Ethics and Health Education/Promotion
Chapter 5
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1
Chapter Objectives – 1
Identify and define the three major areas of philosophy
Define ethics
Explain the difference between ethics and morality
Explain why it is important to act ethically
Define professional ethics
Explain and briefly describe the two major categories of ethical theories
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Chapter Objectives – 2
Identify principles that create a common ground for all ethical theories
Outline a guide for making ethical decisions
Identify ethical issues associated with the profession of health education/promotion
Explain how a profession can ensure that its professionals will act ethically
Define code of ethics and identify the source of the code available for health education specialists
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Key Terms and Origins
Major areas of philosophy
Ethics (the study of morality)
Epistemology (the study of knowledge)
Metaphysics (the study of the nature of reality)
Ethics dates back to 470–399 B.C.
Ethos and Mores – both mean character
Ethics – the science of how choices are made
Morality – the activity of making choices and of deciding, judging, justifying, and defending those actions
People use terms such as good, right, bad, and wrong when referring to ethical judgments about human behaviors
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Why Should People Act Ethically? – 1
Ethics provide a standard by which we live
Ethical behavior brings meaning and purpose to life
Ethical behavior leads to a healthier and more satisfying life
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Why Should People Act Ethically? – 2
Professional ethics
Focuses on the “actions that are right and wrong in the workplace and are of public matter”
Professional ethics guide individual behavior in the work setting
Professional socialization – coming to an understanding of what behaviors are appropriate in a professional role
Research ethics – subset of professional ethics
“Comprises principles and standards that, along with underlying values, guide appropriate conduct relevant to research decisions”
Voluntary participation is the foundation of research ethics
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Ethical Theories
Provide frameworks to evaluate whether human actions are acceptable
Major categories of theories
Deontological (formalism or non-consequentialism)
Looking at the act; the end does not justify the means
Theories “that claim that certain actions are inherently right or wrong without regard to their consequences” (Reamer, 2006)
Teleology (consequentialism)
Looking at the consequences; the end does justify the means
Evaluate the moral status of an act by the goodness or the consequences (Reamer, 2006)
Neither category of ethical theory can be used for all moral issues
Ethical questions are answered through philosophical thought, using reason, logic, & argument
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Basic Principles for Common Moral
Ground – 1
Five principles
Value of Life – First & most basic principle
Goodness (or rightness) – Subdivided into two related principles
nonmaleficence – First duty is to do no harm
beneficence (or benevolence) – Doing good; actions that provide for the greater good of the community
Justice (or fairness) – just in distributing goodness & badness; subdivided into two area
procedural justice – fair procedures followed
distributive justice – allocation of resources
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Basic Principles for Common Moral
Ground – 2
Honesty
At the heart of any moral relationship is communication; telling the truth
Autonomy (or individual freedom)
People must have the freedom to choose their own way of being ethical within the framework of the other principles
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Making Ethical Decisions – 1
Ethical decision making
Requires practitioner to make choices when the circumstances involve conflicting principles
Requires people to rely on their values, principles, and ethical thinking
Should begin before any ethical problem surfaces
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Making Ethical Decisions – 2
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Figure 5.2 Steps in ethical decision making
Sources: Adapted from: Balog et al., (1985); Mellert (1995); Nelson (2005); Reamer (2006); Remley & Herlihy (2007); Svara, (2007).
Making Ethical Decisions – 3
Importance of moral sensitivity
Be aware of the context in which an ethical decision is made
Consider
Place
Time
Identity
Social relationships
The ideal
The concrete
Seriousness
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Ethical Issues & Health Education/Promotion – 1
Ethical issues interface with all aspects of our professional lives
Obligations of professions & professionals (Bayles, 1989)
Obligations & availability of services
Obligations between professionals and clients
Obligations to third parties
Obligations between professionals and employers
Obligations to the profession
Ethical dilemmas (Penland & Beyrer, 1981)
Must be an issue (a controversy); two sides
Must involve a question of right and wrong
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Major categories of issues (McLeroy et al., 1993)
Assigning individual responsibility
Changing behavior vs. social environment
Use of public policy or coercive strategies
Overemphasizing behavior change
Overemphasizing the importance of health
Educating the public on the concept of risk
Underemphasizing professional behavior
Ethical Issues & Health Education/Promotion – 2
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Major categories of issues (McLeroy et al., 1993) (continued)
Ethical issues to be considered with community interventions
Confidentiality
Consent
Disclosure
Competence
Conflict of interest
Grossly unethical behavior
General ethical responsibilities
Ethical Issues & Health Education/Promotion – 3
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Ensuring Ethical Behavior – 1
Professionals act unethically for specific reasons
Profession can put into place procedures that help to ensure ethical behavior by all
Selective admissions into academic programs
Retention standards for students in academic programs
Graduation from an academic program
Completion of internships
Becoming credentialed
Continuing education unit or update of credentials
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Ensuring Ethical Behavior – 2
Once individuals have been admitted to the profession
Expected to behave according to professional norms
Code of ethics
Considered the professional norm
Principal function is to “organize in a systematic way basic
ethical standards, rules, and principles of professional conduct”
(Pritchard, 2006)
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Ensuring Ethical Behavior – 3
Types of statement found in codes of ethics
Don’t statements
Obligations and responsibilities
Virtues, personal qualities, and/or values
Aspirations
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Ensuring Ethical Behavior – 4
Professions should have a means to discipline individuals that violate the code of ethics
Sanctions based upon a variety of factors
Type of violation
Number of prior violations
Willfulness of the violation
Level of responsibility of the professional
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Ensuring Ethical Behavior – 5
Ensuring ethical behavior in the health education/promotion profession
Health education/promotion has unclear standards for admission into the profession
The profession of health education/promotion has a code of ethics
Society for Public Health Education (1976)
Association of the Advancement of Health Education (1994) [now know as the American Association of Health Education]
Current code of ethics is recognized by the Coalition of National Health Education Organizations [CNHEO]
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Summary – 1
Ethical questions impact all aspects of life
Health education specialists are constantly being confronted with ethical dilemmas, thus must have a basic understanding of how to make an ethical decision
Key terms: philosophy, ethics, & morals
Professionals should work from an ethical base
Two major categories of ethical theories: deontology & teleology
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Summary – 2
Principles to guide ethical behavior: value of life, goodness (nonmaleficence & beneficence), justice (procedural & distributive) truth telling, & individual freedom
Ten step process for making ethical decisions
Ethical issues facing health education specialists in just about every aspect of the job
Ensure that professionals act ethically by: admission to the professional preparation program, retention in the program, appropriate education, internships, code of ethics & enforcement
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Ethics and Health Education/Promotion
Chapter 5: The End
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