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Ethics Resources

What is Ethics?
Ethics is concerned with morals and values. It requires us to think deeply and systematically about some fundamental questions:

  • What is right? What is Wrong? What do we think and why?
  • What is important in life? What do we think and why?

Why is ethics important to health care?
When we work in health care, do we always know

  • What is important (valued) in the lives of patients, residents, clients and families?
  • What is important (valued) in health in our communities?
  • What is important (valued) in our work?

If we are to successfully navigate the many ethical challenges that we encounter in the provision of health care, it is important to have an understanding of:

  • How we think about right and wrong
  • How we justify our own moral positions
  • Why others may disagree with our positions
  • How they might think, and justify, their moral positions
  • How we can discuss ethical issues reasonably

 

Organizational Ethics
Organizational ethics is concerned with the ethical climate of the health care organization. It requires conscious commitment and effort to integrate ethics at every level and corner of the organization.

Integrating Ethics
In recent years, there has been a movement across North America away from isolated ethics committee structures and towards the integration of ethics throughout health care organizations. These efforts require Board and Senior Management commitment, support and engagement; dedicated staffing; strategic planning to address key ethics priorities; staff management with ethics at all levels of the organization and in all contexts; ethics networking and communication; and organizational commitment to stay current with advancements in professional, clinical and research ethics nationally and internationally. Integrated ethics practices are a major expectation in Accreditation Canada standards.

Key assumptions in an ethical health care organization

  • Everyone has a role to play in fostering an ethical climate in health care.
  • Ethics must be integrated into health care processes, policies and practices.
  • Leaders must model the ethical behavior they expect of the organization's staff.
  • "Compliance models" of ethica are insufficient: people should do the right thing because it's the right thing to do, not because there could be undesirable consequences if they don't.
  • Health ethics is not just about clinical situations. Business decisions and practices must also be grounding in the organization's values.

Clinical Ethics
Clinical ethics focuses on ethics in the direct delivery of health care. Making ethical decisions requires many considerations, including:

  • Ethics Consideration: Virtue, relationships, consequences, rules, duties and obligations, values.
  • Bioethics Principles: Respect for autonomy, beneficence (doing good), non-maleficence (avoiding harm), justice.
  • Moral Rules: Veracity (truth), fidelity (faithfulness/loyalty), privacy, confidentiality.

Clinical issues or cases are ethically charged when they involve values conflicts and/or the decisions made have the potential for significant ethical implications. Ethical frameworks are often used to guide clinical decision-making. They are tools to help systematically think through all the ethical considerations in a situation, allowing stakeholders to come to the decision that is the most ethically sound.

Research Ethics
"Respect for human dignity requires that research involving humans be conducted in a manner that is sensitive to the inherent worth of all human beings and the respect and consideration that they are due. In this policy, respect for human dignity is expressed through three core principles - Respect for Persons, Concern for Welfare, and Justice".
(Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS2), 2010)

Considering the long history of unethical and ethically questionable methods for research and developing new health care knowledge, it is now expected that any organization that allows research to be conducted remains compliant with the TCPS. Health care providers and organizations are in a position of considerable trust, and must be held to high standards in order to ensure people are treated fairly and not exposed to unnecessary risk. Contact your regional ethics contact or Research Department for questions related to research ethics in your area.