Science and Problem Solving Techniques
The Search for Solution
- Theory versus Reality: One Professions Approach to Identifying Values
- Influencing Factors
- Some Different Types of Perspectives
Theory versus Reality: One Professions Approach to Identifying
Ethics or moral philosophy is the study of the principles and
methods for distinguishing right from wrong and good from bad.
A related field called metaethics tries to determine the meaning
of ethical terms such as the words "right" or "wrong".
Philosophers such as Kant, Aristotle, and Plato have written complex
texts about these fundamental issues.
Ethical problems in medicine have long posed real life tests of
how well these theoretical principles are able to assist physicians
in making responsible decisions which may have legal and moral
consequences. Bioethics and medical ethics are fields of study
composed of experts using a multi-disciplinary approach to analyze
possible options in complicated cases. A professional code for
ethical behavior, which has grown out of Western traditions, helps
make these hard decisions. Health providers should choose an action
- Benefits the patient - life is sacrosanct (beneficence).
- Does no harm unless balanced by the hope for improvement (non-maleficence).
- Is even handed in allocating scarce resources- characterized
by fairness (justice ).
- Respects others as equal partners in making a decision (autonomy).
The tricky part is that in any given situation, some of these
values may be in direct conflict and require prioritizing. (Ref:
Ernle Young, Alpha and Omega; Ethics at the Frontiers of Life
Looking at all sides of a conflict is not an easy task. Factors,
which we may not be aware of, contribute to our understanding
(or misunderstanding) and hence, influence the final choice. Consequently,
people involved in the same conflict may arrive at different solutions
using the following:
- Context, the circumstances surrounding the issue, influences
what parts are thought important or unimportant. For instance,
if the individuals in a conflict are acquainted, the nature of
the relationship matters. The bond between family members is very
different than the one between friends. Gender, past experiences,
education and age also act as a frame, modifying how the problem
and the consequences are viewed.
- Values, which are personal beliefs, are learned from
traditional sources such as family, religion and school. They
form an underlying framework which focuses our attention on certain
aspects of a problem and advocates a particular course of action.
Values vary from individual to individual reflecting cultural,
religious and other personal experiences.
- Principles are equations which assist with conflicting
values by giving greater "weight" to one particular
value. Adhering faithfully to a particular principle is a requirement
of our conscience, although experience may modify the priority
given to any one value.
- Perspective is a way of viewing the world - a particular
frame of reference or "lens" through which certain principles
Here is a story which might help clarify your understanding of
some of the words just described:
The setting is in California and the conflict about the use of
medicinal marijuana. In November of 1996, Californians were asked
to vote on a voter's initiated ballot measure. Among other things,
Proposition 215 exempted patients and defined caregivers
from criminal prosecution for the possession and cultivation of
marijuana for medical treatment when recommended by a physician.
As of November 6, 1996, with 78% of the precincts reporting, 56.1%
of California voters, voted "yes" on Proposition
215. The results of court challenges are not known as of the publication
Jane, who is a law abiding, caring person, believes that people
should have access to drugs which provide relief to those suffering
from the side effects of chemotherapy used to treat cancer and
AIDS. Jane's friend, John is confined to bed while receiving intravenous
therapy. He has nausea and weight loss from his chemotherapy and
he requests that Jane purchase some marijuana for him, as has
been recommened by his doctor.
Jane is genuinely concerned about her friend's physical health,
but she has observed what she believes is John's developing psychological
dependence on marijuana. To be consistent with her view about
access to drugs in the face of suffering, she feels obligated
to buy the marijuana for John. However, she is troubled by the
thought that giving drugs to her friend might also be harmful.
What if John were injured or injured someone else while driving
under the influence of marijauna?
Jane's values include honoring the quality of her friend's life,
responding to requests for help, and obeying the law. These values
are in conflict, creating a dilemma. Jane must set some priorities
and realize that a course of action can, on the surface, appear
contrary to her feelings about drug access, but at the same time,
be internally consistent with principles having higher priority
such as obeying the law or not harming others. Meeting her friend's
need for more marijuana does not have to outweigh all the other
values. Her perspectives may include both a belief in law and
order and a strong need to maintain her friendship.
How does she go about prioritizing the conflicting values and
arriving at a decision which honors her values and also respects
The following are examples of perspectives which have been described
by educators and psychologists after interviewing adolescents
and adults. These perspectives, which are practical rather than
theoretical, may co-exist in one individual and are not mutually
exclusive. They may produce different approaches to the same conflict
and lead to different courses of action.
- Perspective of Justice: Conflicts are:
viewed from the perspective where you think of yourself as a separate
person from others. You think of others as you would like them
to think of you. Relationships are defined by rules and obligations
to a particular role in life.
approached by referring to impartial rules or standards. When
deciding on a course of action, you consider what your obligations
are and how you would like to be treated if you were in the other
- Perspective of Care: Conflicts are:
concerned with issues that involve maintaining relationships.
You might see yourself connected rather than separate from others.
You view others in their own situations and contexts.
approached by responding to others on their own terms. The welfare
of others is emphasized. You try to do no harm and to relieve
- Perspective of Fairness or Equality: Conflicts:
come from a need to balance resources or desires among
individuals or groups.
are evaluated by deciding on how an ideal group of people, blind
to their own needs and desires, might have concluded was fair
when originally faced with a similar problem. In principle, no
one benefits at the expense of another, particularly if that person
can least afford the sacrifice.
In selecting a course of action, a particular perspective is defined
by the answers to these questions:
- What is more important, my needs or the other person, group
- Are maintaining relationships or adhering to impartial standards
or rules more important?
- Are there inherently right and wrong choices or are the standards
for deciding what is fair purely arbitrary? What makes an action
right? By whose rules do we abide?
- Is equality the best definition of what is appropriate behavior
Anxiety plays a big role in making the final decision. Too many
trade-offs or compromised principles increase the level of anxiety
felt. If a choice becomes too difficult, then no course of action
is taken, which, of course, represents a decision. Experience
gained from any course of action often affects subsequent behavior
by modifying priorities and perhaps reducing anxiety.