Decision Making in Value Issues

Over the course of our lives, each of us as human develops a coherent set of attitudes, feelings, and opinions, with which we judge the world of actions around us–in terms of good and bad, right or wrong, positive or negative. This value system or worldview is culturally shaped by the events of our lives and the traditions of our people.

Several ethical systems have been proposed to assist and bring order to value–laden decision making. Clearly the settling of these issues by flipping of a coin is unacceptable, as it will lead to an ethical pluralism, where any choice is as good as another. To allow a morally neutral society is not in keeping with social order and progress. Currently, the ethical systems with the highest level of acceptability are duty orientation, consequence orientation, divine mandate and virtue ethics. Each of these systems allow for the examination of ethical problems and provides a framework for decision making. Each of these general systems with which we look at ethical problems has contemporary theorists with varying models, which can be classed as being duty, consequence, divine mandate or virtue ethics oriented.

Each of the general ethical systems has been subjected to legitimate criticisms that they fail to overcome, and none of these point seems to have universal acceptance. When we examine our own personal value systems, we can be found to be duty oriented in some decisions, and consequentialistic in others. An individual could be very duty oriented in regard to an issue such as abortion, and yet approach the withdrawal or removal of life support from a consequence orientation. It has been noted that, just as in the fox hole there are no atheist, in the practice of healthcare, there is little comfort in decision making without a situational framework or the reliance on principle. Van Rensselaer Potter, who is credited with coining the word “bioethics”, explained that this new discipline had as it’s focus the traditional task of medical ethics, that of aiding the individual practitioner to make decisions and to live with them. Ethics, then, is a generic title that we give to systems that seek to bring sensitivity and method to the human task of decision making in the arena of moral values.

What ever ethical framework one chooses in order to solve problems, usually the method contain the six basic steps.

  • Step One— Identify the characteristics of the problem. Describe the problem and identify the principles involved? Who is charged with making the decision
  • Step Two — Gather the facts of the case. What is fact, what is opinion? What are the legal ramifications? Has the issue been decided by the courts before? What documentation exists that outlines the problem?
  • Step Three — Examine the options with initial credibility. The more options you can think, the more likely you are to find one you can support.
  • Step Four — Weigh and evaluate the potential options. What happens to the individuals involved, given each option? Has everyone been considered equally? “What principles are favored and which are sacrificed?” “What ethical systems are going to use to make the choice: utilitarianism, duty-oriented, or virtue ethics?”
  • Step Five — Make your decision and act upon it.
  • Step Six — Assess and evaluate the results.

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