaking analyses into a systemic manner leads to an ethical
formulation that clearly restricts self within the boundaries of law but reflects man’s fundamental
rights. Therefore, the Rights Model operates as a great template in this moral terrain where
ethical decisions are tolerant and fair.
4. Philosophy of Utilitarianism and the Utility Model
Utilitarianism is concerned with the Utility Model, a consequentialist theory of choice
that aims to preserve and promote wellness.
The 6-step process of the Utility Model is a systematic guide for decision-makers
navigating ethical quandaries:
1.
Identifying All Possible Actions and Their Consequences: To begin with, the
model analyzes every possible alternative and its result. This global analysis can be the
foundation for a reasonable choice.
2.
Estimating Overall Happiness or Pleasure: The activities are assessed based on
the level of satisfaction and pleasure that these would produce. This step is a semi-quantitative
metric that shows the value of each action.
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3.
Considering Pain or Suffering: Even more important is the actual recognition of
pain or suffering that would certainly be generated in each step. This step ensures a bias-free
evaluation of both positive and negative cases.
4.
Calculating Net Happiness or Pleasure: The quantitative model computes the net
happiness or pleasure for every activity (Mökander et al., 2021). This is the process of
subtracting pain and suffering from happiness or pleasure.
5.
Choosing the Action with the Highest Net Happiness: This step is a vital choice
point where the greatest net happiness action must be selected. The model encourages the
decisionmakers to choose options that maximize net well-being.
6.
Implementing the Chosen Action: The final stage is the implementation of the
decision. With the implementation of the chosen action, the identified decision-makers attempt to
achieve everyone’s maximum and other relevant stakeholders.
The legitimacy of the Utility Model lies in its perpetual attempts at improving total
Utility. By taking a consequentialist approach and quantifying the effects of possible actions, this
model offers an organized way to make moral considerations. It is consistent with utilitarianism
because it focuses on actions that produce the most happiness for the largest number of people.
By and large, the Utility Model is an effective ethical compass that can lead decision-makers
toward the right choices, which not only benefits all but also promotes utilitarianism.
5. The Exceptions Model of Ethical Decision-Making
The Exceptions Model is a unique ethical decision-making framework that recognizes the
fact that, in some situations, it may be justifiable to take actions that are generally considered
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unethical. As a supplementary method, this model can be introduced once other decision-making
models have been brought into play.
Central to the Exceptions Model is a key question that guides its application: if there are
exceptional circumstances that require a deviation from the typical case ethics. This basic
question as the anchor helps in navigating some of the ethical dilemmas posed by a specific case.
The 5-step process of the Exceptions Model delineates a systematic approach to
decisionmaking:
1.
Identifying the Ethical Norm or Rule: At first, an analysis of a fine-grained nature
may prove helpful in determining which substantive ethical norm or rule governs this case. This
general data provides the basis for more sophisticated analysis.
2.
Evaluating Whether the Situation Qualifies as an Exception: Situation analysis is
the understanding that a deviation from a general ethical premise should be viewed as different
(Tamvada, 2020). This section is dedicated to details of settings that may require some form of
deviation.
3.
Weighing the Significance of the Exception: If an exception is identified, its
veracity needs to be evaluated next. This shows it as a rather complex metaphorization of the
crisis and wake left by variance in such an environment.
4.
Seeking Alternatives that Uphold Ethical Principles: The stage focuses on
imagination and perception as the main factors influencing decision-making patterns.
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5.
Making a Decision Based on the Evaluation of Exceptions: The final stage is the
decision after analysis of abnormalities. This choice arises from an ethical rule, one of the
potential exceptions and ethical principles that are used for such verdicts.
This model is distinct in that it accommodates exceptions, which are outside of the
ordinary values on limits. Nevertheless, it is apparent that these rules have a peculiar subjective
definition, allowing different options for interpretation.
The empirical side of the exceptions model stems from an assumption that not all ethical
issues can be readily fitted into its paradigm. In fact, this model could be seen as one of the
critical ethical capitals because it is an act dealing with problematic situations for areas requiring
additional justification. To do so, an Exceptions Model is built and enables one to achieve ethical
discussion by managing complications in some instances because of its formal but also flexible
form being a beneficial frame for problem solvers.
6. The Choices Model of Ethical Decision-Making
In comparing between ‘negative’ and “positive,” the Choices Model is concentrated on
dilemmas cases where something must be chosen under the circumstances, determining the
significance of options.
Negative Moral Rights: The freedoms are meant to provide security, either from harm or
inappropriate intrusion. For example, there is a prominent case in the health domain relating to a
patient’s right not to be treated. It aligns with one of the negative moral rights that ensures
autonomy and security for patients.
Positive Moral Rights: Conversely, positive moral rights constitute the right of
individuals to basic commodities or services. For instance, in the field of health access. As
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viewed from this perspective, the model recognizes that it not only protects individuals but also
is related to satisfying their positive health needs (Sahu et al., 2020). The Choices Model, on
contrary to Euthanasia, is an approach whereby such debates are resolved due to morality as
opposed to liability. The present ethic model depicts forces of morals instead of juridical limits.
The 4-step process of the Choices Model unfolds as a structured guide for ethical
decision-making:
1.
Identifying Relevant Moral and Legal Rights: To start with, the model starts by
listing ethical and legal principles relevant to an ethical dilemma. In this phase, one will confirm
whether he or she understood the rights included properly.
2.
Resolving Conflicts in Favor of Moral Rights: As per the Choices Model, these
conflicts should occur in any form but must be regarded on an ethical basis. Such a hierarchy
allows an individual to pay moral attention, but such moves are met with legal obstacles.
3.
Determining the Expectations in the Situation: In this model, expectations
represent the very essence. The knowledge of the outcomes to be achieved and their moral
premises provides a basis for guidance in making decisions.
4.
Making a Decision Based on the Identified Expectations: The final step is to shift
the understanding of expectations into a definite decision. The decision is made as per the needs
identified, thus ensuring consistency and ethical course.
The Choices Model has its validity in the fact that it focuses on both negative and positive
moral rights to reflect a compromise between ethnocentric judgments. Thus, by recognizing the
need to be protected from harm and provided with essential resources, this model is compatible
with the complicated ethics of healthcare (Dhir et al., 2021). It offers an effective structure to the
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decision-makers who consider intricate legal and ethical factors, guiding decisions with a holistic
understanding of all that healthcare culture implies.
7. The Common Good Model of Ethical Decision-Making
The Common Good Model stresses what is required in the larger interest of society and
differs from Utility by bringing into light communal welfare rather than self-benefit.
This model involves a 6-step process:
1. Identifying the common good involved.
2. Measuring the effect that actions have in promoting or diminishing public good.
3. Considering other options that promote the common good.
4. The action that would serve the better interests of all.
5. Implementing the chosen action.
6. Monitor and re-evaluate its effects on the public interest.
In healthcare, one might say that the difference between the Common Good Model and
the Utility Model is how limited medical resources are allocated to benefit society rather than
increasing individual happiness. The strength of the Common Good Model comes from its
emphasis on community interests and encouraging behavior that brings benefit to society.
8. The Social Media Model of Ethical Decision-Making
The Social Media Model is also called the Publicity Model, and it poses its main question to
think about how a given decision or action will be perceived if disclosed publicly.
The 3-step process of the Social Media Model involves:
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1. Considering how the decision or action would appear if it occurred in the public domain.
2. Assessing the possible reputational fallout on the organization.
3. Decision-making based on the public opinion criteria.
The Social Media Model validates itself through the need to take public opinion into
consideration in this information-sharing age. By considering the possible implications of public
exposure, this model is a useful method in moral judgment.
9. The Virtue Model of Ethical Decision-Making.
The Virtue Model focuses on the virtues inherent to healthcare professionals, whereby
character qualities that foster ethical behavior are highlighted.
The ten virtues of healthcare professionals include:
1. Empathy
2. Compassion
3. Integrity
4. Honesty
5. Fairness
6. Courage
7. Respect
8. Responsibility
9. Wisdom
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10. Altruism
Unlike other models of ethical decision-making, the Virtue Model does not follow a
specific sequence. Rather, it promotes virtues that serve as guides to right conduct. The
difference from other models might be illustrated with a healthcare example, when the
professional shows empathy and compassion in challenging patient interactions, representing
virtue cultivation.
The Virtue Model’s validity stems from the focus on character development and cultivation of
virtues, which promotes a more comprehensive approach to ethical decision-making in
healthcare.
10. The Justice Model of Ethical Decision-Making
The Justice Model provides a unique view of ethical decision-making by stating that
Justice means fulfilling the norm while fairness involves equal treatment.
Difference Between Justice and Fairness: As per the model, Justice refers to conformity
with established standards in each scenario. However, Justice is concerned with equal or
proportionate treatment of people it symbolizes equitable apportionment.
The focus of the Justice Model: According to the Justice Model, activities should fit into
the parameters of a new situation. (Payne et al., 2020). This requires not only recognizing these
expectations but also evaluating alternatives in favor of justice and eventually selecting actions
consistent with the mentioned ones.
The 5-Step Process/Framework:
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1.
Identifying Expectations: The model starts with a most specific formulation of the
assumptions contained in an ethical environment.
2.
Assessing Alignment with Expectations: The actions are evaluated based on their
consistency with the given expectations, which provides a base for ethical evaluation.
3.
Considering Alternatives for Promoting Justice: Decision makers identify other
alternatives that abide by or promote justice in the given environment.
4.
Choosing Action Aligned with Expectations: The act of choice that matches the
presented expectations with an ethically congruent decision is referred to as a decisive action.
5.
Implementing the Chosen Action: Convert the selected strategy into a subsequent
action to realize an intention of meeting established expectations within any given situation.
Strengths and Limitations: The key advantage of the Justice Model is that it encourages
fairness, and most people want to make this part of everyday life. However, limits may be
observed when defining and ranking expectations, leading to a cloak of subjectivity in
decisionmaking.
Validity of the Justice Model: The Justice Model takes on particular significance in the
healthcare environment, especially when equal treatment is required to be provided. It is a 5-step
framework that guarantees an all-encompassing and systematic approach to bring action into
agreement.
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References
Dhir, A., Koshta, N., Goyal, R. K., Sakashita, M., & Almotairi, M. (2021). Behavioral reasoning
theory (BRT) perspectives on E-waste recycling and management. Journal of Cleaner
Production, 280, 124269.
Lim, W. M., O’Connor, P., Nair, S., Soleimani, S., & Rasul, T. (2023). A foundational theory of
ethical decision-making: The case of marketing professionals. Journal of Business
Research, 158, 113579.
Mökander, J., Morley, J., Taddeo, M., & Floridi, L. (2021). Ethics-based auditing of automated
decision-making systems: Nature, scope, and limitations. Science and Engineering
Ethics, 27(4), 44.
Payne, D. M., Corey, C., Raiborn, C., & Zingoni, M. (2020). An applied code of ethics model for
decision-making in the accounting profession. Management Research Review, 43(9),
1117-1134.
Sahu, A. K., Padhy, R. K., & Dhir, A. (2020). Envisioning the future of behavioral
decisionmaking: A systematic literature review of behavioral reasoning theory.
Australasian Marketing Journal, 28(4), 145-159.
Sambala, E. Z., Cooper, S., & Manderson, L. (2020). Ubuntu as a framework for ethical decision
making in Africa: Responding to epidemics. Ethics & Behavior, 30(1), 1-13.
Tamvada, M. (2020). Corporate social responsibility and accountability: a new theoretical
foundation for regulating CSR. International Journal of Corporate Social
Responsibility, 5(1), 1-14.
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van Bruchem-Visser, R. L., van Dijk, G., de Beaufort, I., & Mattace-Raso, F. (2020). Ethical
frameworks for complex medical decision making in older patients: A narrative review.
Archives of Gerontology and Geriatrics, 90, 104160.
Wagner, J. (2020). Ethical Decision-Making Model. Ethics.
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