Ethics of care and the ethics of justice in ethical decision making in the health team

Abstract

Inaugural lecture--Dept. of Nursing, Rand Afrikaans University, 27 August 1997

From case studies it appears that nurses and doctors as central agents in ethical decision making in the health team, approach ethical problems from two different and opposing perspectives. The way in which doctors make ethical decisions is associated with Kohlberg's (1981) ethics of justice, while the ethical decisions made by nurses are associated with Gilligan's (1982) ethics of care. There is little or no interaction between the different disciplines in the health team when ethical decisions are made. Such a situation leads to ineffective ethical decision making since it involves conflict and unnecessary physical and mental suffering with accompanying financial implications. A possible solution to this problem is the complementary use of the ethics of justice and the ethics of care in ethical decision making in the health team. The way in which the two ethical perspectives are used complementary to one another is through discourse which involves a wider rationality model and ethics of virtues are used. This solution is found in an investigation into the nature of the two ethical perspectives. Such a solution makes interaction possible, and probably also more effective ethical decision making without expecting significant paradigm changes in the two disciplines.