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The nature of disasters and their challenges to healthcare ethics / JEFFERY EVANS

Swansea University Author: JEFFERY EVANS

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DOI (Published version): 10.23889/SUthesis.61567

Abstract

Disasters are exceptional events that cause damages on a scale that result in widespread unmet human needs that are critical and urgent. The exceptional circumstances in disasters may render established ethical norms of healthcare practice inapplicable or inappropriate. Healthcare professionals who...

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Published: Swansea 2022
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Calder, Gideon ; Upton, Hugh
URI: https://cronfa.swan.ac.uk/Record/cronfa61567
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first_indexed 2022-10-17T08:59:38Z
last_indexed 2023-01-13T19:22:24Z
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spelling 2022-10-17T10:19:47.6344214 v2 61567 2022-10-17 The nature of disasters and their challenges to healthcare ethics b2317f13c1b7d6a6333c5101a3011994 JEFFERY EVANS JEFFERY EVANS true false 2022-10-17 Disasters are exceptional events that cause damages on a scale that result in widespread unmet human needs that are critical and urgent. The exceptional circumstances in disasters may render established ethical norms of healthcare practice inapplicable or inappropriate. Healthcare professionals who work in disasters are faced with choices that have direct impacts on the life, death, and suffering of both disaster victims, and themselves. Some choices faced may be dilemmatic choices between competing irreconcilable moral principles. Whilst some choices reflect uncertainty as to how to realise moral precepts. In these situations, there is an appeal for guidance that is fitted to the circumstances found within disasters. Appealing to codes of professional conduct and ethics is problematic as many codes are either silent on the difficulties encountered in disasters, or overly demanding through the use of imperative language. Considering the relative weakness of published codes, universal principles of first do no harm and do good are offered as guiding principles. However, in disasters opportunities exist for harming through nondoing, creating the possibility that as aid is rendered to some, harm is occasioned to others. When considering doing good in disasters, maximising aggregate benefit is the established ethical framework employed. However, this framework’s foundational assumptions of aggregation of benefits and harms, commensurability of different ends, and the privileging of the greater number are open to critique. Thus, the principles of first do no harm and do good are problematic in disaster settings. Virtue ethics is proposed as a novel response to the difficulties faced by healthcare professionals in disasters. Virtue ethics provides an account of the healthcare professional as one who must choose with wisdom, courage and integrity in exceptional circumstances. Further, virtue ethics provides an understanding of how it is possible to act well in the tragic circumstances found within disasters. E-Thesis Swansea Disaster, disaster ethics, healthcare ethics, virtue ethics, triage 12 10 2022 2022-10-12 10.23889/SUthesis.61567 ORCiD identifier: https://orcid.org/0000-0001-7914-2586 COLLEGE NANME COLLEGE CODE Swansea University Calder, Gideon ; Upton, Hugh Doctoral Ph.D 2022-10-17T10:19:47.6344214 2022-10-17T09:54:29.5242975 Faculty of Humanities and Social Sciences School of Culture and Communication - Politics, Philosophy and International Relations JEFFERY EVANS 1 61567__25473__b899bf13e6ab411ba8cbae225bb61561.pdf Evans_Jeffery_PhD_Thesis_FINAL_Redacted_Signature.pdf 2022-10-17T10:12:04.4594954 Output 1523798 application/pdf E-Thesis – open access true Copyright: The author, Jeffery Evans, 2022. Released under the terms of a Creative Commons Attribution-Non-Commercial No–Derivatives (CC-BY-NC-ND) License. Third party content is excluded for use under the license terms. true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title The nature of disasters and their challenges to healthcare ethics
spellingShingle The nature of disasters and their challenges to healthcare ethics
JEFFERY EVANS
title_short The nature of disasters and their challenges to healthcare ethics
title_full The nature of disasters and their challenges to healthcare ethics
title_fullStr The nature of disasters and their challenges to healthcare ethics
title_full_unstemmed The nature of disasters and their challenges to healthcare ethics
title_sort The nature of disasters and their challenges to healthcare ethics
author_id_str_mv b2317f13c1b7d6a6333c5101a3011994
author_id_fullname_str_mv b2317f13c1b7d6a6333c5101a3011994_***_JEFFERY EVANS
author JEFFERY EVANS
author2 JEFFERY EVANS
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institution Swansea University
doi_str_mv 10.23889/SUthesis.61567
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hierarchy_top_id facultyofhumanitiesandsocialsciences
hierarchy_top_title Faculty of Humanities and Social Sciences
hierarchy_parent_id facultyofhumanitiesandsocialsciences
hierarchy_parent_title Faculty of Humanities and Social Sciences
department_str School of Culture and Communication - Politics, Philosophy and International Relations{{{_:::_}}}Faculty of Humanities and Social Sciences{{{_:::_}}}School of Culture and Communication - Politics, Philosophy and International Relations
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description Disasters are exceptional events that cause damages on a scale that result in widespread unmet human needs that are critical and urgent. The exceptional circumstances in disasters may render established ethical norms of healthcare practice inapplicable or inappropriate. Healthcare professionals who work in disasters are faced with choices that have direct impacts on the life, death, and suffering of both disaster victims, and themselves. Some choices faced may be dilemmatic choices between competing irreconcilable moral principles. Whilst some choices reflect uncertainty as to how to realise moral precepts. In these situations, there is an appeal for guidance that is fitted to the circumstances found within disasters. Appealing to codes of professional conduct and ethics is problematic as many codes are either silent on the difficulties encountered in disasters, or overly demanding through the use of imperative language. Considering the relative weakness of published codes, universal principles of first do no harm and do good are offered as guiding principles. However, in disasters opportunities exist for harming through nondoing, creating the possibility that as aid is rendered to some, harm is occasioned to others. When considering doing good in disasters, maximising aggregate benefit is the established ethical framework employed. However, this framework’s foundational assumptions of aggregation of benefits and harms, commensurability of different ends, and the privileging of the greater number are open to critique. Thus, the principles of first do no harm and do good are problematic in disaster settings. Virtue ethics is proposed as a novel response to the difficulties faced by healthcare professionals in disasters. Virtue ethics provides an account of the healthcare professional as one who must choose with wisdom, courage and integrity in exceptional circumstances. Further, virtue ethics provides an understanding of how it is possible to act well in the tragic circumstances found within disasters.
published_date 2022-10-12T04:20:29Z
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