The Ethics of Uncertainty

2021 ◽  
pp. 118-168
Author(s):  
L. Syd M Johnson
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Decision Makers ◽  
Legal Cases ◽  
Respect For Autonomy ◽  
Ideal World ◽  
Minimally Conscious

The ethics of uncertainty is an approach to ethical decision-making under conditions of uncertainty. Two legal cases involving patients in the minimally conscious state—Robert Wendland, and a U.K. patient known as M—illustrate the difficulty and complexity of making decisions when so much is unknown about the experiences and minds of these patients. The ethics of uncertainty refocuses ethical enquiry concerning patients with disorders of consciousness, placing less emphasis on their contested personhood and more on inductive risk, on respect for autonomy, and on justice, especially epistemic justice, and the duties of privileged epistemic agents like physicians and medical staff. It encourages an expansive All Things Considered approach to ethical decision-making where the goal is not to arrive at clean, consistent, abstract, ideal decisions for an ideal world, but to enable decision makers facing complexity and uncertainty to fulfill their duties as moral and epistemic agents.

Altruism as a pathway to unethical action

2020 ◽  
Vol 36 (2) ◽  
pp. 235-247
Author(s):  
Michael Babula ◽  
Max Tookey ◽  
Glenn Muschert ◽  
Mark Neal
Keyword(s):  
Decision Making ◽  
Decision Maker ◽  
Unethical Behavior ◽  
Design Methodology ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Self Esteem ◽  
Decision Makers ◽  
Content Type ◽  
The Poor

Purpose The purpose of this paper is to answer the question, “Can particular types of altruism influence people to make unethical decisions?” The purpose of seeking to answer this question is to better understand those cases in personal, public and commercial life whereby a decision-maker is influenced by what is widely perceived to be a positive thing – altruism – to make unethical choices. Design/methodology/approach An experiment was designed to test the influence of different categories of altruism on decision-making about whether to find another guilty for a regulatory transgression. This involved the establishment and running of a student panel at a UK university, which was given the task of determining the guilt or otherwise of two students accused of plagiarism – one from a poor background; one from a rich background. Through a survey of both the decision-makers and their judgments, and by analyzing the data using t-tests and Mann–Whitney tests, the associations between different categories of altruism and the decisions made could be ascertained. Findings A total of 70.7% of the participants voted “not-guilty” for the poor student, whereas 68.3% voted “guilty” for the wealthy student. This indicated that self-interested, namely, egoistic altruism complemented by social and self-esteem needs gratification was significantly associated with violating foundational ethical principles. Originality/value This is the first study to be done that attempts to evaluate the relationships between different categories of altruism and ethical decision-making. The findings here challenge aggregating all forms of empathy together when exploring the antecedents of unethical behavior.

All things considered: Surrogate decision-making on behalf of patients in the minimally conscious state

2020 ◽  
Vol 15 (3) ◽  
pp. 111-119
Author(s):  
L Syd M Johnson ◽  
Kathy L Cerminara
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Vegetative State ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Disorders Of Consciousness ◽  
Medical Decision ◽  
Surrogate Decision Making ◽  
Surrogate Decision ◽  
Minimally Conscious

The minimally conscious state presents unique ethical, legal, and decision-making challenges because of the combination of diminished awareness, phenomenal experience, and diminished or absent communication. As medical expertise develops and technology advances, it is likely that more and more patients with disorders of consciousness will be recognized as being in the minimally conscious state, with minimal to no ability to participate in medical decision-making. Here we provide guidance useful for surrogates and medical professionals at any medical decision point, not merely for end-of-life decision-making. We first consider the legal landscape: precedent abounds regarding unconscious patients in coma or the vegetative state/Unresponsive Wakefulness Syndrome (VS/UWS), but there is little legal precedent involving patients in the minimally conscious state. Next we consider surrogates’ ethical authority to make medical decisions on behalf of patients with disorders of consciousness. In everyday medical decision-making, surrogates generally encounter few, if any, restrictions so long as they adhere to an idealized hierarchy of decision-making standards designed to honor patient autonomy as much as possible while ceding to the reality of what may or may not be known about a patient’s wishes. We conclude by proposing an ethically informed, practical guide for surrogate decision-making on behalf of patients in the minimally conscious state.

Respect for Autonomy: Is It Always Paramount?

1996 ◽  
Vol 3 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Diane Morgan
Keyword(s):  
Decision Making ◽  
Obese Patient ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Patient Choice ◽  
Respect For Autonomy ◽  
Patient’S Autonomy ◽  
Decision Making Model

Following the argument proposed by Tschudin in 1986 that many nurses do not have the skills for ethical decision-making, this article identifies and discusses one ethical prob lem from practice. The problem concerns an extremely obese patient who refuses to be moved by a hoist. The nurses acquiesce to the patient's wishes and she is moved manually by four mem bers of staff. The issues identified for discussion are: the paramountcy of the principle of respect for the patient's autonomy; the rights and obligations of the nurses; and the jus tification for influencing patient choice. The approach used by the ward nurses is analysed and the value of using an ethical decision-making model is considered.

scholarly journals Ethics in Organization and Management

2020 ◽  
Vol 1 (3) ◽  
pp. 67-74
Author(s):  
Thomas Joseph
Keyword(s):  
Decision Making ◽  
Unethical Behavior ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Decision Makers ◽  
Global Environment ◽  
Organization And Management ◽  
Self Sufficiency ◽  
Care And Justice ◽  
Compare And Contrast

A fundamental challenge for scholars and practitioners of organization and management is the integration of theoretical ethics with practical decision-making. This article discusses the historical evolution of ethics in organization and management through today. Additionally, the article utilizes a compare and contrast approach of three contemporary theories of ethical decision-making, namely ethics of virtue, ethics of care, and ethics of justice, to implicate their applicability to practice under conditions of globalization. Ethics of virtue, care, and justice share common concepts imperative for organizations in a global environment. They address the idea of equality and self-sufficiency and are concerned with the establishment and sustenance of lasting relationships. Organizations can, therefore, succeed in any environment providing that decision makers make the effort to adhere to standards that are moral, fair, caring, and just. Every unethical behavior should be condemned.

Facts, Lies, and Videotapes: The Permanent Vegetative State and the Sad Case of Terri Schiavo

2005 ◽  
Vol 33 (2) ◽  
pp. 363-371 ◽  
Author(s):  
Ronald Cranford
Keyword(s):  
Vegetative State ◽  
Minimally Conscious State ◽  
The United States ◽  
Conscious State ◽  
Artificial Nutrition ◽  
Artificial Nutrition And Hydration ◽  
Legal Cases ◽  
Normal Manner ◽  
Nutrition And Hydration ◽  
Minimally Conscious

Right to die legal cases in the United States have evolved over the last 25 years, beginning with the Karen Quinlan case in 1975. Different substantive and procedural issues have been raised in these cases, and society's thinking has changed as a result of the far more complex legal issues that appear today as opposed to the simplistic views raised in early landmark cases. Many of the early cases involved patients in a vegetative state, but more recently patients who were in a minimally conscious state have been the center of attention. Early cases involved the withdrawal of respirators and other sophisticated technology, but later cases centered on the withdrawal of artificial nutrition and hydration, and even whether it was permissible for competent patients to stop eating and drinking in a normal manner. Initial cases pitted families who argued for withdrawal of treatment, usually against the attending physicians and hospitals and/or the state or federal government, who argued for continuation of treatment.

Beyond Relativism to Ethical Decision Making

2006 ◽  
Vol 16 (3) ◽  
pp. 216-239
Author(s):  
Keith D. Walker ◽  
J. Kent Donlevy
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Decision Makers ◽  
Ethical Relativism ◽  
Educational Decision ◽  
Ethical Choices ◽  
Postmodern Ethics

This article examines the ethical conundrum of educational decision makers when faced with a plethora of conflicting value-based decisions. It offers an analysis of a well-known fable as the foil to demonstrate the problematic nature of ethical relativism and postmodern ethics in resolving that conundrum while advocating the use of five core commitments that enable reasonable, consistent, and justifiable warrants for ethical choices.

16. Medical Futility

2019 ◽  
pp. 520-571
Author(s):  
G. T. Laurie ◽  
S. H. E. Harmon ◽  
E. S. Dove
Keyword(s):  
End Of Life ◽  
Vegetative State ◽  
Minimally Conscious State ◽  
Medical Futility ◽  
Conscious State ◽  
Decision Makers ◽  
Best Interests ◽  
A Value ◽  
Permanent Vegetative State ◽  
Minimally Conscious

This chapter begins with a discussion of the concept of medical futility. It examines cases dealing with selective non-treatment of the newborn and selective non-treatment in infancy. The chapter argues that while concepts such as ‘futility’ and ‘best interests’ have strong normative appeal, the search for objectivity in their application may itself be a futile exercise. The reality is that decision-makers are involved in a value-laden process, and this is no less true when the decision is taken in a court rather than at the patient’s bedside. The chapter then considers the issue of end of life, examining cases of patients in a permanent vegetative state and those in a minimally conscious state.

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