Book - Ethical Decision-Making
1 Principles of Ethical Decision Making
This institute has many resources useful for the study of ethics in social affairs: http://www.globalethics.org
Principles of Ethical Decision Makingtext (c) 2005 Joyce S. McKnightAcademic Area Coordinator, Community and Human ServicesCenter
for Distance Learning, SUNY/Empire State College
This course is primarily about solving ethical dilemmas or making decisions when "right strives with right" or "wrong with wrong."
We begin by re-visiting some philosophical terms associated with ethics. Deontology refers to ethical decisions made based on principles of
right and wrong that are universal and absolute (Reamer, 2013, p. 70). One's choice of absolute authority is the key basis for deontologic
decision making. Some examples of absolute authority include secular laws, biblical injunctions such as the Ten Commandments, other
sacred writings such as the Koran, or consultation with a human authority figure who is given ultimate control. It is fair to say that all
religious fundamentalism is based primarily on a deontological view of morality and is also based on a natural human need for certainty.
Those who use a deontological framework are largely free (at least in their own minds) from agonizing over ethical decisions. In deontology
wrong means never justify admirable ends.
Teleology, on the other hand, emphasizes the consequences of action whether or not the action itself is ordinarily judged to be "good" or
"bad" in some absolute sense. Teleologists believe that to adhere to a rule or law absolutely without taking consequences into account is to
deify it (Reamer, 2013, p. 70). Teleologists recommend that one decide on a course of action based on the likely consequences of various
choices, choosing based on overriding principles or values (Reamer, 2013, p. 71).
The books in this module cover teleological frameworks mainly derived from Western rationalism, religious frameworks based on several of
the world's great religions, and post-modern ethics. Read each section carefully.
2 Teleological Frameworks in Human Service Ethics
Teleological Frameworks in Human Service Ethics(c) 2005, 2007 Joyce S. McKnightAcademic Area Coordinator Community and Human
ServicesCenter for Distance LearningSUNY/Empire State College
Reamer (1999) reviews some possible teleological frameworks that are mostly based in a Eurocentric view of ethical decision making.
Egoism (which is rarely found in human services) is based on the principle that when faced with ethical dilemmas (also called conflicting
duties), people should always choose to maximize their own good and enhance their own self-interest (p. 66). Utilitarianism states that
when faced with an ethical choice one should do what will produce the greatest good (p. 66). There are two principal forms of utilitarianism.
Good-aggregate utilitarianism bases ethical choice on the action that will produce the greatest total "good" (with "good" defined according
to the values of the decision maker) (p.67). Locus-aggregate utilitarianism bases ethical decisions on the action that will produce the
greatest good for the greatest number (p.67). In human services practice these two approaches conflict fairly frequently. It is easy to
imagine situations in which a few individuals may gain a great deal from a particular course of action while many others may be harmed or
at least not helped. In fact, such dilemmas are common in human service management where choices must be made about the use of
scarce resources. Those using the good-aggregate decision making model would argue that it is better to use limited resources to help a
few people thoroughly than to distribute limited resources over a large number of people and be unable to help anyone very much. Those
using the locus-aggregate model would argue that justice requires equally sharing limited resources among all those eligible for services,
even if that means "watering down" program quality.
In addition to the good aggregate v. locus aggregate dichotomy in utilitarianism, some philosophers argue that a differentiation should be
made between act and rule utilitarianism (Reamer, 1999, p. 67). In act utilitarianism the morality of a decision or action is based on the
consequences for the individual case (p. 67). In rule utilitarianism morality is determined by the likely results if such behavior generalizes
from the case at hand to society at large (p. 67). Rule utilitarians look carefully at whether their actions may set a harmful precedent. Rule
utilitarianism seems similar to Kant's categorical imperative which bases ethical decision making on the consideration of the logical
consequences if one's behavior were to be copied by all persons in all circumstances.
Most people consciously or unconsciously probably use a form of utilitarianism. We base our acts on our personal values, on our family upbringing, on our cultural context, on professional guidelines, on political ideologies or on religious principles or even sometimes on whim or
expediency. One obvious problem with utilitarianism is that these clashing values can cause internal conflict within the decision maker. The
theologian Dietrich Bonhoeffer put it eloquently: "Right strives with right and wrong with wrong." Another problem with utilitarianism is that
good people can disagree, sometimes violently, on decision making principles and processes.
3 Reamer's Framework
While Reamer sees no easy way out of this quandary, he does propose a decision making framework for prioritizing ethical decisions based
on the thinking of philosopher Alan Gerwith (Reamer, 1999, p. 69). Reamer has devised a decision making framework based on Gerwith's
principles. This framework is important, particularly in social work, but it seems difficult to "un-pack" or put into practical terms. I intend to
Reamer's framework is based on Gerwith's concept of various "goods" ...not material possessions which the term "goods" often implies in
common usage, but something more abstract, which might be defined as conditions which constitute a "good" life. Gerwith distinguishes
among basic goods, i.e. the necessities of life such as food, clothing, shelter, protection from harm etc., non-subtractive goods, whose loss
would detract from one's ability to pursue a satisfactory life, and additive goods, those materials and activities that add to one's existing
resources (Reamer, 1999, p. 71). In Gerwith's hierarchy basic goods take priority over non-subtractive goods which, in turn, take priority over
additive goods (p.71).
Reamer (1999) has overlaid Gerwith's concepts with some basic social work values and has developed the following decision making
framework. I have chosen to put his concepts into table form with titles I have chosen.
Reamer's Framework Simplified:
1. Rights of
"Rules against basic harms to the necessary
preconditions of human action (such as life itself,
health, food, shelter, mental equilibrium) take
precedence over rules against harms such as lying or
revealing confidential information or threats to
additive goods such as recreation, education and
The responsibility for a society to take care of the
basic needs of all its citizens should take priority over
the provision of "nice, but not necessary" provision
of government goods and services. It is sometimes
OK to lie or to share confidential information if to do
so assures that someone will live.
"An individual's right to basic well-being (including
goods that are essential for human action) takes
precedence over another individual's right to selfdetermination
Human service workers must break confidentiality
and inform authorities if a client threatens to harm
another person. It is wrong to "get rich" at another's
3. Right to
right to basic
"An individual's right to self determination takes
precedence over his or her right to basic well-being
Human service workers should not "force" clients to
accept help even if that help is "for their own good"
4. Laws take
"The obligation to obey laws, rules, and regulations
to which one has voluntarily and freely consented
over personal ordinarily overrides ones right to engage voluntarily
Human service workers cannot change laws, rules,
regulations, or even agency policies simply because
and freely in a manner that conflicts with these laws,
rules, and regulations.
they "feel" like doing so.
5. Laws can
but only for
"Individuals' rights to basic well-being may override
laws, rules, regulations, and agreements of voluntary
associations in cases of conflict."
Human services workers may decide that it is
necessary to break the law in order to protect a client
from harm. This is to be done carefully and
6. Pay taxes
"The obligation to prevent basic harms such as
starvation and to promote public goods such as
housing, education, and public assistance overrides
the right to complete control over one's property."
Even though our society prizes private ownership
and capitalism, all people have a basic right to life
which takes priority over private ownership.
(c) 2005, 2007 Joyce S. McKnight based on Reamer (1999, p. 75)
4 Lowenberg and Dolgoff's Ethical Principles Screen
Lowenberg and Dolgoff (2000, cited in Reamer, 2005) have created a decision-making model that can be used for ethical decision making.
They suggest that one must first consult the ethical principles of one's profession for guidance in ethical decision making (p.10). If the
ethical guidelines do not give concrete guidance or if they are contradictory, one may use the following hierarchy of values or decision
making principles as a "screen" for decision making:
• Principle 1: Principle of the Protection of Life. Biological life must always take precedence over any other principles, because it is in the
context of life that ethical decisions are made.
• Principle 2: Principle of Equality and Inequality. Similar situations and circumstances should be treated the same. However, if there are
relevant significant differences these should be taken into consideration and unequal treatment may be accorded where it would lead
to greater equality.
• Principle 3: Principle of Autonomy and Freedom. Client's autonomy and self-determination should always be considered, unless their
autonomous activities would threaten the life of self or other. The right to freedom, however, is less compelling than the prevention of
harm or death.
• Principle 4: Principle of Least Harm. Social workers should avoid causing harm and prevent harm from occurring to clients or others.
Where harm is unavoidable, social workers should choose the course of least harm, or most easily reversible harm.
• Principle 5: Principle of Quality of Life. Enhancing quality of life for clients or others in society should be a goal of social work
• Principle 6: Principle of Privacy and Confidentiality. The right to privacy of clients and others should be enhanced wherever possible
and in accordance with laws. However, it may be necessary to break confidentiality when serious harm or death to clients or others
may result from maintaining such confidentiality.
• Principle 7: Principle of Truthfulness and Full Disclosure. Social workers should be honest and provide full and truthful information to
clients and others in order to support a relationship grounded in trust and honest." (Lowenberg and Dolgoff, 2000, p. 70-71 cited in
Rothman, 2005, p.10)
5 The Bio-ethical or Medical Model
Reamer (2005) presents the bio-ethical or medical model as a third set of principles that can be used along with professional guidelines and
consultation in ethical decision making. Beaucamp and Childress (1994, p.15 cited in Reamer, 2005, p. 11) have suggested a three tiered
approach to ethical decision making that is similar to the one advocated in this course. Their process moves from the abstract to the
concrete. Theories (i.e. deontology, teleology) comprise the most abstract level. Principles are next in abstraction and provide general
guidance for decision making. Next come rules which are slightly more specific. Particular actions and judgments are the final most concrete
level in which the specifics of each case must be taken into consideration (p.11). Beucamp and Childress list four general principles for
ethical decision making. They do not prioritize these principles.
• Principle 1: The Principle of Respect for Autonomy. (or self-determination). Respect for autonomy justifies informed consent and
informed refusal. (Beaucamp and Childress, 1994, p.125-128 cited in Reamer, 2005 p.11.)
• Principle 2: The Principle of Nonmaleficence. This principle is based on the Hippocratic oath, and it simply states "first of all do no
harm." (Beaucamp and Childress, 1994, p.125-128 cited in Reamer, 2005, p.11.)
• Principle 3: The Principle of Beneficence. Doing no harm is not sufficient--one has an additional obligation to actively pursue the
welfare of others. (Beaucamp and Childress, 1994 p.125-128 cited in Reamer, 2005, p.11.)
• Principle 4: The Principle of Justice. Justice is described in terms of fairness. Principles used to determinations of justice are equal share,
need, effort, contribution to society, merit, and free market exchange. (Beaucamp and Childress, 1994, p. 125-128 cited in Reamer
Rules for ethical decision making suggested by Beaucamp and Childress (1994, p.395 cited in Reamer, 2005, p.11.) include (1) the rule of
veracity (truth) (2) the rule of privacy (3) the rule of confidentiality and (4) the rule of fidelity (faithfulness to duty).
Each of these models from Reamer has its own strengths and weakness, but each can be used in ethical decision making.
6 Toward a Quality of Life Ethical Paradigm
The following text is a portion of the ethics chapter of Joyce S. McKnight's text "Community Organizing: Theory and Practice" which is in
press at Allyn and Bacon with an anticipated publication date of 2014. All rights reserved.
Toward a Quality of Life Paradigm
This book is based on an explicit values framework that emphasizes humanity’s mutual responsibility for building and maintaining a high
quality of life for everyone. This “quality of life” paradigm moves beyond the industrial paradigm’s emphasis on production and exploitation
of resources to a vision of sustainability and a global commonwealth. The ideas in this section are taken primarily from the work of my
colleague Drew Hyman, professor emeritus of the State University of Pennsylvania who is the inspiration for much of this text.
The Quality of Life paradigm is a vision of a world where everyone has enough. A Quality of Life environment has clean air and water,
sufficient food, medical care, and affordable housing for everyone. Its villages, towns, and city neighborhoods are safe and have a sense of
neighborliness and belonging. Each person has a voice in community decisions and experiences himself or herself as a person of value.
People have a sense of mutual responsibility for important aspects of life, especially for the care of children who are safe and loved.
Diversity is respected, honored, and celebrated. There are opportunities for healthful recreation, learning, and spiritual growth.
These high quality communities will be supported by an economy that does not use up the world’s resources, but uses a sustainable
development model that can be maintained indefinitely (Buck, 2006; UN Department of Economic and Global Affairs: Division of Sustainable
Some basic premises of this model are as follows:
• All life takes place within a natural environment of non-renewable resources such as clean air, pure water, livable temperatures, and
uncontaminated soil. All human and animal life is dependent upon these resources, therefore, economic life must take place within
their limits and cannot be allowed to damage them (UN Department of Economic and Global Affairs, 2007), Sustainable Pittsburgh,
• Economic life should be based on appropriate technology and regional economics, local needs, local resources, local customs and the
application of models that have worked in similar situations. This idea of appropriate, regionalized economics was first introduced by
the British economist E.F. Schumacher in his book Small Is Beautiful: Economics as if People Mattered published in 1965 (Schumacher,
• A positive quality of life does not simply mean job creation. In fact, the whole concept of “jobs” is an invention of the industrial revolution.
In the quality of life world everyone will be engaged in tasks that build community life. There will be more emphasis on actual
production of goods and services and far less emphasis on investments than currently (Perman, 1988).
• While many people will probably still work for wages or salaries, there will be many models of family and self-support including nonexploitive combinations of part-time work, self-employment, and voluntary engagement (Perman, 1988).
• Individuals will have different patterns of work across their lifetimes that fit appropriately into their lives at different stages. For instance,
parents will be better able to balance child-rearing with work without sacrificing either (Perman, 1988).
• Tasks that are socially valuable, but are currently unpaid or underpaid will have value and worth. These include child rearing, community
volunteer work, and artistic expression including poetry (Perman, 1988).
• The social sphere including family, religion, education, cultural activities, and wellness which are dependent on both a sound ecology and
a solid economy will flourish.
• National success will be evaluated on indicators of a healthy, happy population such as increased maternal and child health, reduced
morbidity, increased literacy levels, improved housing conditions and improved air, water and soil quality rather than on the Gross
National Product (UN Department of Economic and Global Affairs, 2007), Sustainable Pittsburgh, 2006).
The Quality of Life paradigm is a synthesis of the warmth of the communal spirit, the scientific and technological methods of the industrial
revolution and the ease of the information age. The Quality of Life world will not only be based on healthy geographic communities, but will
be tied together by many communities of interest united by the internet and other means of global communication.
Creating this post-industrial, Quality of Life world will not be easy. It is predicated on a very different value system than has been the norm
since at least the mid-eighteenth century. A glance at the nightly news shows how far we seem to be from a truly new paradigm. The
industrial paradigm (sometimes also called modernism or globalization) is still largely in control. Its power can be seen in global
dependence on fossil fuels, in the power of multi-national corporations with budgets greater than those of many nations, and in wars
fought for obscure but probably mainly economic reasons. Its costs can be seen in the suffering of millions of civilians, massive refugee
problems, extensive pollution of air and water, loss of animal species and people groups, major climate changes, and the continuing
struggle of working people to be more than “human capital.”
In spite of it all, there is the same hope that Tocqueville (1840) found so long ago and Margaret Mead articulated so well: “Never doubt that
a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has." The change to a quality of
life paradigm will be accomplished “from the ground up” by dedicated people like the ones di ...
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