Framework on MORAL Balance

Ethical Analyses

Mon, 01 Jan 0001 00:00:00 +0000

The below are ethical analyses using the MORAL Balance framework.

Please note we are not recommending any particular course of action in specific circumstances. Different people and institutions will weigh the Balancing Box differently.
That is to be expected.

Rather the framework is an aid to objectively describing an ethical situation, establishing facts and outcomes of relevance, providing a tool for balancing competing demands and a method for documentation.
This is useful for decision-making, communication, and conflict resolution.

Ethical Theory

Mon, 01 Jan 0001 00:00:00 +0000

Adapted and taken from our BJA Education paper

The Four principles #

In medical school, if you could spell non-maleficence you passed the exam. The four principles are much more than this.
They can help you make objective ethical decisions at the bed space that are individualised to the patient, time and place.

Beauchamp and Childress’s four principles were first published in 1979 in their seminal book, Principles of Biomedical Ethics. The four principles are best understood as a distillation of the ethical theorems that preceded them (Table 1). One common criticism is that the principles are often in conflict with one another and are thus of little practical use. In fact, the inevitable conflict between principles represents the strength of this approach and superiority over alternative ‘mono-ethical’ approaches.

Introduction

Mon, 01 Jan 0001 00:00:00 +0000

Introduction #

One of the factors that leads to high levels of health professional burnout is moral distress. Moral distress can occur when doctors and nurses feel unable to do what they perceive to be the right thing or when faced with ethical uncertainty. It is therefore of no surprise that moral distress occurs frequently in critical care. The continuing capacity of technology and medical advances to improve our ability to maintain life, leads to the question of whether critical care is prolonging life or merely prolonging existence.