Two strategies of ethical decision making

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Two strategies of ethical decision making

Difficult questions will inevitably arise regarding how to prioritize access to treatment ethically and equitably.

This chapter examines these ethical issues, focusing on options for building ethical decision-making capacity in Africa as a complement to the discussion of strategies to build capacity for prevention, treatment, and care in Chapter 5. Policy and Programming in Africa.


The National Academies Press. Likewise, governments and donors have ethical obligations to address the full range of pressing global health needs, which can represent competing moral claims on limited resources. Therefore, significant resources will need to be dedicated to combating the epidemic IOM,and this chapter addresses ethical issues regarding the utilization of those resources.

Such trade-offs are and will continue to be a reality, and the ways in which policy makers and others weigh them and their consequences are at the heart of this ethical inquiry.

This chapter first reviews existing principles for ethical decisions in health care that have been promulgated by international organizations. Page Share Cite Suggested Citation: Important ethical responsibilities exist at all three levels because decisions at each level are based on values and have significant consequences for the health and well-being of individuals and communities Williams, At the macro level, governments determine the overall health budget and its distribution across such categories as human resources, hospital operating expenses, research, and disease-specific treatment programs Williams, Additionally, policy makers must consider competing societal goods, such as transportation, education, energy, and employment, especially since multiple socioeconomic determinants have powerful effects on the health of individuals and populations.

At the meso level, institutions such as ministries of health, hospitals, and clinics determine which services they will provide and how much they will spend on such expenses as staff, equipment, and supplies Williams, At the micro level, health care providers decide what expenditures to recommend for the benefit of each individual patient, such as tests, referrals, hospitalization, and generic versus brand-name pharmaceuticals Williams, Key Moral Imperatives The committee identified two key imperatives it believes should guide ethical decision making: Ethical decisions at the macro and meso levels should equitably protect the interests of everyone who stands to lose or gain from those decisions.

At their gravest, decisions on resource allocation can deny life-saving prevention or treatment to patients in need. A morally acceptable approach to trade-offs in rationing scarce health care resources should satisfy the following conditions Purtillo, There should be a demonstrable need that the trade-off is necessary; the burden of proof is on those who propose the trade-off.

There should be no choice other than the trade-off. All affected individuals should participate in the decision-making process, either directly or through the representatives of groups.

Beneficial services withheld should be proportional to the actual scarcity that exists. When considering trade-offs in the context of endemic disease and public health needs, African countries face serious dilemmas.

As societies differ in the degree of ethical importance they place on either individual interests or the common good and the interests of communities, a range of value systems must be respected and understood.

Even at the micro level, resource allocation trade-offs sometimes occur between individual patients, in which case an additional ethical responsibility for fairness arises. Donors, national laws, ministries of health, local health departments, managers, hospital ethics committees where they exist, and health care professionals all make resource allocation decisions using a variety of additional criteria.

The criteria in use may be explicit, as are those of some governments, or may be implicit in the choices practitioners make.Read chapter 6 Strategies to Ensure Ethical Decision-Making Capacity for HIV/AIDS: Policy and Programming in Africa: HIV/AIDS is a catastrophe globally bu Login Register Cart Help Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility ().

Making ethical choices requires the ability to make distinctions between competing options. Here are seven steps to help you make better decisions: Stop and think: This provides several benefits. Apr 01,  · In this lesson, we explore ethical dilemmas that face normal people around the world, in all walks of life.

Each example features individuals who followed the guidance of their own moral code, often risking personal injury or community censure to do so.

Two strategies of ethical decision making

Mar 19,  · This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem.

dilemmas, leading others in ethical decision making, and making sure any decision becomes part of an organization’s systems and procedures. The sixth and final element is a sense of moral obligation, which serves as a motivating force to engage in moral judgment and to implement decisions.

Two strategies of ethical decision making

This study was designed to address how the use of these reasoning strategies influences the earliest stages of ethical decision-making (i.e., sensemaking) and to help define the conditions in which an individual is more or less likely to use these strategies.