Deontological or Utilitarian? An Eternal Ethical Dilemma in Outbreak.

Both deontological ethics and utilitarian ethics are important theories that affect decision making in medical and health care. However, it has been challenging to reach a balance between these two ethical theories. When there is a conflict between these two ethical principles in the medical context, the conflict must be addressed in order to reach an appropriate solution for patients and others involved. To demonstrate decisions made in terms of deontological ethics and utilitarian ethics, the study will use the film Outbreak as example to further understand these two ethics in relation to epidemiology and public health. The paper will also analyze film scenarios to examine how deontological ethics and utilitarian ethics are involved and strike a balance with different pearspectives to reach an appropriate public health solution. To reach more just solutions, it is essential to determine how to make wise decisions by balancing deontological ethics and utilitarian ethics. However, the decision-making process is complicated because any solution must consider not only medical ethics but also political, environmental, and military issues. In order to reach an appropriate public health decision, those involved should be inclined toward empathy and contemplate things from different ethical perspectives to deal with ethical/moral dilemmas and create greater beneficence and justice for patients and humanity at large.

Moral uncertainty: A case study of Covid-19.

BACKGROUND: Most writing about uncertainty in healthcare has addressed empirical uncertainty - that is, resulting from insufficient or conflicting facts. OBJECTIVE: To consider moral uncertainty by exploring how different theories apply to a single clinical case. METHOD: In this philosophical reflection, I briefly acknowledge empirical uncertainty before introducing and exploring the topic of moral uncertainty - defined as the question of what to do when we do not know what (morally) to do-using a case study of my own mother's deterioration and death from Covid-19. RESULTS: I identify and apply a number of philosophical theories relevant to managing moral uncertainty, including utilitarianism, deontology, practical rationality and feminist philosophy. CONCLUSION: Different moral theories lead to different conclusions about the best course of action in situations of moral uncertainty. PRACTICE IMPLICATIONS: Detailed analysis and close reading of a single case can provide insights into how to act in morally complex situations, but learning is in the form of enriched understanding, not formulaic rules.

[Ethical support units: benefits and limits of externalised ethics in times of crisis]. / "Cellules éthiques de soutien", apports et limites d'une éthique externalisée en temps de crise.

This health crisis has revealed the difficulties, but also the creativity of the caregiving teams. In this context, assisting health professionals through the creation of an ethical support unit is valuable. However, the implementation of such a unit requires reflection with the definition of the resulting limits. Two questions are raised: is it really possible to externalise ethical reflection? Is there such a thing as ethics of crisis?

The moral values of nursing undergraduation: perception of teachers and students / Los valores morales de la carrera de grado de enfermería: la percepción de docentes y estudiantes / Os valores morais da graduação de enfermagem: percepção de professores e estudantes

ABSTRACT Objective: to compare the moral values that nursing teachers and students consider important for vocational training with those they believe are promoted throughout undergraduate study. Method: a qualitative research; an ethnographic study conducted at a public nursing school in the state of Rio de Janeiro, in 2018, involving 40 interviews with teachers and students and a participant observation phase. Results: the moral values that teachers and students consider important for vocational training, as well as those that are promoted, converge on prudence, respect, responsibility, and empathy. It is noteworthy that the knowledge was much cited by the respondents and this article interpreted it as prudence. However, in relation to the values promoted during undergraduation, students warn that these are stimulated when referring to the binomial student-user of health, because they do not feel to the same intensity the presence of these moral values in the teacher-student relationship. Conclusion: a powerful strategy for teaching about moral values is to promote the care of their own students, teachers and staff. In this way, mismatches are avoided between what is said and what is done by experiencing values such as prudence, respect, responsibility and empathy within interpersonal relationships and in the daily life of the school.

RESUMEN Objetivo: comparar los valores morales que los profesores y estudiantes de enfermería consideran importantes para la formación profesional con los que creen que se promueven a lo largo de la carrera de grado. Método: investigación cualitativa; un estudio etnográfico realizado en el año 2018 en una facultad pública de enfermería del estado de Río de Janeiro, por medio de 40 entrevistas con profesores y estudiantes y una fase de observación de los participantes. Resultados: los valores morales que los profesores y estudiantes evalúan como importantes para la formación profesional, al igual como los que se promueven, convergen en la prudencia, el respeto, la responsabilidad y la empatía. Cabe destacar que el conocimiento fue muy citado por los entrevistados y, en este artículo, se lo interpretó como prudencia. Pese a ello, en relación con los valores promovidos a lo largo de la carrera de grado, los estudiantes manifiestan que se los fomenta cuando se refieren al binomio estudiante-usuario de servicios de salud, puesto que no sienten con la misma intensidad la presencia de estos valores en la relación profesor-estudiante. Conclusión: estamos frente a una poderosa estrategia para enseñar sobre los valores morales y promover el cuidado de sus propios estudiantes, profesores y personal administrativo. De esta manera, se evitan desencuentros entre lo que se dice y lo que se hace al respetar valores como la prudencia, el respeto, la responsabilidad y la empatía dentro de las relaciones interpersonales y en la vida cotidiana de la facultad.

RESUMO Objetivo: comparar os valores morais que professores e estudantes de enfermagem consideram importantes para a formação profissional com aqueles que eles acreditam que são promovidos ao longo da graduação. Método: pesquisa qualitativa; um estudo etnográfico realizado em uma faculdade pública de enfermagem do estado do Rio de Janeiro, em 2018, envolvendo 40 entrevistas com professores e estudantes e uma fase de observação participante. Resultados: os valores morais que os professores e estudantes avaliam ser importantes para a formação profissional, bem como aqueles que são promovidos, convergem para a prudência, o respeito, a responsabilidade e a empatia. Vale destacar que o conhecimento foi muito citado pelos entrevistados e, este artigo, interpretou-o como prudência. Todavia, em relação aos valores promovidos ao longo da graduação, os estudantes alertam que estes são estimulados quando referem-se ao binômio estudante-usuário de saúde, pois não sentem na mesma intensidade a presença desses valores morais na relação professor-estudante. Conclusão: uma potente estratégia para ensinar sobre os valores morais é promover o cuidado dos seus próprios estudantes, professores e funcionários. Dessa maneira, evitam-se desencontros entre o que se diz e o que se faz ao vivenciar os valores como a prudência, o respeito, a responsabilidade e a empatia dentro das relações interpessoais e no cotidiano da faculdade.

Consideraciones éticas en la dispensación de medicamentos en farmacias de Ecuador / Ethical considerations in the dispensing of medications in pharmacies in Ecuador

RESUMEN Introducción: Los farmacéuticos enfrentan conflictos éticos en la dispensación de medicamentos. La resolución de estos asegura un servicio eficaz, seguro, digno y de calidad. Objetivo: Caracterizar desde una perspectiva ética-deontológica la dispensación de medicamentos en las farmacias de Cuenca-Ecuador, 2018. Material y Métodos: La investigación tuvo un diseño no experimental, descriptivo y transversal. La muestra no probabilística fue de 65 dependientes. Se aplicó un cuestionario para identificar la resolución de conflictos éticos y el nivel de conocimientos sobre Ética y Deontología Farmacéutica. Las respuestas fueron codificadas y analizadas con SPSS 23.0. Resultados: Los conflictos más frecuentes fueron el consentimiento informado (83 por ciento), prescripción médica (95 por ciento) y conflicto de intereses (84 por ciento). La resolución ética de los conflictos fue superior en dependientes capacitados en Ética y Deontología, con una correlación de 0,34 (p= (0,009) con el nivel de conocimientos en Deontología Farmacéutica. El nivel de conocimiento sobre Ética y Deontología Farmacéutica fue bajo en 60 por ciento de la muestra, con asociación inversa a la autopercepción de conocimiento (ρ=-0,259; p≤ 0,001). Conclusiones: La resolución empírica de los conflictos éticos durante el ejercicio de la profesión se realiza sin un fundamento ético-deontológico. El nivel de conocimiento en Ética y Deontología requiere una intervención desde la capacitación institucional y formación profesional de modo que se revierta en la adopción de decisiones acertadas que garanticen la seguridad del paciente como persona(AU)

ABSTRACT Introduction: Pharmacists face ethical conflicts related to the dispensing of medications. Their resolution ensures an effective, safe, dignified, and quality service. Objective: To characterize the dispensing of medications from an ethical-deontological perspective in pharmacies of Cuenca-Ecuador in 2018. Material and methods: A non-experimental, descriptive and cross-sectional study was conducted. The non-probability sample consisted of 65 pharmacists. A survey was applied to identify the resolution of ethical conflicts and the level of knowledge of Pharmaceutical Ethics and Deontology. Data were coded and analyzed with SPSS 23.0. Results: The most frequent conflicts included informed consent (83 percent), medical prescription (95 percent) and conflict of interests (84 percent).The resolution of ethical conflicts was higher in pharmacists with training in Ethics and Deontology, with a correlation of 0.34 (p =0.009) with the level of knowledge of Pharmaceutical Deontology. The level of knowledge of Pharmaceutical Ethics and Deontology was low in 60 percent of the sample, with an inverse association with the self-perception of knowledge (ρ= -0.259; p≤ 0.001). Conclusions: Empirical resolution of ethical conflicts while exercising the profession is carried out without ethical-deontological foundation. The level of knowledge of Ethics and Deontology requires intervention from institutional and professional training so that it is reverted to make the right decisions to guarantee the safety of the patient as a person(AU)

Social (not fiscal) conservatism predicts deontological ethics.

Prior research has reported that political conservatives rely on a deontological approach to resolving moral dilemmas by favoring moral rules and moral edicts rather than expressing a willingness to sacrifice one life in order to save multiple others. In the current research, we sought to firstly demonstrate the underlying process and secondly to clarify the exact nature of the link between political ideology and deontological ethics. In Study 1, political conservatism predicted deontological judgments because of greater intuition. That is, conservatives think rather intuitively, and intuitive thinking is one antecedent to deontological judgments when resolving moral dilemmas. Following, in Study 2, we demonstrate that only social-not fiscal-conservatism predicts intuition and thus deontological ethics. Accordingly, we tease apart the typical left-right measure of political ideology into its two key aspects and argue that only the social but not fiscal dimensions predicts intuition and deontological ethics. We are not the first authors to suggest the existence of a link between political conservatism and moral processing, but we are the first to suggest an explanation and the first to clarify which aspect of conservatism is associated with deontological ethics.

Análise comparativa entre os códigos de ética odontológica e médica brasileiros / Comparative analysis of Brazilian medical and dental ethics codes / Análisis comparativo de los códigos brasileros de ética médica y dental

Os códigos de ética profissional são normas jurídicas (resoluções de autarquias federais) elaboradas pelos membros das mais diversas categorias de trabalhadores com o intuito de orientar a condutas desses profissionais no que diz respeito à ética na relação com os pacientes, com seus pares e com a sociedade. O objetivo deste estudo foi realizar uma análise comparativa entre os Códigos de Ética Odontológica e Médica. Observou-se que as diferenças entre estes documentos deontológicos surgem muito mais em virtude das particularidades de cada profissão do que por abordagens distintas frente a problemas similares. Concluiu-se que os Códigos de Ética Odontológica e Médica apresentam muito mais pontos em comum do que diferenças, mas seria interessante que os Conselhos de classe ao propor atualizações e modificações dos seus atuais códigos observassem o que as outras profissões da saúde contemplam em suas normas deontológicas, com o intuito de levar em consideração aspectos que também poderiam ser importantes para sua classe profissional de modo a engrandecer os códigos tornando um pouco mais fácil para os médicos e cirurgiões-dentistas a tomada de decisões éticas no seu trabalho diário em benefício da saúde do ser humano e da coletividade.

Los códigos de ética profesional son normas (resoluciones de autoridades federales) preparadas por los miembros de las diferentes categorías de trabajadores con el fin de orientar la conducta ética de estos profesionales en la relación con pacientes, colegas y la sociedad. El objetivo de este estudio fue realizar un análisis comparativo de los códigos de ética en Odontología y Medicina. Se observó que las diferencias entre estos documentos se deben más a las particularidades de cada profesión que a enfoques distintos frente a problemas similares. Se concluyó que los códigos de ética en Odontología y Medicina presentan más puntos en común que diferencias, pero sería interesante que los Consejos de Clase, al proponer actualizaciones y cambios a sus actuales códigos, observaran lo que otras profesiones de la salud contemplan en sus normas deontológicas, con fin de tener en cuenta aspectos que también podrían ser importantes para su clase profesional, de modo de ampliar los códigos y hacer un poco más fácil para los médicos y cirujanos dentistas la toma de decisiones éticas en su trabajo diario en beneficio de la salud del ser humano y la comunidad.

Professional ethics codes are norms (federal authority resolutions) prepared by members of the different categories of workers with the goal to guide the ethical conduct of these professionals in relation to patients, colleagues and society. The aim of this study was to carry out a comparative analysis of ethical codes in Dentistry and Medicine. It was observed that differences between these documents were due more to the particularities of each profession than to different focus, facing similar problems. It was concluded that Dentistry and Medicine ethical codes have more points in common than differences, but it would be interesting that Class Advisory Committees, when proposing actualizations and changes to their current codes, they will look what other health care professions view as deontological norms, with the end to have into account aspects which may be important also for their professional class, in order to extend the codes and facilitate to physicians and dentists ethical decision making in their daily task in benefit to the health of human beings and community.