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Toronto Long-Term Care Homes and Services

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Ethics


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"We are discussing no small matter but how we ought to live."

— Socrates



Ethics


Many people have differing definitions related to ethics and ethical decision-making. Ethics comes from the Greek ethos — a question of good, right, duty, obligations, and morality - or a set of moral principles and values. The definition alone does not provide a lot of guidance re how to make decisions when we face ethical dilemmas — and these occur quite often in our personal and professional lives.

Toronto Long-Term Care Homes and Services has established comprehensive policies and protocols related to guide staff, volunteers and partners in ethical decision-making. We are a values-based organization and work hard to demonstrate these values every day.

In 2006, we developed a Guide to Ethical Decision Making, to assist staff in making decisions when they face ethical dilemmas. This resource document and the ongoing education that we provide re-affirm our core values and our commitment to respecting, supporting and enabling residents and clients to achieve the best possible quality of life, recognizing their own personal values, strengths, desires and needs.

We have also an established Ethics and Research Committee to provide support for staff related to their respective ethical responsibilities and to review research proposals that are consistent with our vision, mission and values.

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Ethical dilemmas:


We understand that there are two basic kinds of ethical dilemmas:

  1. Right versus Wrong
  2. Right versus Right

Right versus Wrong dilemmas are relatively easy to understand — things like how to treat people with respect and how not to use public resources for personal gain. The second type of ethical dilemma — the Right versus Right — involves situations when there are two conflicting sets of "right" values. In these situations, it is more difficult to make the correct decision and where decision-making is helped through an ethics decision-making model.

Our Ethics and Research Committee established an ethics decision-making approach that moves problems and dilemmas through a series of decision-making steps:

  1. define the problem
  2. define the ethics considerations
  3. Identify obligations & responsibility & explore alternatives;
  4. Examine feelings, beliefs & reasoning
  5. Critique, implement (using key principles of ethical decision making) and evaluate

In addition, it is often helpful to apply an ethics lens to the ethical problem being faced:

P = Policies: Is it consistent with the organization's policies and procedures?
L = Legal: Is it acceptable under applicable laws and regulations?
U = Universal: Does it conform to the universal values the organization has adopted?
S = Self: Does it satisfy personal definition of right, good and fair?

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Ethics framework


The Toronto Public Service Framework defines our responsibilities for:

  1. Service;
  2. Stewardship
  3. Commitment

As part of the Toronto Public Service, we:

  1. act with integrity and
  2. apply judgement and discretion to serve the public well, serve City Council well, serve the public service well, maintain political neutrality and use our resources responsibly

Toronto Long-Term Care Homes and Services uses an ethics framework to develop policies and protocols related to, but not limited to:

  1. informed consent
  2. resource allocation
  3. life care directives
  4. confidentiality
  5. conflict of interests
  6. conflict resolution
  7. care and service issues, as they relate to protection of rights;
  8. professional (clinical) decision-making
  9. administrative decision-making

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Advocacy and ethical decision-making


Toronto Homes for the Aged is deeply committed to advocacy. We have clear standards and expectations for working with residents, clients and/or their family members to plan care and service in a manner that respects rights and to resolve any concerns and issues that may arise. We are extremely proud of the fact that we have a dedicated Resident — Client Advocate, who is available to provide advice and support to residents, clients, families, staff and/or volunteers who are seeking assistance in navigating the system to find a solution for an issue.

Toronto Long-Term Care Homes and Services is committed to respecting, supporting and enabling residents' and clients' rights to dignity, self-esteem, decision-making and independence. We are also committed to ongoing quality improvement in all that we do. We are committed to providing an open, responsive and respectful environment where residents/clients and family members feel comfortable in expressing concerns, issues and suggestions and where we can work together to resolve any issues or concerns.


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