Moral Agency as Enacted Justice: A Clinical and Ethical Decision-Making Framework for Responding to Health Inequities and Social Injustice

This descriptive study of the ethical decision-making among a group of Canadian principals provides a rich portrait of how and why principals engage their moral agency through their decision-making processes. Using a leadership responsibility framework linking moral agency and transformational leadership, the researchers found that: modeling moral agency is important for encouraging others to engage their own moral agency in the best interests of all children; despite efforts to engage in collaborative decision-making, principals are often faced with the reality that they are the one to absorb the cost of the decisions; and principals tend to engage less often in transformational aspects of leadership as part of the decision-making process. More research is needed to understand how school leaders can engage more often and more substantially in transformational leadership among their teachers and staff and how they build moral agency capacity in their schools.

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The Role of Ethical Decision-Making Frameworks in Education and Practice for Professional Accountants

Journal of Business Ethics Education ◽

10.5840/jbee2018156 ◽

2018 ◽

Vol 15 ◽

pp. 99-132

Author(s):

Lawrence P. Kalbers ◽

Arthur Gross-Schaefer ◽

Keyword(s):

Decision Making ◽

Ethics Education ◽

Ethical Decision ◽

Ethical Decision Making ◽

Mission Statement ◽

Ethical Dilemmas ◽

The United States ◽

Professional Standards ◽

Future Research ◽

Decision Making Framework

In the aftermath of the accounting scandals of the early 2000s, the accounting profession experienced increased legislation and rules regulating ethical behavior of professional accountants and accounting firms. This paper considers ethics education for professional accountants (particularly Certified Public Accountants (CPAs)) and concludes that there is a need for a broader, principles-based approach to continuing professional ethics (CPE) in the United States. This conclusion is supported by the recent trend toward principles-based global ethics standards and a review of the current professional standards and CPE requirements for ethics education for CPAs. We present tools, such as listing core values, creation of a personal mission statement, and the utilization of a comprehensive ethical decision-making framework, that can be incorporated into ethics CPE courses for CPAs, ethics education in academic programs, and ethical decisions in practice. We also present results from a survey about ethical dilemmas distributed to a sample of CPAs taking CPE ethics courses. Consistent with our expectations, we find that for ethical dilemmas in which professional standards more clearly apply and the facts were less ambiguous, the CPAs in the sample responded with higher average levels of ethicality and more agreement than for ethical dilemmas when professional standards were not as applicable and facts were more ambiguous. Finally, the paper demonstrates how a comprehensive ethical decision-making framework may be applied to ethical dilemmas, particularly those that cannot be satisfactorily resolved using a rulesbased approach and makes recommendations for future research.

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The scope of psychiatric ethics

Psychiatric Ethics ◽

10.1093/med/9780198839262.003.0001 ◽

2021 ◽

pp. 3-10

Author(s):

Sidney Bloch ◽

Stephen A. Green

Keyword(s):

Mental Health ◽

Decision Making ◽

Mental Health Professionals ◽

Moral Agency ◽

Ethical Decision ◽

Ethical Decision Making ◽

Professional Associations ◽

Theoretical Frameworks ◽

Ethics In Psychiatry ◽

Evaluative Terms

Ethical decision-making is no easy matter, as absolutes of right and wrong, good and bad, should and ought, and other evaluative terms are elusive. Both providing the best attainable care for the patient and conducting scientific research guided by lofty ethical principles are paramount. This chapter, an introduction to the fifth edition of Psychiatric Ethics, outlines how the book aims to promote the moral agency of psychiatrists and mental health professionals when relating to patients and their families, colleagues, professional associations, and other organizations, and the society in which they work. It summarizes theoretical frameworks used in ethical decision-making and the range of topics discussed in the other 24 chapters, and offers guidelines to mental health students and graduate clinicians about how to master the field of ethics in psychiatry.

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Developing a moral compass: Themes from the Clinical Ethics Residency for Nurses’ final essays

Nursing Ethics ◽

10.1177/0969733019833125 ◽

2019 ◽

Vol 27 (1) ◽

pp. 28-39

Author(s):

Susan Lee ◽

Ellen M Robinson ◽

Pamela J Grace ◽

Angelika Zollfrank ◽

Martha Jurchak

Keyword(s):

Decision Making ◽

Clinical Ethics ◽

Moral Agency ◽

Ethics Education ◽

Ethical Decision ◽

Ethical Decision Making ◽

Research Question ◽

Educational Approach ◽

Knowledge And Skills ◽

Moral Compass

Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making.

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