Worldviews: The Foundation of Ethics

HAS 6000

Dr. Burton

JCAHO Standards• RI 2.10 The hospital respects the rights of

patients:– Elements of Performance

2. Each patient has the right to have his or her cultural, psychosocial, spiritual and personal values, beliefs and preferences respected

4. The hospital accommodates the right to pastoral and other spirituals services for patients.

• RI 2.220 (LTC only) Residents receive care that respects their personal values, beliefs, cultural and spiritual preferences, and life-long patterns of living

If we are to comply with JCAHO standards, how important is it to understand the differing worldviews on which our patients base their values and spiritual beliefs as well as knowing our own?

Five Questions about WV

1. What is ultimately the prime reality? (...such as "God", or Matter/Energy)

2. What is the basic nature of the universe?

3. What is the basic nature and condition of man?

4. What happens to man at death?

5. What is the reason or basis of ethics and morality?

Conflicting world views?

“I am aware that no one….is neutral on such emotionally charged issues. None of us can tolerate the notion that our worldview may be based on a false premise and, thus, our whole life headed in the wrong direction.”

Dr. Armand M. Nicholi Jr.

“Most of us make one of two basic assumptions:

we view the universe as a result of random events and life in this planet is a matter of chance;

Or we assume an Intelligence beyond the universe who gives the universe order, and life meaning.”

Dr. Armand M. Nicholi Jr.

The basis for an approach to ethics

• Worldview establishes the foundation that individuals rely on to form their approach to ethics. There are two fundamental worldviews from which ethics and values manifest in behavior and decision-making:– A belief that humans are created beings

accountable to a creator.– A belief that humans evolved from the result

of a chance event.

Worldview.

“Every individual bases his thoughts, decisions and actions on a worldview.”

“Because worldviews are pertinent to every person’s life—the way we think and the way we act—and because virtually all worldviews promise salvation or utopia, the study of worldviews is of critical importance.”

David Noebel

“Our worldview informs our personal, social, and political lives. It influences how we perceive ourselves, how we relate to others, how we adjust to adversity, and what we understand our purpose to be.”

Dr. Armand M. Nicholi Jr.

“Our worldview helps determine our values, our ethics, and our capacity for happiness. It helps us understand

where we come from, our heritage; who we are, our identity; why we exist on this planet, our purpose;what drives us, our motivation; and where we are going, our destiny.”

Dr. Armand M. Nicholi Jr.

Theism Pantheism AtheismJudaism

ChristianityIslam

HinduismBuddhismNew Age

NaturalismHumanism

Marxism/LeninismNihilism

Theism

EasternPantheistic

Monism

Deism

Naturalism

NihilismExistentialism

New Age

Postmodernism

Animism

Historical development of world views.

The European Worldview: We are randomly

assembled protoplasm living in a contract culture.

Classical American Worldview: We are created beings

endowed with certain inalienable rights

Newt Gingrich 1/12/05

The Law of Non-Contradiction

"One cannot say of something that it is and that it is not in the same respect and at the same time.“

Aristotle

“There is no absolute truth”

Is that absolutely true?

“…in all of my years in public life I have never obstructed justice...People have got to know whether or not their President is a crook. Well, I'm not a crook.“

Richard M. Nixon

Bill Clinton testifying before a Grand Jury.

"It depends on what the meaning of the word 'is' is.

If the--if he--if 'is' means is and never has been, that is not--that is one thing. If it means there is none, that was a completely true statement.... Now, if someone had asked me on that day, are you having any kind of sexual relations with Ms. Lewinsky, that is, asked me a question in the present tense, I would have said no. And it would have been completely true.“

• Abstract: The court has ordered HCA Inc to pay the US $631 million in civil penalties and damages arising from false claims the government alleged it submitted to Medicare and other federal health programs. The settlement, which was announced in June, resolved HCA's civil liability for false claims resulting from a variety of allegedly unlawful practices, including cost report fraud and the payment of kickbacks to physicians.

– Frist company fraudRussell Mokhiber. Multinational Monitor.  Washington: Jul/Aug 2003.Vol.24, Iss. 7/8;  pg. 40

HCAHospital Corporation of America

The owners of a nursing home where 34 residents are believed to have drowned during Hurricane Katrina were charged Tuesday with negligent homicide. … "They were warned repeatedly that this storm was coming. In effect, their inaction resulted in the deaths of these patients." Neighbors described a horrible scene that unfolded on Aug. 29, the day Katrina hit. Floodwaters rose to the roof of the one-story nursing home in St. Bernard, outside New Orleans, trapping elderly and infirm residents inside. Neighbors came in boats and smashed a hole in the roof."We tried to get out as many as we could," said Steve Snyder, 29, an oil rig worker. "All we could go by was the hollering and screaming, 'Help, help!' ""We got 25 to 27 people out alive," Snyder said. "And then we didn't hear any more screaming, any more people calling for help.“

……"He was sure the levees were going to hold, and if he put people on the bus, there was a good chance of losing two or three people on the ride to Lafayette,"

PAS

According to an article by USA Today (1998-JUL-6) physician assisted suicide is:

• Permitted in Oregon under very tightly controlled conditions. Not specifically mentioned in the laws of North Carolina, Utah and Wyoming. Specifically criminalized in the remaining states.

• In Canada, assisted suicide comes under a Federal law and is thus a criminal act everywhere in the country.

Hemlock SocietyHemlock extols assisted suicide for elderly people who

are not ill.• "Some couples choose to die together, regardless of

whether both are in poor health, or only one….That the couple would wish to die together is a tribute to the strength of a loving relationship."

Derek Humphry, Final Exit, (Hemlock Society, 1991), Chapter Twenty: "Going Together," p. 101. Humphry and his wife, Ann, co-founded the Hemlock Society.

• "Ending your life can be complex, you only do it once, and failure could be disastrous."

Self-Deliverance: Helium," Hemlock's EOL Choices, Vol. 1, No. 1, Winter 2002, p. 5.

* Note:  In mid 2003, the Hemlock Society changed its name to "End-of-Life Choices."  At the end of 2004, End-of-Life Choices merged with Compassion in Dying.  The organization is now known as "Compassion and Choices." http://www.internationaltaskforce.org/hemlockcf.htm

The beginning of life?

FINE’

?