Abstract
The authors led the development of a framework for ethical decision-making for an Academic Health Sciences Centre. They understood the existing mission, vision, and values statement (MVVs) of the centre as a foundational assertion that embodies an ethical commitment of the institution. Reflecting the Patient and Family Centred Model of Care the institution is living, the MVVs is a suitable base on which to construct an ethics framework. The resultant framework consists of a set of questions for each of the MVVs. Users of the framework are expected to identify two or more possible decisions to address the issue at hand and then, by applying the provided sequence of questions to each, examine these options and determine the overall ethically preferable decision. The construction of such a framework requires the creative involvement of the institution’s staff. Thus the development of the framework can represent a training process in ethical decision-making as well as advance the ethical atmosphere of the institution. This novel approach has the advantage of placing the MVVs on active duty, at the centre of ethical decision-making, and lifts it from its otherwise relative obscurity in most institutions.
Similar content being viewed by others
References
Accreditation Canada. (2012). Qmentum Program. Leadership Standards. Ottawa. May 28, 2012.
Bean, S. (2011). Navigating the murky intersection between clinical and organizational ethics: A hybrid case taxonomy. Bioethics, 25(6), 320–325.
Center for Ethical Deliberation, University of Northern Colorado. (2005–2007). Frameworks. Retrieved April 1, 2013, from http://mcb.unco.edu/ced/frameworks/.
Centre for Clinical Ethics, Toronto. (2013). A principle based framework/process for ethical decision making. Retrieved March 31, 2013, from http://www.stjoe.on.ca/patients/pdf/framework.pdf.
College of Nurses of Ontario. (2009). Practice standard. Retrieved March 30, 2013, from http://cno.org/Global/docs/prac/41034_Ethics.pdf?eps;anguage=en.
Coughlin, M. D. (2002). A framework for making ethical decisions in health care. St. Joseph’s Health System. Retrieved April 3, 2013, from http://www.smgh.ca/wp-content/uploads/2012/01/A-Framework-for-Making-Ethical-Decisions-in-Health-Care.pdf.
Ethics Services at Providence Health Care. (2012). The framework for ethical decision-making. Retrieved April 1, 2013, from http://www.providencehealthcare.org/ethics_services/decision-making-framework.html.
Giacomini, M., Kenny, N., & DeJeans, D. (2009). Ethics frameworks in Canadian health policies: foundation, scaffolding, or window dressing? Health Policy, 89(1), 58–71.
Hamilton Health Sciences Centre. (2010). Ethics framework. Retrieved April 1, 2013, from http://hamiltonhealthsciences.ca/workfiles/CLINICAL_ETHICS/HHSEthicsFramework.pdf.
Joint Commission Resources. (2013). Ethics framework. Retrieved April 18, 2013, from http://www.jcrinc.com/Chapter-1-Defining-Main-Components/Developing-and-Implementing-an-Ethical-Infras/Ethics-Framework/.
Jonsen, A., Siegler, M., & Winslade, W. (2006). Clinical Ethics: a practical approach to ethical decision making in clinical medicine (6th ed.). New York: McGraw Hill Professional.
Kirby, J. (2013). Ethics decision-making framework. South West Health. Retrieved March 31, 2013, from http://www.swndha.nshealth.ca/pages/Ethics%20Decision-Making%20Framework2008.pdf.
McDonald, M. (with Rodney, P., & Starzomski, R.). (2001). A framework for ethical decision-making: Version 6.0. Retrieved April 18, 2013, from http://www.ethics.ubc.ca/upload/A%20Framework%20for%20Ethical%20Decision-Making.pdf.
Nor-Man Regional Health Authority. (2005). Framework for ethical decision-making. Retrieved April 18, 2013, from http://www.norman-rha.mb.ca/documents/EthicsFramework_000.pdf.
Northwest Association for Biomedical Research, Seattle, WA. (2013). Decision-making frameworks. Retrieved April 3, 2013, from http://nwabr.org/sites/default/files/DMF.pdf.
Ontario Shores Centre for Mental Health Sciences. (2013). Clinical ethical decision-making framework. Retrieved April 3, 2013, from http://www.ontarioshores.ca/about_us/our_approach/ethical_decision_making/.
Queensway Carleton Hospital. (2013). Ethical framework. Retrieved April 14, 2013, from http://www.qch.on.ca/Home.aspx?PageId=535.
Sokol, D. K., McFadzean, W. A., Dickson, W. A., & Whitaker, I. S. (2011). Ethical dilemmas in the acute setting: A framework for clinicians. BMJ. doi:10.1136/bmj.d5528.
Trillium Health Centre. (2013). The IDEA: Ethical decision making framework. Retrieved March 31, 2013, from http://www.trilliumhealthcentre.org/about/documents/TrilliumIDEA_EthicalDecisionMakingFramework.pdf.
Vancouver Island Health Authority. (2013). A generic framework for ethical decision making. Retrieved March 13, 2013, from http://www.viha.ca/NR/rdonlyres/13229200-51A3-4296-AD13-0FC431F4D048/0/a_generic_framework_for_ethical_decision_making.pdf.
Velasquez, M., Andre, C., Shanks, T., & Myer, M. J. (2013). Thinking ethically: A framework for moral decision making. Markkula Centre for Applied Ethics at Santa Clara University. Retrieved March 31, 2013, from http://www.scu.edu/ethics/practicing/decision/thinking.html. A condensed version of this framework is used by Vancouver Island Health Authority in combination with procedural steps. Retrieved March 31, 2013, from http://www.viha.ca/NR/rdonlyres/13229200-51A3-4296-AD13-0FC431F4D048/0/a_generic_framework_for_ethical_decision_making.pdf.
Wellington, A. (2009). Sample ethical decision making models. Ryerson University, Toronto. Retrieved March 31, 2013, from http://www.ryerson.ca/ethicsnetwork/resources/ethicaldecision/.
Acknowledgments
Many thanks to Loretta Delea and Wendy Lange for administrative support and to Marion Agnew for editorial assistance.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kotalik, J., Covino, C., Doucette, N. et al. Framework for Ethical Decision-Making Based on Mission, Vision and Values of the Institution. HEC Forum 26, 125–133 (2014). https://doi.org/10.1007/s10730-014-9235-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10730-014-9235-7