Jun 19, 2020 in Informative

Application of Ethical Theories to Nursing Practice

John Rawl’s Theory of Social Justice

John Rawls, one of the most prominent philosophers of the twentieth century, developed a social justice theory for determining whether a particular act or course of action is ethical. According to Rawls’ social justice framework, an action is considered moral when it is fair, just, considers interests of all involved and does harm to none. Therefore, in Rawls’ opinion, fair actions are moral and good, and genuinely just actions are fair. The author promoted the concept of “justice as fairness”. The philosopher explains that a truly ethical action is fair since it equally respects and considers interests of all affected by this action, even the most disadvantaged members of society. Rawls states, “The principles of justice ensure that none is advantaged or disadvantaged in the choice of principles by the outcome of natural chance or the contingency of social circumstances”. In other words, the author believes that a moral and truly good action benefits all affected, regardless of their social rank or a position, not just the majority of people involved or a particular group of people.

Therefore, in the context of provision of health care services, Rawls’ theory of social justice promotes equal access to health care services and establishes premises for creating a more just health care system where all people can equally enjoy quality health care. Since Rawl’s approach equally considers health-related interests of all regardless of their socio-economic status (SES), Rawls’ theory of social justice can serve as a foundation for overcoming disparities in access to health care and eliminating inequalities between low-income and affluent populations in their access to quality care. Therefore, one can argue that Rawls’ theory of social justice has following implications for health care system. First, it promotes universal health coverage, based on principles of social justice, not market justice. Second, health care system should provide a full range of health care services to all patients, regardless of their SES.

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Aristotle’s View of Personal Ethics and Moral Development

Aristotle’s ethical theory is based on value that a person possesses and brings into society through fulfilling his or her function in search for happiness. According to Aristotle, happiness is “final and self-sufficient…end of action” and “the chief good”. Furthermore, Aristotle said, “Happiness is an activity of soul in accordance with perfect virtue”. Thus, in his view, happiness can be achieved by combining harmoniously one’s professional life, emotions, and vulues. Aristotle believed that one can lead a happy life by forming virtuous habits and practicing such virtues as wisdom, honor, intelligence, and insight and engaging in certain pleasures. He emphasizes the importance of achieving a harmony between one’s emotions and intellect and living a virtuous/ ethical life. Although the philosopher does not provide explicit guidance on how a person should act in specific situations when faced with moral dilemmas, Aristotle points out the importance of adhering to universally accepted values such as justice, honor, temperance, wisdom, courage, and patience.

Therefore, it seems that Aristotle’s theory of moral development has following implications for professional and personal ethics that guide health care workers in their practice. First, it leaves room for medical workers to exercise free will in determining an ethical course of action and making moral choices in each particular situation. Second, Aristotle’s theory of moral development encourages each health care worker to find a unique personal and professional balance that allows leading a happy and professionally satisfying life that allows fulfilling one’s professional function. Third, the overall tone of Aristotle moral theory encourages its followers to adhere to ethical values, act morally, and place greater good before one’s interests.

Comparison of Rawls’ and Aristotle’s Theories

The analysis of Rawls’ ethical theory and Aristotle’s theory of moral development demonstrates that these two theories have several noticeable differences. It seems that while Rawl’s theory of social justice suits well both for guiding personal and institutional decision-making, Aristotle’s theory of moral development is more appropriate for personal and professional decision-making on an individual level. For example, Rawl’s theory of justice argues that an action is just only when it is fair and harms none’s interests. Hence, Rawl’s theoretical framework promotes universal equality. This clearly defined focus on equality and fairness serves as a standard that one can use to determine whether a committed or planned action is moral. However, while Aristotle’s theory of moral virtue emphasizes adherence to ethical living, it does not provide explicit standard or universal guidance on how a health care provider should act when faced with an ethical dilemma. Therefore, while Rawl’s theoretical framework can be used to establish a straightforward standard for determining what a moral action is, Aristotle theory of personal ethics provides rather general guidance for determining moral value of an action.

There are several reasons why ethical theories play an important role in health care. First, policymakers use theoretical frameworks to guide their decision-making and design policies that affect access to health care and health coverage on a national level. Therefore, applying one or the other ethical framework, when developing and implementing policies for a health care sector, can have a significant impact on patients’ access to health care and subsequent wellness and health of an entire nation. Second, ethical theories guide the development of codes and general principles that set an approach to health care, establish ethical environment, and shape attitudes shared by providers of health care services. Third, ethical theories guide decision-making in resolving ethical problems that arise in daily health care practice. For example, health care workers can use ethical theories to guide their actions in resolving ethically controversial matters such as end-of-life issues and issues related to donating organs. 

Personal and Professional Values and Qualities Important for Health Care Professionals

Just about any occupation requires possessing a combination of personal qualities and professional qualifications that help one succeed in his or her place of work. Likewise, health care workers should adhere to professional values and conduct themselves in a manner that promotes patient safety and high quality of care. For example, the “Code of Ethics for Nurses” emphasizes such nursing ethical values as respect for human dignity and patients’ rights, promotion of equal access to health services, professional competency, sympathy, compassion, commitment to patient’s best interests, the focus on patient safety, autonomy in decision making, and integrity. Possessing listed characteristics is highly important for medical workers for several reasons. First, adherence to these foundational values is essential for providing respectful and compassionate high-quality care. Second, described values set high professional standards that ensure considerate treatment, respect for a patient’s dignity, protection of patients’ rights, and commitment to patients’ best interests. 

Furthermore, it should be noted that adherence to high professional and ethical standards is one of the keys to building trust between patients and health care workers, raising prestige of a nursing profession, and fostering confidence of patients and their family members in competence and professionalism of health care professionals. As the analysis of ethical theories demonstrates, health care providers can use ethical theories and works of philosophers to promote wellness, health, and equal access to health care. Therefore, ethical theories serve as credible and time-tested points of reference for providing patient care and designing health care policies.

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