Ethical Foundations

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Ethical Foundations
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Ethics

• The study of morality
• Ethics vs morals

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Ethics and Health Education

• Ethical behavior is conscious behavior
• Ethical behavior is acting with integrity.
• Moral positions require thought and are NOT
  primarily dependent on feelings.

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Consequentialism (teleologial)

• Evaluates the moral status of an act by looking
  at the consequences
• The END (consequences) does justify the Means
  (the act).

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Formalism

• AKA deontological or nonconsequentialism
• Determine morality by whether or not an act is
  right or wrong in itself
• The END (consequences) does not justify the Means
  (the act)

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• Basic Principles for Common Moral Ground

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1 Value of Life Principle

• Human beings should revere life and accept
  death. (Cottrell et al, p. 147)
• No life should be ended without very strong
  justification.

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2 Goodness (rightness) Principle

• Good and right are at the core of every ethical
  decision.
• Beneficence or benevolence
• Promotes the welfare of others
• Nonmaleficence
• Do not cause needless harm or injury to others
• Commission harm from action
• Omission harm from inaction

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3 Justice/Fairness Principle

• We can expect to be treated justly and fairly in
  our dealings with other people and institutions.

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4 Truth Telling (honesty) Principle

• Communicating truth is essential to morality.

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5 Individual Freedom Principle

• AKA Equity or Autonomy
• Having and respecting the origins of individuals
  to deliberate, choose, and act within the
  framework of the other basic principles.

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The critical imperative (Mellert, 1995)

• Would you want your course of action to be a
  model for others?
• If others were faced with the same decision, is
  this how you would want them to act?

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What would you do?

• You are a health educator responsible for the
  employee health promotion program at the
  Corvallis Clinic. Based on the results of the
  health risk appraisals (HRAs) you administered,
  you are aware that one of the department managers
  is a consistent abuser of alcohol. The employee
  in question is well liked at the Clinic and is a
  good employee. To the best of your knowledge,
  alcohol has not impacted this persons work
  performance, but you feel it has the potential to
  do so. What should you do with this information?

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What would you do?

• You are a high school health teacher. The board
  of education has a policy that prohibits the
  teaching or discussing of any contraceptive or
  birth control method in the district. The only
  approach that can be mentioned in the classroom
  is abstinence. As a professional health educator,
  you have read that the abstinence-only approach
  is ineffective with a significant number of
  students. After class one day, one of your
  students approaches you and asks for the name and
  location of an abortion clinic. She also asks
  that you not tell anyone else about this. What
  will you do?

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What would you do?

• You are the health educator for a large county
  health department. Your supervisor has asked you
  to develop a program on safer sex practices for
  the gay and lesbian population. The program will
  be made available to lesbian/gay groups in the
  community. You have no prior experience working
  with gays and lesbians and you feel uncomfortable
  dealing with this population. How will you handle
  this situation?

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What would you do?

• You have been hired as a research assistant on an
  National Institutes of Health (NIH) funded grant
  project. Your role on the project is to assist
  the Principal Investigator (P.I.) in preparing
  the year-end report to be sent to the NIH. You
  have read the original grant proposal and are
  familiar with what was proposed to be done, and
  what has been done, to date. It is clear to you
  that the project team has not met the proposed
  objectives and yet the first draft of the
  year-end report suggests there have been no
  problems with the timeline or deliverables. What
  would you do?

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Consideration for Health Educators

• Confidentiality
• Guided by HIPAA
• Informed Consent
• Negligence
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Code of Ethics

• document that maps the dimensions of the
  professions collective social responsibility and
  acknowledges the obligations individual
  practitioners share in meeting the professions
  responsibilities. (Cottrell et al., p. 161)

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Code of Ethics for the Health Education Profession

• Article I Responsibility to the Public
• Article II Responsibility to the Profession
• Article III Responsibility to Employers
• Article IV Responsibility to the Delivery of
  Health Education
• Article V Responsibility to Research and
  Evaluation
• Article VI Responsibility to Professional
  Preparation