“It really doesn’t matter whether you are Muslim or Christian or Jew. In every religion, in every country, in every region at every time, there are some basic principles. We all know what good is, what correct is, what obligatory is – all those things that compose ethics. They are the same.”
— Sergio Munoz, executive editor of La Opinion
Multiculturalism, diversity, and cultural competency are currently hot and important topics for health professionals and have been for some time. So many philosophers have predicated differing value systems based on these cultural differences, and so many conflicts have arisen among and between persons who hold to distinctly different religious traditions, that many people believe there is no such thing as a universal value. Many also believe that there are no rights or wrongs in human conduct, only varying assumptions based on transient beliefs conditioned by circumstances. Each person must create his or her own reality — and that includes a personal concept of right and wrong, good and bad. This was the state of secular philosophy at the dawn of the 20th century, and, in many ways, the anguished cri de coeur of the existentialists — and people are left rootless, like so many leaves scattered in the wind.
The situation in science was quite different 100 years ago: scientists around the world believed that they had arrived at an accurate picture of the physical world. Indeed, many scientists proclaimed that the study of the physical world was complete: no big discoveries were left to be made, and all future work in science would be but an explanatory footnote. Strict adherence to the immutable laws of science and reason offered assurance in an insecure world! Such arrogant certitude, however, was soon to be shattered, and who would believe that science — pure, theoretical physics — would prove, beyond a reasonable doubt, that the ancient metaphysicians were pretty much on target?
The scientific foundations of ethical concern
But I’m getting ahead of myself. Let us put a timeline on the scientific developments that led to the rebirth of a “philosophical” system, and thus the possibility of an ethical system. In the 1890s, when all of physical science was thought to be known, Roentgen discovered X-rays that passed through flesh. How could this be? Then Henri Becquerel puzzled over the ability of a metallic element (uranium) to cloud a photographic plate even though it had no direct contact with it! How could this be? And in 1897, J.J. Thompson discovered the electron—a tiny particle that seemed to “carry” electricity. Physicists studied these phenomena, and others that followed them, and postulated that each represented energy that took the form of continuous, flowing waves. In fact, the recognition that all forms of energy shared this wave-like nature was one of the great discoveries of the late 19th century. The problem is, as Max Planck proved a few years later, energy did not consist of waves, but rather of particles, which he called “quanta,” that usually, but did not always, flow in wave-like patterns.
Two decades later, Albert Einstein determined that light itself was composed of particles, which he named photons. Eventually, Einstein developed his Theory of Relativity (the balance of matter and energy in the universe), and the atomic age was born. However, two decades after that (1964), J.S. Bell uncovered the unity of the subatomic world, and postulated that all-that-is is fundamentally inseparable. What came to be known as Bell’s Theorem was later confirmed experimentally by Alain Aspect at the University of Paris in 1972: a discovery described by physicist Henry Stapp of the University of California at Berkley as “the most profound discovery in the history of science.”
Meanwhile, David Bohm of London’s Birbeck College published Wholeness and the Implicate Order in which he postulated that both the material world and consciousness are one: parts of a single unbroken totality of movement. According to Bohm, the totality of existence is enfolded within each “fragment’” of space and time. Thus, a single object, thought, or act affects—however infinitesimally—everything else because all are part of the same unbroken whole. This is what Camus meant when he said, “When I choose for myself, I choose for all mankind.” This is what the Taoists mean when they say, “If you cut a blade of grass, the universe trembles.” And this is what Jesus Christ meant when he said, “Whatsoever you do…you do unto me.” What is yet to be understood is how the individual exists within the whole, and the whole exists within the individual. What is even more puzzling, if possible, is how intentionality is infused? Formed? Directed?
Thus scientists and philosophers have come full circle: Physics quite literally became metaphysics, and ethical systems now make sense. They are, in fact, demanded by the findings of science. The leaves finally have learned that they are part of the tree!
Ethics in the new age
Neils Bohr, one of the most important scientists of this century, said: “Anyone who is not shocked by quantum theory, does not understand it.” Indeed! Perhaps because its implications are beyond our capacity to comprehend, we humans stubbornly continue to focus on fragments rather than the whole. Our preference for fragmentation is manifested in our language, laws, and behaviors. It’s even become politically correct: We are not one, we are many, so celebrate the diversity, respect it, promote it, despite the fact that it feeds the human inclination to isolate people and groups as “other” than oneself, thus “justifying” prejudice, selfishness, privilege, greed—even genocide.
People create barriers between themselves and others by focusing on nonessentials like economic status, race, disability and the like (what the old “natural law” philosophers used to call the accidents of the human condition; i.e., those conditions which have nothing to do with your worth as a human being) and ignoring the essentials, including that we are all fundamentally one. Thus, more people were agitated than comforted when Rush Kidder found substantial agreement among people who represented all the major races, religions, and political systems about what is important in life (we call them values). Kidder interviewed two dozen “men and women of good conscience” (so identified by the people from their own culture/religion/country) from around the world and asked them two questions: Is there a single set of values that wise, ethical people from around the world use to make decisions? And, if there is a common core of values, can it be identified and articulated? The answer was “Yes.” And the values they identified, in descending order of importance include the following:
Love — defined as a strong and spontaneous willingness to reach out to others in need. Of all the world’s proverbs and parables, perhaps the one that best expresses this kind of love is the story of the Chinese farmer who, while gathering his rice harvest high up on the side of a mountain near the sea, happened to look out over the ocean and saw the first signs of a tidal wave heading rapidly their way. He looked down the mountain at his neighbors gathering in their harvests, knowing that there was no time to warn them all. So, thinking quickly, he set fire to his field, ands rang the temple bell to summon help. All who came to help him were saved from the tidal wave. “For it is in giving that we receive…”
Truthfulness — not brutal honesty but rather an honesty of intent and purpose (even when one’s perceptions differ), for it is in sharing each person’s interpretation of fact that we come to some approximation of truth. In all cultures. Everywhere. The most pertinent story that illustrates this value may well be the time-honored story about the three blind men and the elephant. Each approaches the elephant and explores its body with his hands, and then each describes the elephant: “An elephant is long and flexible,” claims the one who touched the trunk. “No,” says the second, “It is large and very thin and rounded, like a huge cabbage leaf” asserts the one who felt the elephant’s ear. “You are both wrong!” claims the third who came into contact with the elephant’s hindquarters, “an elephant is huge and roughly rounded as a boulder with legs like tree trunks,” he confidently claimed. Each is right—and it is in hearing and believing that each is right that we come to some idea of the truth.
Fairness — Fairness means treating people equitably, without bias or partiality. It means actively working to set aside self-interest or group loyalty when rendering a judgment. In day-to-day life, fairness manifests itself in simple ways such as taking turns, listening intently, sharing, and not taking advantage of others based on their weaknesses. Impartiality is a key part of fairness. Being impartial doesn’t mean having no biases—rather it means knowing what those biases are, striving to set them aside, and requesting outside perspectives as needed. While inspired by the ideal of justice, fairness is not necessarily treating all people the same, nor is it following the letter of the law. Fairness makes room for us to generate solutions and compromises based on reason and circumstance.
Freedom — not a license to do whatever one wishes, but rather a fundamental recognition of the human need for freedom of conscience. A great Indian leader Bal Gangadhar Tilka said, “Freedom is my birth right and I shall have it. But even this has limits.” Oscar Arias, former president of Costa Rica, put it this way: “Without the principle of individual conscience, every attempt to institutionalize ethics must necessarily collapse… World leaders may see their effect in headlines, but the ultimate course of the globe will be determined by the efforts of innumerable individuals acting on their consciences.”
Unity — all of the emphasis on diversity is in direct opposition to the sentiments expressed by the respondents. Dame Whinna Cooper, a New Zealand Maori, said, “I want unity. God wants us to be one people.” All prejudice arises when we focus on our differences—and use them as justification for claiming our own superiority or entitlement. Individualism, as it often is interpreted today, is destructive. Fr. Bernard Przewozny, the Vatican delegate to the World Council of Churches’ Conference on Justice, Peace and Integrity of Creation, elaborated further: “…individualism, carried to the extreme, is destructive of social life, destructive of communal sharing, destructive of participation…the world and its natural goods are the inheritance of all peoples.”
Tolerance — Graca Machel, the first lady of Mozambique, said in respect to tolerance, “It is a question of respect for the dignity of each of us. If you have a different idea from mine, it’s not because you are worse than me. You have the right to think differently.” Ideas, and the way in which each of us choose to interpret and express values are what constitutes the vast majority of our differences…and when such differences are suppressed, each one of us is diminished. Environmentalist Kenneth Boulding explained it this way, “If the blue whale is endangered, we feel worried about this because we love the variety of the world…In some sense I feel about the Catholic Church the way I feel about the blue whale: I don’t think I’ll be one, but I would feel diminished if it became extinct.” And this attitude is what the two-dozen men and women of good will think will allow for diversity in our unity!
Responsibility — the emphasis here is not so much on the actions of the future, as on a self-respect in the present. “This is Confucius’ teaching,” says Nien Cheng, “You must take care of yourself. To depend on others is a great shame.” Too often we speak of rights…but they are no more important than responsibilities. Also given very high marks were respect for life, courage, wisdom, hospitality, peace, stability, women’s place, and protection of the environment. Each deserves — needs — more discussion and clarification to ensure that there are no misunderstandings. So say the people of this world!
Ethical principles for nurses
Professional ethics derive from the profession; quite literally the “public promises” (Latin: profitere), which comprise the profession’s social contract: to do no harm, to act in the patient’s best interests, to keep in confidence all private matters entrusted to one, to maintain competence, and to advocate for the patient’s needs. Thus, for the professional, the public commitments of his or her profession expand the demands of honesty to include fidelity to these commitments. Therefore, professional ethics are deontological, or duty-oriented: All issues and actions are analyzed through the prism of one’s professional obligations.
Ethical decision-making and behavior helps to reconcile perspectives and interests, and to keep values and mission uppermost in one’s mind. In the process, ethical behavior — walking your talk — establishes long-term relations of trust and cooperation, regardless of your ethnicity, gender, or religion.
Leah Curtin is Executive Editor, Professional Outreach for American Nurse Today.
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