Chapter Two Principles of Health Care Ethics 1 2 Principles of Ethics Extends your foundation of ethics. Gives you ways to apply ethics to practical situations. The four most often used in health care are nonmaleficience, beneficence, autonomy, and justice. 3 3 Nonmaleficience Sometimes this is translated as “first do no harm”. Ethical theories define harm in different ways. Consequentialist says harm is that which prevents good. Natural law says harm is something that limits our potential. 4 4 Nonmaleficence Deontologists say harm is something that prevents you from doing your moral duty. Virtue ethicists say harm is something that leads you away from practicing high moral character. Ethical egoists say that harm is something that goes against your self interest. 5 5 Harm in the Clinical Setting Harm is something that negatively affects patients. Clinically, we think of physical harm but other harm is possible. Harm is also caused by negligence. Harm can be caused by violating autonomy. 6 6 Beneficience Beneficience comes from the Latin “bene” and means to benefit. Requires a decision to engage in beneficent acts or to be altruistic. It is a fundamental principle of health care practice. What theories support beneficence? 7 7 Health care and Beneficience The standard of altruism is higher for health care professionals. Altruism is expected. Beneficence sometimes is extended to paternalism when the health care professional makes decisions for the good of the patient. What is this called? 8 8 Autonomy Autonomy means that you can rule yourself. It implies a respect for others. In health care, we have a duty to treat, but not to judge. What are the conditions necessary for autonomy in health care? 9 9 Specific Competence Is defined as the ability to do some things but not others. One can be competent in a limited way. In issues where a person is not competent, the concept of substitute judgment can be used. This also involves the idea of a reasonable person’s decision. 10 10 Specific Competence Coercion can also affect a person’s ability to exercise autonomy. Issues of competence and autonomy also are part of informed consent and other health care issues which are discussed in later chapters. 11 11 Justice The term can be used to mean fairness. Aristotle thought we should treat similar cases in a similar way unless there was some relevant or material difference. We need to examine types of justice: procedural and distributive. 12 12 Procedural Justice This is sometimes called due process. It means that you get your turn; you are treated like everyone else. Procedural injustice can occur with employee situations. Due process is also involved with policy making in procedural justice. 13 13 Distributive Justice This form of justice involves balancing benefits and burdens. Health care resource allocation is one example of a distributive injustice. Health care is a scarce resource, so Resource a.

1. Chapter Two
Principles of Health Care Ethics
1
2
Principles of Ethics
Extends your foundation of ethics.
Gives you ways to apply ethics to practical situations.
The four most often used in health care are nonmaleficience,
beneficence, autonomy, and justice.
3
3
Nonmaleficience
Sometimes this is translated as “first do no harm”.
Ethical theories define harm in different ways.
Consequentialist says harm is that which prevents good.
Natural law says harm is something that limits our potential.
4
4

2. Nonmaleficence
Deontologists say harm is something that prevents you from
doing your moral duty.
Virtue ethicists say harm is something that leads you away from
practicing high moral character.
Ethical egoists say that harm is something that goes against
your self interest.
5
5
Harm in the Clinical Setting
Harm is something that negatively affects patients.
Clinically, we think of physical harm but other harm is possible.
Harm is also caused by negligence.
Harm can be caused by violating autonomy.
6
6
Beneficience
Beneficience comes from the Latin “bene” and means to benefit.
Requires a decision to engage in beneficent acts or to be
altruistic.
It is a fundamental principle of health care practice.
What theories support beneficence?
7
7

3. Health care and Beneficience
The standard of altruism is higher for health care professionals.
Altruism is expected.
Beneficence sometimes is extended to paternalism when the
health care professional makes decisions for the good of the
patient. What is this called?
8
8
Autonomy
Autonomy means that you can rule yourself.
It implies a respect for others.
In health care, we have a duty to treat, but not to judge.
What are the conditions necessary for autonomy in health care?
9
9
Specific Competence
Is defined as the ability to do some things but not others. One
can be competent in a limited way.
In issues where a person is not competent, the concept of
substitute judgment can be used. This also involves the idea of a
reasonable person’s decision.
10
10
Specific Competence

4. Coercion can also affect a person’s ability to exercise
autonomy.
Issues of competence and autonomy also are part of informed
consent and other health care issues which are discussed in later
chapters.
11
11
Justice
The term can be used to mean fairness.
Aristotle thought we should treat similar cases in a similar way
unless there was some relevant or material difference.
We need to examine types of justice: procedural and
distributive.
12
12
Procedural Justice
This is sometimes called due process.
It means that you get your turn; you are treated like everyone
else.
Procedural injustice can occur with employee situations.
Due process is also involved with policy making in procedural
justice.
13
13

5. Distributive Justice
This form of justice involves balancing benefits and burdens.
Health care resource allocation is one example of a distributive
injustice.
Health care is a scarce resource, so
Resource allocation issues are common in health care; what are
some examples of these issues?
14
14
Material Reasons to Discriminate
Basic argument is that the person deserves it or needs it
In the U.S., if you work hard, you deserve to be rewarded.
In contrast, if you disobey the law, you deserve to be punished.
15
15
Discrimination based on Need
Need can be based on misfortune or disability.
Need can be based on special talents or abilities and on
opportunities.
Need can be based on past discrimination.
Need can also be based on structural social problems.
16
16

6. In the larger society,
There is a need to discriminate based on material need.
You are rewarded based on how much you contribute.
You are also rewarded based on how much effort you put forth.
This thinking also applies to patient care. Can you give some
examples?
17
17
Need based on Misfortune
Misfortune can lead to discrimination based on or against need
for care.
For example, life threatening situations are treated before minor
emergencies.
Special talents or the potential loss of opportunity can be
arguments for special treatment.
What other groups fall into the need based category?
18
18
Need based on past Discrimination
Redress of past injustices may be a reason for different
treatment.
The health care system has responded to the needs of some
special groups.
Structural problems have also been considered in needs based
discrimination; what are some examples?
19

7. 19
Distributive Justice and Rights
We are still debating if health care is a right or a commodity.
Need to think about whether something is a legal right or a
moral right.
There are many types of rights and many overlap with each
other (See figure in text).
20
20
Legal or Positive Rights
Legal right means that someone has a legal obligation to fulfill
your right.
Positive right means that you are entitled to something.
Sometimes legal rights become that which you can get enforced.
21
21
Substantive Rights
Can be legal rights or not.
They are right to a particular thing such as education, health
care, minimum wage, etc.
Different nations have differing opinions about substantive
rights for their citizens.
22

8. 22
Negative Rights
You have the right to be left alone.
The Bill of Rights lists many negative rights.
The negative right of one person may be in conflict with the
negative right of another (i.e. smokers).
Other negative rights include freedom from sexual harassment,
and medical record privacy.
23
23
Process, Natural, and Ideal Rights
You have the right of due process.
Natural rights means that you respect the attributes that people
have in nature.
These rights allow humans to reach their full potential.
Natural rights express our common morality and ideal rights
inspire.
24
24
Reflective Equilibrium Model
Making ethical decisions requires considered judgments.
These judgments require rational moral reasoning.
Ethical theories and principles are used to explain moral
reasoning.
Reflective equilibrium model provides a process for considering

9. and reconsidering decisions.
25
25
Reflective Equilibrium Model
26
26
How can you Use the Model in Practice?
Describe a situation where making an ethics choice might be
difficult.
Now, use Reflective Equilibrium Model to assist you in
deciding the most ethical decision to make.
Why is this model not in common practice in health care?
27
In Summary…
28
28
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10. DFM2: Critical Commentary
PAGE 1
Task 1 Video List
Select three videos from this list to watch prior to completing
the requirements for this task.
The videos you choose should, collectively, represent examples
of teachers addressing the
cultural, social, and emotional needs of students. To determine
the content of each video, it
may help to read the descriptions on the web pages.
1. “Writing a Cooperative Paragraph,” English learners (ELs)—
second grade
https://lrps.wgu.edu/provision/200783990
2. “Building Classroom Community through the Study of
Chinese Art and Culture,” second
grade
https://lrps.wgu.edu/provision/200783347

11. 3. “Creating Fractured Fairy Tales Using Story Maps,” fifth
grade
https://lrps.wgu.edu/provision/200783189
4. “Defining the Problem, Effect, and
Solution
through an Interactive Read Aloud,”
kindergarten
https://lrps.wgu.edu/provision/200783059
5. “Determining the Influence of Media on American Culture
and Stereotypes,” 12th grade
https://lrps.wgu.edu/provision/200782854
6. “Developing Drug Awareness and Resistance Skills,” sixth
grade

12. https://lrps.wgu.edu/provision/190967517
7. “Learning about Cultural Identity,” kindergarten
https://lrps.wgu.edu/provision/134389413
https://lrps.wgu.edu/provision/200783990
https://lrps.wgu.edu/provision/200783347
https://lrps.wgu.edu/provision/200783189
https://lrps.wgu.edu/provision/200783059
https://lrps.wgu.edu/provision/200782854
https://lrps.wgu.edu/provision/190967517
https://lrps.wgu.edu/provision/134389413
DFM2: Critical Commentary Task 1 Video List
PAGE 2

13. 8. “Developing U.S. History Content Vocabulary,” fifth grade
https://lrps.wgu.edu/provision/200782444
9. “Adding Mixed Numbers with Like and Unlike
Denominators,” sixth grade
https://lrps.wgu.edu/provision/200782060
10. “Analyzing American Literature through a Fish Bowl
Discussion,” 11th grade
https://lrps.wgu.edu/provision/200781790
11. “Analyzing Diverse Media to Clarify Text,” seventh grade
https://lrps.wgu.edu/provision/200778242
https://lrps.wgu.edu/provision/200782444
https://lrps.wgu.edu/provision/200782060
https://lrps.wgu.edu/provision/200781790

14. https://lrps.wgu.edu/provision/200778242
2048.3.1 :
Recognizing the Community of Care
The graduate plans for learning environments that meet
all students' cultural, social, and emotional learning needs by
incorporating knowledge of individual learners, diverse
cultures, and communities.
INTRODUCTION
Western Governors University employs a three-step
developmental framework to support you through your
preclinical and clinical experiences. This framework also helps
to ensure you exit the program confident in your ability to meet
the needs of your future students and school system. This
assessment falls under step one of the three-step framework. In
this task, you will engage in activities that will go toward
preclinical hours of your Early Preclinical Experiences
requirements.
In this task and others in this program, you will use Gibbs'
Reflective Cycle (Gibbs, 1988) as a framework to respond to
observations and experiences. Gibbs' Reflective Cycle
encourages you to think systematically about the phases of an
experience or activity, first describing the experience, then

15. addressing how it made you feel, next evaluating and analyzing
it, then drawing a conclusion, and finally considering how this
experience will apply to your future practice.
For this task you will select three videos that allow you to
observe learning environments where efforts are being made to
meet cultural, social, and emotional learning needs of students.
In each video, you will observe teachers in their classrooms and
will then evaluate their efforts to incorporate the diverse
cultures and communities of individual learners into the
learning environment.
Please note: To assist you in this task, we strongly recommend
you start by reviewing the SOE Professional Dispositions and
Ethics linked in the Web Links section below. You might
consider reviewing Module 13 prior to starting this task.
REQUIREMENTS
Your submission must be your original work. No more than a
combined total of 30% of the submission and no more than a
10% match to any one individual source can be directly quoted
or closely paraphrased from sources, even if cited correctly. The
originality report that is provided when you submit your task
can be used as a guide.

16. You must use the rubric to direct the creation of your
submission because it provides detailed criteria that will be
used to evaluate your work. Each requirement below may be
evaluated by more than one rubric aspect. The rubric aspect
titles may contain hyperlinks to relevant portions of the course.
Tasks may not be submitted as cloud links, such as links to
Google Docs, Google Slides, OneDrive, etc., unless specified in
the task requirements. All other submissions must be file types
that are uploaded and submitted as attachments (e.g., .docx,
.pdf, .ppt).
A. Identify
three videos from the attached “Task 1 Video List”
found in the “Supporting Documents” section.
Note: When selecting three videos to observe, it may be helpful
to read the description available on the web page for each
video. You will want to choose videos that will give you enough
relevant material to respond to parts B1–B5.
B. Reflect on your video observations by doing the following:
1. Discuss specific examples of how the teachers in the videos
effectively incorporated the needs of individual learners within
their learning environments, including

17. at least one example of
each of the following from
any of the three videos:
• cultural needs
• social needs
• emotional needs
2. Discuss ways that the teachers could have more effectively
incorporated individual learners’ cultural, social, or emotional
needs in the learning environments.
3. Discuss
two culturally sustaining pedagogy strategies you
learned from observing the videos that you could incorporate
into your future practice as a teacher.
a. Explain how you can apply the two strategies from B3 in
your future classroom.
4. Explain how you could involve your students’ caregivers in
the execution of the strategies from part B3, including specific
examples.
5. Explain how you could involve the community in the
execution of the strategies from part B3, including specific
examples.

18. C. Acknowledge sources, using in-text citations and references,
for content that is quoted, paraphrased, or summarized.
D. Demonstrate professional communication in the content and
presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these
symbols: ! - _ . * ' ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf,
txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg,
wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
Task 1 Video List
Select three videos from this list to watch prior to completing
the requirements for this task.
The videos you choose should, collectively, represent examples
of teachers addressing the
cultural, social, and emotional needs of students. To determine
the content of each video, it
may help to read the descriptions on the web pages.
1. “Writing a Cooperative Paragraph,” English learners (ELs)—
second grade
https://lrps.wgu.edu/provision/200783990
2. “Building Classroom Community through the Study of

19. Chinese Art and Culture,” second
grade
https://lrps.wgu.edu/provision/200783347
3. “Creating Fractured Fairy Tales Using Story Maps,” fifth
grade
https://lrps.wgu.edu/provision/200783189
4. “Defining the Problem, Effect, and