Normative Theories

Normative Theories

Simone Camille Y. Tar

Capella University

Normative Theories

In medical facilities, ethical dilemmas and issues are always present. Commonly, the ethical issues are so widespread that practitioners and medical office employees do not realize the existence as they make decisions by the minute. Nevertheless, medical office professionals make use of their critical thinking skills when faced with ethical situations. In many cases, these professionals consider their individual values, ethical principles, and ethical theories when an ethical decision must be made. In this instance, an answer must be given to the question, “what is the right thing for me to do?” and “what type of professional am I? Or want to be?”

In (Reference.com Editors, n.d.), an ethical dilemma is defined as “a situation whereby a person is obliged by their moral code to take at least two actions, and while able to take either, the person is not able to take both.” Based on this definition, we deduce that three conditions need to exist for a situation to be classified as an “ethical dilemma.”

1. A situation where an individual (agent) has to make a decision as to what path of action suits the situation best.
2. There have to be different choices of action from where one can select.
3. Regardless of what decision is made, one or more ethical principle(s) will be undermined.

The question to ask now is “what exactly makes an issue an ethical dilemma?” A study completed by (Braunack-Mayer, 2001) suggests that classifying a problem as a moral issue depends on the individual, and the moral domain is possibly bigger and richer than traditional medical ethics would usually allow. If this is the case, one can assert that solving an ethical issue is in the hands of whoever (agent) is facing the situation.

Case Study: Ethical Issue in a Medical Facility

To determine the ethical issue in a case, I will examine the scenario below:

Scenario: While working in the business office of a primary care medical facility, you come across records showing that one of your daughter's grade-school teachers has been prescribed antipsychotic medication for the control of schizophrenia. Although you have been told to respect patient confidentiality in the workplace, you fear the potential harm such a person could cause in a position of authority over children. Develop your position on this ethical issue. What would you do? (Gerber, 2016)

In a medical arena, many ethical aspects combine to play a primary role in enhancing health in the community. To balance these roles, administrators come across many ethical issues. In most situations, it is easy for a person to pass his/her ethical duties or responsibilities; however, some other situations require a person to know or do the right thing, which may be filled with doubts and risks. In the above situation, several facts make it an ethical situation, and being aware or doing the right thing is uncertain. The events are:

1. The patient is mentally ill and teaches at my daughter’s school.
2. I agreed to maintain the confidentiality of patients.
3. My individual values and beliefs to tell the truth always are threatened.
4. The school, the patient, the medical practice, and I will be affected by whatever decision I make.
5. There is an “imprecise” dilemma because the situation puts me at conflict between my values, the medical office’s code of ethics, policies, and the laws of the country.

The following features within the scenario are crucial for me to make an ethical decision:

1. Agent (myself): In this scenario, several of my character traits could motivate me to make a decision. Some of the traits include benevolence, caring, bravery, confidence, creativity, dependability, diligence, honesty, justice, impartiality, and integrity. Each person has a goal to be good in life. Nevertheless, situations as this make it difficult to find solutions when my personal virtues are put in line. My emotions, experiences, and thoughts will influence the decision. For this scenario, my emotions include fear of harm and love of children.
2. Actions (Duty, ethical rules): The above situation includes various steps I must consider. The actions are: follow the confidentiality rule completely, inform the school, tell my supervisors, or ignore everything all together.
3. Outcomes (what will happen): In this feature, I consider what may happen if I decided to follow my moral virtues or perform my duty. The situation does not advise what may occur in the future, but there is one clear result: I could breach the confidentiality, and disobey the rules of the company or follow the rules and allow harm by the patient to the schoolchildren. If I tell the school, the victim could sue the establishment, stop coming for therapy, and kill themselves due to trauma from the stigma, or the patient could lose their job. The company could also have a bad reputation.

Application of Immanuel Kant’s Deontological Theory to the Scenario

When faced with an ethical situation an individual needs to be trained to sensitivity on ethical issues. Making a decision that is considered “ethical” requires a person to know what steps to take. Only following one’s moral instinct is not advisable as the situation may require critical thinking. If the choice is difficult, a person needs discussions with others about the ethical dilemma. To make a moral decision, an individual uses normative ethics – “a branch of philosophical ethics that looks at the set of questions that come up when determining how a person should act morally speaking” (Wikipedia Foundation, Inc, 2016). The solution to the issue is then divided to three – who we are, what we do, and what happens. These three elements of behavior represent the agent, the action, and the outcome, respectively. Of these three actions, three normative ethical theories emerge that guides a person when making the moral decision. The theories are Virtue Ethics, Deontological Ethics, and Consequential Ethics.

Deontological ethics or nonconsequential theory to ethics is linked with German philosopher- Immanuel Kant. Kant contended that executing what is right is not about the results of our actions, but it is about having the proper intent in carrying out the work. The moral action here is duty-based. Kant also said that all rational persons have the same ethical duties. Kant’s formula for finding our moral obligation is called the “categorical imperative.” Categorical imperatives “represent the idea that an action as objectively necessary of itself, without reference to another end” (Kant, 2002). Categorical imperatives are expressions of moral law. Kant profiled categorical imperatives into three methods- Universal law formulation, Humanity as an end in itself, and Realm of Ends formula.