participants (Schwitzgebel et al.
2012
p. 331). They examined whether participants talked
loudly during the sessions, let the door slam when entering or leaving the sessions, and left
trash and cups behind at the end of the sessions. However, the results of the three measures
did not demonstrate a significant difference between the courtesy of ethics philosophers and
non-ethics philosophers. In other words, the hypothesis that the engagement in ethics
would improve moral behavior was not supported by the results (Schwitzgebel et al.
2012
).
This situation may be illuminated by three suppositions. First, as the aforementioned
studies show, ethics education does not directly develop ethical behavior. Second, a
correlation between teaching ethics and virtuous conduct may exist, but shortages or
shortcomings of ethics education preclude the emergence of possible positive conse-
quences. Third, there are methodological defects of the research seeking to prove the
influence of teaching ethics on moral behavior. However, instead of choosing one of
these options, maybe some other questions should be asked, such as
‘
should ethics
education change individuals
’
character or behavior?
’
, is it an ethical and real expec-
tation to desire to change one
’
s character, especially in adult education?
’
, or
‘
does the
teaching of ethics differ from the teaching of other subjects?,
’
and so on.
In terms of the method of teaching ethics, Bayard L. Catron (
1989
) underlines a
close relationship between ethics and conduct and claims that the teaching of ethics is
not different from the teaching of other subjects. Catron (
1989
) looks at teaching ethics
as conveying the knowledge of ethics and likens the role of ethics professors to retailers
who sell knowledge. In
the Vocation Lectures
, Max Weber (
2004
) explains young
American students
’
attitudes by their tendency to equate a teacher
’
s effort to that of a
greengrocer
’
s work; the former sells knowledge, while the latter sells cabbage. Weber
(
2004
) emphasizes the students
’
expectation of teachers being leaders in their fields.
Nevertheless, Weber (
2004
) calls to his students as:
Fellow students! You come to our lectures with the expectation that we will be
leaders, but you do not say to yourselves beforehand that out of one hundred
professors, at least ninety-nine
…
neither claim, nor have any right to claim, to be
B
leaders
^
of any kind in matters of conduct (p. 25).
From this perspective, if a professor in management is not expected to be an
outstanding leader, if a professor in economics is not expected to be a successful
CEO, or if a professor in political science is not expected to be an inspiring politician,
why is a professor in ethics supposed to be a role model of virtuous behavior?
Moreover, why is the teaching of ethics considered more complex than the teaching
of other subjects? In light of Weber
’
s and Catron
’
s approaches, an ethicist or a professor
in ethics is merely a person selling her/his knowledge, like other professors in other
academics disciplines.
It is an ideal situation to expect behavioral changes or influences from education.
However, expertise in knowledge does not bring about expertise in practice per se. For
Determining the goals of ethics education
133
example, being an exceptional soccer player does not mean to be an excellent soccer
coach, and vice versa because each person cannot successfully transfer knowledge into
practice. This circumstance is valid for all academics areas including teaching ethics.
As the research carried out by Schwitzgebel and his colleagues (
2012
) shows, if ethics
education does not engender a remarkable difference in ethics professors
’
moral
conduct, how would it be realistic to expect changes in ethical behavior of students/
individuals with limited knowledge of ethics? Of course, teaching ethics may create
perfect role models of virtuous conduct, but lack of this should not be regarded as the
failure of ethics education. The expectation of changes in ethical behavior points out the
desire for character education which is a traditional approach in moral
education (Narvaez
2006
).
Some approaches about ethics education
The issue of whether education should instill a particular moral character is one of the
essential subjects of ethics education. The response to this circumstance is directly
related to the apprehension of the role of teaching ethics. UNESCO
’
s COMEST Report
delineates the aim of ethics study as follows:
–
the study should increase the students
’
awareness of ethical issues
–
provide a deep understanding of ethical matters and greater clarity in ethical
questions
–
place ethical problems in a wider context and make explicit the alternatives that we
may choose from, and how their various positive and negative consequences are
experienced by those who are affected
–
develop the skill for ethical analysis and argumentation
–
determine areas where social practice or legislation is at odds with ethical stand-
points which seem to be well-founded (p. 11).
Therefore, even though the Report calls attention to the improvements in ethical
awareness, the insight of ethical issues, and the judgement of ethical problems, it does
not mention the necessity of any character changes.
Darcia Narvaez (
2006
) touches on two major approaches in ethics education,
traditional character education and rational moral education, and suggests a third
approach as integrative ethical education for shaping the moral development of
children. According to Lapsley and Narvaez (
2006
), the moral formation of
children is a classic objective of formal education. However, children
’
s first
educational institutions and their first teachers are their parents who inculcate in
the children certain moral values (Gutmann
1999
). Therefore, not just formal
education, but also informal education aims to contribute to childhood moral
development. Nonetheless, traditional character education does not represent a
liberal moral formation of individuals; it denotes the transmission of packaged
moral norms, which may come from the family
’
s, school
’
s, church
’
s, or state
’
s
moral acceptances, and the compliance with these norms (Lapsley and Narvaez
2006
).
The second approach Narvaez (
2006
) mentions is rational moral education, also
known as the cognitive-developmental approach, which
B
seeks to facilitate the
134
E. Avci
development of autonomous moral judgement and the ability to resolve disputes and
reach consensus according to canons of fairness
^
(p. 703). Traditional character
education tries to instill in individuals a particular morality, whereas rational moral
education strives to teach individuals how to establish good moral character without
imposing a specific morality. The former limits the learner to a ready-made moral
system, but the latter empowers the learner to discover all moral systems and build her/
his own moral character. For this reason, in traditional character education, the educator
aims to directly shape the learner
’
s moral acceptances, while in rational moral educa-
tion, the educator only helps the learner to improve her/him moral judgement.
Traditional character education might be criticized due to its authoritarian aspects,
and rational moral education could be denounced because of not containing certain
moral perspectives (Narvaez
2006
).
Another approach concerning teaching ethics is ethical acculturation proposed by
Handelsman, Gottlieb, and Knapp (
2005
). They adapt John W. Berry
’
s acculturation
concept to ethics training. Handelsman and his colleagues (2005) liken the process of
psychologists learning ethics to the reactions of a person encountering a new culture.
Berry (
1997
) states that in multicultural societies, the members and groups of
dominant as well as non-dominant cultures must pay attention to cross-cultural
understandings and influences. According to Berry (
1997
), when individuals and
groups from distinct cultures meet, in light of cultural maintenance as well as contact
and participation, one of the four possibilities of acculturation occurs: assimilation,
separation, integration, or marginalization.
Cultural maintenance
shows the insistence
on the continuation of the existing culture, and
contact and participation
exhibits the
interaction among culturally dissimilar individuals and groups. Assimilation and
separation depend on how individuals and groups encounter and interact with indi-
viduals and groups from other cultures. Exhibiting low cultural maintenance and
desiring high interaction with others demonstrates
assimilation
, while a preference
for high cultural maintenance and little or no interaction with others indicates
separation
. On the other hand, integration and marginalization reveal the level of
unification of cultures and interests in having a relationship with others.
Integration
implies a balance between maintaining the existing culture and internalizing the new
culture as well as a high interest in communicating with others, whereas
marginali-
zation
points out little or no cultural maintenance as well as little or no relationship
with individuals and groups from other cultures.
The ethical acculturation model focuses on the process of ethics training of graduate
students in psychology who have already learnt some professional behaviors and
values. Furthermore, this model considers ethics training to be more complicated than
merely teaching or learning ethical norms. Handelsman, Gottlieb, and Knapp (
2005
)
equate the existing ethics knowledge of graduate students who desire to become
psychologists with the experience of individuals who enter a new culture. This
approach asserts that similar to individuals encountering new cultures, psychologist
candidates must experience the process of ethical acculturation to develop their ethical
knowledge, behavior, and skills (Handelsman, Gottlieb and Knapp
2005
). Cultural
maintenance, in ethical acculturation, denotes students
’
reliance on
B
preexisting notions
of right and wrong professional behavior,
^
and the matter of contact and participation
represents
B
the APA Ethical Standards and other indicators of psychology ethics
^
(Bashe et al.
2007
p. 61). In other words, maintenance refers to students
’
assuming
Determining the goals of ethics education
135
the sufficiency of their own personal values and contact, whereas participation means
their increased awareness of professional ethics, norms, and standards.
Like cultural acculturation, ethical acculturation has four strategies emerging in
accordance with the relationship between maintenance and contact. In ethical accultur-
ation, integration is the most desired strategy, demonstrating students
’
high tendency to
maintain their preexisting values and high interest in new professional standards, which
B
represents the most consistency or coherence between personal and professional
identities and values
^
(Bashe et al.
2007
p. 61). Contrary to integration, marginalization
which indicates a low interest in personal morality and professional values is the least
popular strategy due to denoting the lack of personal as well as professional moral
development (Gottlieb, Handelsman and Knapp
2008
). The third strategy is assimilation
which represents students
’
indifference to their own moral values and high enthusiasm
for professional identity. Under the presence of assimilation, individuals give up their
own ethical standards and completely internalize professional rules. Handelsman and his
colleagues (
2005
) regard this strategy as dangerous for students because of the possi-
bility of causing
B
empty, legalistic, and overly simplistic applications of our ethical
principles
^
(p. 61). The last strategy of ethical acculturation is separation exhibiting a
high concentration on personal moral acceptances with the negligence in ethical prin-
ciples and rules of the profession. This strategy may also lead to detrimental conse-
quences due to not understanding the importance and necessity of applying professional
standards (Handelsman, Gottlieb and Knapp
2005
).
The ethical acculturation model acknowledges the strategy of integration as the ideal
situation. Ethical acculturation aims to integrate individuals
’
preexisting personal and
professional identities into new professional rules, principles, and values. The students
’
previous moral standards are respected, and the students are requested to be aware of
their own personal, cultural, and professional backgrounds, but they are also required to
internalize the ethical codes, values, and principles of the profession they want to enter.
Therefore, assimilation, separation, and marginalization are deemed problematic strat-
egies; ethical acculturation is defined in the scope of the strategy of integration as an
ongoing process giving the student
B
an opportunity to identify and clarify their
personal, cultural, and family of origin values and to consider how these will
align with the new or changing professional culture
^
(Bashe et al.
2007
p. 62). In this
sense, the ethical acculturation model accepts ethics education not only as the
teaching or learning of a list of ethical codes and rules, but also as
B
a process
of developing and maintaining a professional identity
^
through integrating the partici-
pants previous individual cultures and experiences into the professional moral require-
ments (Bashe et al.
2007
p. 61).
However, the convenience of transition from the preexisting culture to the new one
may not be as easy as expected. Gottlieb and his colleagues (2008) draw attention to
this issue. They state that in the event of too much gap between personal and
professional cultures, some students might implement the strategy of assimilation to
be able to accommodate themselves to the new professional qualifications.
Nevertheless, remarkable conflicts between the students
’
previous moral systems and
the new professional culture may cause the appearance of separation and marginaliza-
tion strategies as well. Assimilation indicates a reaction welcoming the new profes-
sional identify. However, the reaction deriving from the cultural conflict may come out
as rejecting this new identify, so separation and marginalization are also likely
136
E. Avci
possibilities in the case of high inconsistency between previous and new conditions.
For such cultural distance-based challenges, Gottlieb and his colleagues (
2008
) suggest
an early detection of the problem and its magnitude as well as the students
’
eagerness
and capability to adopt integration.
According to Bashe et al. (
2007
), the ethical acculturation model has four benefits.
First, this model emphasizes the significance of ethics in professional identity and the
essentiality of refurbishing ethical knowledge. Second, ethical acculturation does not
impose an assimilating strategy; on the contrary, it recognizes the worthiness of
personal experiences and values. Third, ethical acculturation is regarded as an
ongoing process, hence individuals remain active in the integration between
their personal virtues and their professional standards. Fourth, this model
represents a journey starting by identifying personal values and professional needs
and ending by integrating personal and professional identities. Therefore, ethical accul-
turation provides a progressive development for ethics education.
In case of comparing the ethical acculturation model with the character education
approaches (traditional character education and rational moral education), it may be
said that some advantages and disadvantages of each can be mentioned. However, one
of the main differences between the ethical acculturation model and character education
approaches is the distinction between their primary groups; the ethical acculturation
model is established on the idea of acculturating graduate students who choose to be
psychologists, whereas the character education approaches focus on the moral devel-
opment of children. The former tries to increase ethical knowledge and skills of already
educated adults in light of professional requirements, while the latter strives to
discover the most appropriate way to form or shape the character of children
according to moral values (Handelsman, Gottlieb and Knapp
2005
; Narvaez
2006
). From this perspective, in terms of the target groups, the ethical accul-
turation model seems to suit ethics education in healthcare more than character
education approaches. Furthermore, the essential feature of ethical acculturation
which requires integrating personal values into professional identity is a superiority of
this method. The combination of respecting the differences in individuals
’
cultural
backgrounds and experiences and recognizing the necessity of professional moral
standards is crucial in teaching ethics in professions. On the other hand, the liberal
aspect of rational moral education which
B
is concerned with the development of
reasoning and autonomy
^
also exhibits potential for proposing/forming a new model
for ethics education in healthcare (Narvaez
2006
p. 703).
The goals of ethics education
In the first section, the concepts of ethics, education, and ethics education were
explained to clarify what these terms imply. Furthermore, in the second section,
two major approaches in education, traditional character education and rational
moral education, as well as the ethical acculturation model suggested by
Handelsman and his colleagues were succinctly expounded. In this section,
some important issues will be highlighted in light of the acquired ideas from
the earlier sections, and then the goals of ethics education in healthcare will be
proposed.
Determining the goals of ethics education
137
How to understand ethics education
Prior to delineating the goals of ethics education, underlining some points in light of the
matters mentioned in the above sections would be beneficial. First, ethics education is a
very broad concept pertinent to all academic disciplines. Even though it may be
probable to outline certain objectives of teaching ethics available for more than one
academic area, due to the unique characteristics and requirements of each field,
focusing on a specific discipline would give the opportunity to address more definite
goals. For this reason, in this paper, ethics education refers to the teaching of ethics in
healthcare which can also be named as bioethics education. Henk ten Have (
2014
)
defines bioethics as
B
the discipline that is focusing on ethical issues in medicine, health
care, and associated technologies
^
(p. 447). Indeed, though bioethics may be evaluated
as conceptually more comprehensive than healthcare ethics, in the scope of the present
article, the terms
‘
ethics education in healthcare
’
and
‘
bioethics education
’
are regarded
as interchangeable.
Second, the term
‘
healthcare
’
covers many professionals including physicians,
nurses, pharmacists, therapists, psychologists, and so on. In this view, healthcare
ethics/bioethics does not denote a particular profession, but all healthcare professions.
According to Grob, Leng and Gallagher (
2012
),
B
[p]rofessional ethics relates to the
values and standards of a particular profession, which are generally made explicit in
professional codes of conduct or practice
^
(p. 36). In this context, bioethics education
does not imply any type of professional ethics, but indicates ethics teaching to any
person who decides to enter a profession in healthcare.
Third, ethics education is an ongoing process improving the learner
’
s ethical
knowledge and skills as well as enhancing the learner
’
s ethical cognitive development
regarding the acquired knowledge and skills. In this view, ethics education aims to
stimulate some changes in learners
’
ethical knowledge, perception, and perspective.
However, these changes do not suggest an assimilation process. Cultural assimilation
means to abandon the preexisting cultural identity, and ethical assimilation implies to
leave the previous morality (Berry
1997
; Handelsman, Gottlieb and Knapp
2005
).
Ethics education should be understood as the integration between preexisting moral
values and new professional ethical standards. The research study conducted by
Rodríguez et al. (
2014
) containing a survey of 136 ethics instructors from American
Psychological Association (APA) accredited programs in the United States and Canada
demonstrates that more than 86% of the educators specify the aims of ethics education
as
‘
advancing critical thinking
’
,
‘
preparing students to use ethical decision making
models
’
,
‘
providing specific information and resources on ethics
’
, and
‘
teaching the
ability to make difficult decisions.
’
From this perspective, ethics education should not
impose a specific morality on learners; it should teach the relevant ethical theories,
norms, and principles to learn how to think critically and make ethical assessments and
autonomous decisions (Bashe et al.
2007
). For example, in terms of the beginning of
life issues, bioethics education should not insist on pro-life or pro-choice arguments. It
should teach all aspects of the arguments, pertinent moral theories, and ethical princi-
ples as well as appropriate methods for making morally acceptable judgements in
accordance with cultural, religious, and philosophical backgrounds.
Fourth, bioethics education is not traditional character education. Traditional char-
acter education is a widespread, but also a contentious approach aiming to design
138
E. Avci
children
’
s moral personality (Lapsley and Narvaez
2006
).
B
For traditional character
education, morality is ready-made and good character requires submission to its
preexisting norms
^
(Lapsley and Narvaez
2006
p. 261). On the other hand, bioethics
education intends to increase healthcare professionals
’
knowledge and skills to identify
ethical issues and make ethical judgements (Thornton, Callahan and Nelson
1993
).
Therefore, traditional character education focuses on children
’
s moral development,
whereas bioethics education concentrates on the teaching ethics of healthcare profes-
sionals. Moreover, the former imposes a particular morality and requests obedience,
while the latter tries to enhance ethical awareness and moral reasoning. In this view, it is
believed that bioethics education does not have a function to form a new character. The
improvement of ethical knowledge and skills may influence the individuals
’
personal
behaviors in a positive manner. However, the effectiveness of ethics education should
not be measured by non-profession-related behaviors or activities; it should be gauged
by the adaptation to professional moral requirements as well as by the ability of ethical
awareness, ethical analysis, and moral judgement in professional implementations.
Finally, bioethics education may be formulated in the scope of the rational moral
education approach and the integration strategy of the acculturation model. Even though
rational moral education is related to the moral development of children, its neutral aspect
aiming to teach morality in an impartial manner and its indirect feature considering
educators solely the facilitators of moral development may be applicable to bioethics
education to create a liberal and humanistic teaching environment (Narvaez
2006
).
Moreover, the perspective of the integration strategy of ethical acculturation produces a
useful approach to emphasize the significance of the consolidation of personal moral
values and professional ethical qualifications (Bashe et al.
2007
). Furthermore, the view
of recognizing and respecting individual moral differences and diverse experiences could
facilitate the development of global bioethics which focuses on
B
the ethical concerns of
humanity
^
worldwide and
B
contains
B
the ethical values and principles of various pop-
ulations without assuming that one specific set of values and principles is dominant.
^
(ten
Have
2016
p. 9) In this context, bioethics education is not limited to any particular moral
system; rather, it encompasses the teaching of all moral aspects and promotes the
improvement of ethical awareness, thinking, and judgement through the integration of
personal and professional moral acceptances.
The goals of ethics education
Outlining the goals of ethics education is crucial to accurately describe its concept and
determine its scope. Because of this reason, almost every paper examining ethics
education addresses certain goals. For instance, Li-Ling Hsu (2011) points out the
purpose of ethics education in nursing as producing
B
morally accountable nurses
^
(p.
419). Similarly, Sudhir K. Chawla and his colleagues (
2015
) identify the aim of ethics
education in accounting as producing
B
ethical professionals
^
(p. 18). Moreover, Henk
ten Have (
2014
) accentuates the consensus on the eventual objective of ethics educa-
tion in bioethics as producing
B
good health professionals and scientists
^
(p. 458). These
statements suggest that an important goal of ethics education may be to produce good,
ethical professionals.
According to Cubie L. L. Lau (2010), the aim of ethics education in business is
B
to help
students to be more aware and sensitive to the ethical consequences of their actions
^
Determining the goals of ethics education
139
(p. 569). Sanders and Hoffman (2010) express the main goals of ethics education in social
work as improving moral judgement, which indicates how to deal with ethical conflicts,
and moral sensitivity. These goals show the ability of pinpointing ethical issues. Mihyun
Park et al. (
2012
) regard the objective of ethics education in nursing as
B
to develop among
students the necessary skills for ethical decision making: moral sensitivity and moral
reasoning
^
(p. 569). Thornton, Callahan, and Nelson (1993) enumerate the goals of ethics
education in bioethics as
B
(1) to stimulate the moral imagination, (2) to recognize ethical
issues, (3) to develop analytical skills, (4) to elicit a sense of moral obligation and personal
responsibility, and (5) to tolerate and resist disagreement and ambiguity
^
(p. 27). Even
though each of the aforementioned studies evaluates teaching ethics in a different
discipline or profession, they mostly agree on improving ethical awareness, sensitivity,
and judgement to identify, analyze, and resolve ethical issues and conflicts.
All the mentioned interpretations reveal essential elements of ethics education and
its goals. Nevertheless, in this paper, the objectives of ethics education will be
elaborated in light of the four pillars of the Delors Report. In other words, the four
pillars of the lifelong education approach will be adapted to the determination of the
goals of ethics education. The concept of lifelong education which is also named as
‘
learning throughout life
’
was counted as a guiding principle requiring individuals to
B
be in a position to keep learning throughout [their] life
^
by UNESCO
’
s Faure
Commission Report (Faure et al.
1972
p. 181) The Delors Report re-evaluated and
broadened the concept of lifelong education in order to deal with rapid changes and
advances as well as new situations (Delors et al.
1996
). The concept of lifelong
education is parallel to the perspective of ethical acculturation which deems ethics
learning as an ongoing process. Moreover, there is a similarity between the reasons
behind the concept of lifelong education and the arguments counting ethical accul-
turation an as ongoing process. The ethical acculturation model requires individuals to
keep continuing their ethical training throughout their professional lives due to the
ongoing changes (Handelsman, Gottlieb and Knapp
2005
). Therefore, the precondi-
tion of adapting the pillars of the concept of learning throughout life to ethics
education is to acknowledge teaching ethics as an ongoing process throughout
learners
’
professional lives. For overcoming the continuous changes in healthcare
and healthcare-related areas, healthcare professionals should proceed with their ethics
education as long as they practice their professions. In this view, the goals of ethics
education are as follows:
–
to increase ethical knowledge (learning to know),
–
to improve ethical skills to strengthen ethical sensitivity, awareness, and judgement
(learning to do),
–
to develop ethical behavior (learning to be),
–
to promote cultural competence (learning to live together).
Increasing ethical knowledge as learning to know
The acquisition of knowledge is not only the first goal of ethics education, but also the
initial objective of all kinds of education. Some approaches may attribute further qualities
to education, but there is a consensus among them that the primary function of education
140
E. Avci
is to gain knowledge (Peters
2010
). This criterion is also valid for ethics education. For
instance, Campbell, Chin, and Voo (
2007
) explain the goals, assessment methods, and
outcomes of medical ethics education through a three-level ascending pyramid, the first
level of which is knowledge. Similarly, Sudhir K. Chawla et al. (
2015
) define the initial
goal of an ethics course as to
B
[d]eliver a common body of knowledge in ethics
^
(p. 19).
Furthermore, Henk ten Have (
2014
) underscores the weight of knowledge in the
understanding of ethical issues.
This goal of ethics education refers to the possession and increase of the information
about ethics-related subjects. Learning ethical theories, rules, principles, codes, and
other applicable ethical information are related to this objective. Ethics education has
the task to identify, analyze, and resolve ethical issues and conflicts. Having adequate
ethical knowledge is the necessary, but not sufficient, condition of fulfilling the task.
For this reason, ethics education must provide satisfactory ethical information to be
able to establish or improve other pertinent considerations, such as developing ethical
skills. From this perspective, in terms of adapting the concept of learning throughout
life to ethics education,
‘
improving ethical knowledge
’
matches
‘
learning to know
’
which requires
B
combining a sufficiently broad general knowledge with the opportu-
nity to work in depth on a small number of subjects. This also means learning to learn,
so as to benefit from the opportunities education provides throughout life
^
(Delors et al.
1996
p.37). In this view, ethics education should aim to supply adequate information to
know relevant subjects and concepts.
Improving ethical skills to strengthen ethical sensitivity, awareness, and judgement
as learning to do
As aforementioned, acquiring or increasing ethical knowledge is the first step of ethics
education. However, the presence of knowledge is not sufficient per se to identify,
analyze, and resolve ethical matters and challenges. The ability to stimulate knowledge
and transform it into actions is also certainly important and necessary. Henk ten Have
(
2014
) gives an example to clarify the relationship between knowledge and skills and
says that
B
if the focus is on informed consent, students should know what it is; they
should have information and facts about this concept, but they should also learn how to
apply it in practice
^
(p. 452
–
453).
Therefore, besides ethical knowledge, ethics
education should provide the opportunity to improve ethics-related skills: ethical
sensitivity, ethical awareness, and ethical judgement. Catherine Robichaux (
2012
) states
that in the event of creating a learning-friendly environment, ethical skills can be taught
through ethics education. In this context, many authors, such as Jensen and Greenfield
(2012) as well as Mihyun Park et al. (
2012
) recognize the development of skills an
essential purpose of ethics education.
The aim of strengthening ethical skills is to gain or increase the ability of learning to
do a job, as highlighted by the concept of learning throughout life. Ethics education
should enhance healthcare professionals
’
skills to improve their ethical sensitivity,
awareness, and judgement. Developing the pertinent skills is significant not only to
meet daily routines of the professions, but also to deal with unexpected ethical
circumstances (Delors et al.
1996
). Additionally, the acquisition or improvement of
skills needs long-term training, hence the teaching of ethics should be accepted as a
process, in terms of strengthening skills as well.
Determining the goals of ethics education
141
Improving ethical behavior as learning to be
As previously elaborated, ethics education does not refer to traditional character
education. Therefore, in principle, teaching ethics does not necessitate forming virtuous
character of behavior. Moreover, according to several studies, it is questionable whether
ethics education creates moral behavior (Gordijn and ten Have
2013
; Wright
1995
;
Cannaerts, Gastmans and Casterle
2014
). However, at that point, the idea of generating
a virtuous character should be differentiated from the view of influencing professional
behavior. For instance, constantly instilling in a child not lying in life because of
negative consequences may be considered a character formation, whereas taking
a healthcare professional
’
s attention not to lie in the relationship with patients
due to their rights to accurate informed consent could be regarded as profes-
sional behavioral improvement. In this view, the goal of improving ethical behavior
implies to promote professional moral behavior rather than one
’
s general character. Of
course, helping to create more appropriate behaviors in one
’
s life may be desirable, but it
should not be counted as one of the objectives of ethics education in healthcare because
of the professional aspect of bioethics.
Furthermore, improving ethical behavior is formulated in light of learning through-
out life concept's third pillar: learning to be. Learning to be suggests improving one
’
s
personality and discovering her/his potential, like
B
memory, reasoning, aesthetic sense,
physical capacities and communication skills
^
(Delors et al.
1996
p. 37) In case of the
adaptation of this approach to bioethics education, it can be emphasized that the
development of professional ethical behavior should be fulfilled not only through
improving ethical knowledge and skills, but also through exploring and promoting
individual potential.
Promoting cultural competence as learning to live together
Cultural competence implies beliefs, attitudes, behaviors, and policies facilitating a
compatible togetherness in a cross-cultural environment (Chin
2000
; Anderson et al.
2003
). According to Gregory Juckett (2005), cultural competence refers to
B
possessing
knowledge, awareness, and respect for other cultures
^
and requires recognizing
cultural differences and respecting their own characteristics (p. 2267). Cultural,
religious, and social diversity in healthcare as well as in all levels of multicul-
tural societies necessitates finding a peaceful way to prevent cultural assimila-
tion as well as cultural separation or marginalization. In this view, the integra-
tion strategy of ethical acculturation provides an outstanding aspect to encour-
age the survival of moral differences in an integrated structure (Bashe et al.
2007
). This
facet of ethics education should be strengthened by the perspective of
‘
learning to live
together.
’
The Delors Report emphasizes the function of learning to live together as;
by developing an understanding of others and their history, traditions and spiritual
values and, on this basis, creating a new spirit which, guided by recognition of
our growing interdependence and a common analysis of the risks and challenges
of the future, would induce people to implement common projects or to manage
the inevitable conflicts in an intelligent and peaceful way. Utopia, some might
think, but it is a necessary Utopia, indeed a vital one if we are to escape from a
142
E. Avci
dangerous cycle sustained by cynicism or by resignation (Delors et al.
p.
20).
Regardless of being a utopia or not, the underscored understanding should be
reflected to ethics education in order to transcend the teaching or learning of a
list of ethical codes, rules, and principles. For this reason, it is absolutely
believed that promoting cultural competence is a primary goal of ethics
education.
Increasing ethical knowledge and improving ethical skills to strengthen ethical
sensitivity, awareness, and judgement are classic goals of ethics education emphasized
by almost all studies which inquire into the aims of teaching ethics. However, the
cultural, religious, and social diversity bolstering a cultural competence-based approach
is the unique characteristic of the present study. As an idea as well as an ideal,
endorsing diversity is not a new view, but recognizing the importance of diversity as
a central goal of ethics education is an original perspective. For example,
‘
respect for
cultural diversity and pluralism
’
is one of the primary principles of the UNESCO
Universal Declaration on Bioethics and Human Rights (UDBHR), which was declared
in 2005. The UDBHR underlines the significance of diversity and pluralism as a
universal principle and requests respecting this value in light of human dignity and
human rights (Universal Declaration on Bioethics and Human Rights
). Therefore,
formulating the goals of ethics education as encompassing the promotion of cultural
competence is not an extreme approach; on the contrary, it is a requirement of the
UDBHR
’
s vision and principles.
Conclusion
In light of the basic principles of Kohlberg
’
s cognitive-developmental approach (the
rational moral education approach), Handelsman et al.
’
s ethical acculturation model,
and the Delors Report
’
s learning throughout life concept, the conceptual framework of
ethics education and its goals were examined. These three perspectives were integrated
to determine the notion of teaching ethics and its objectives. Rational moral education
demonstrates the role of educators in teaching ethics which demands providing learners
all aspects, ideas, and approaches of ethics without imposing a specific one on learners.
Ethical acculturation represents learners
’
position in ethics learning which requires
integration between learners
’
preexisting moral values and new professional require-
ments. Learning throughout life denotes the precondition of ethics education as an
ongoing process. Under the general perspectives of these three approaches and the
adaptation of the four pillars of the Delors Report to teaching ethics, the goals of ethics
education were defined as increasing ethical knowledge; improving ethical skills to
strengthen ethical sensitivity, awareness, and judgement; developing ethical behavior;
and promoting cultural competence. Assessing ethics education with the aforemen-
tioned objectives would not only give the opportunity to improve learners
’
ethical
knowledge and skills to identify, analyze, and resolve ethical issues and conflicts
through the development in ethical sensitivity, awareness, and judgement, but also it
would provide the chance to discover and appreciate individuals
’
potentials, personal
values, and peaceful ways to live together by enhancing cultural competence.
Determining the goals of ethics education
143
References
Anderson, L.M., et al. 2003. Culturally competent healthcare systems. A systematic review.
American Journal
of Preventive Medicine
24(3 Suppl): 68
–
79.
Avci, E. 2016. Learning from experiences to determine quality in ethics education.
International Journal of
Ethics Education
. doi:
10.1007/s40889-016-0027-6
.
Barrett, A.M., et al. 2006.
The Concept of Quality in Education: A Review of the
‘
International
’
Literature on
the Concept of Quality in Education
, 2
–
3. Bristol: EdQual RPC.
Bashe, A., et al. 2007. An acculturation model for ethics training: the ethics autobiography and beyond.
Professional Psychology: Research and Practice
38(1): 60
–
67.
Bendik-Keymer, J. 2013. The Moral and the Ethical: What Conscience Teaches Us about Morality
^
in
Morality: Reasoning on Different Approaches
, ed. Vasil Gluchman, 11-23. Amsterdam: Rodopi, eBook
& Streaming Video Collection (Gumberg Library), EBSCOhost (accessed September 1, 2016).
Berry, J.W. 1997. Immigration, acculturation, and adaptation.
Applied Psychology: An International Review
46: 5
–
68.
Boon, H. 2011. Raising the bar: ethics education for quality teachers.
Australian Journal of Teacher Education
36(7): 76
–
93.
Burnett, N. 2008. The delors report: a guide towards education for all.
European Journal of Education
43(2): 181-
187.
Campbell, A.V., J. Chin, and T.-C. Voo. 2007. How can we know that ethics education produces ethical
doctors?
Medical Teacher
29: 431
–
436.
Canary, H.E., et al. 2014. Engaging students in integrated ethics education: a communication in the disciplines
study of pedagogy and students
’
roles in society.
Communication Education
63(2): 83
–
104.
Cannaert, N., C. Gastmans, and B. Dierckx de Casterle. 2014. Contribution of ethics education to the ethical
competence of nursing students: educators
’
and students
’
perceptions.
Nursing Ethics
21(8): 861
–
878.
Catron, B.L. 1989. Teaching ethics, teaching ethically.
Policy Studies Review
8(4): 865
–
870.
Chawla, S.K., et al. 2015. Evaluating ethics education for accounting students.
Management Accounting
Quarterly
16(2): 16
–
25.
Chin, J.L. 2000. Culturally competent health care.
Public Health Report
115(1): 25
–
33.
COMEST The Teaching of Ethics, UNESCO, accessed September 10, 2016,
http://unesdoc.unesco.
org/images/0013/001345/134552mb.pdf
.
Delors, J., et al. 1996.
Learning: The Treasure Within
. Paris: UNESCO Publishing.
Domenech Rodríguez, M.M., et al. 2014. Ethics education in professional psychology: a survey of american
psychological association accredited programs.
Training and Education in Professional Psychology
8(4): 241-
247.
Education 2030 Incheon Declaration Towards Inclusive and Equitable Quality Education and Lifelong
Learning for All, UNESCO, accessed September 7, 2016,
http://unesdoc.unesco.org/images/0024
/002432/243278e.pdf
.
Education, Cambridge Dictionary, accessed September 3, 2016,
http://dictionary.cambridge.
org/dictionary/english/education
.
Education Overview, World Bank Group, accessed September 5, 2016,
http://pubdocs.worldbank.
org/en/890441459784763164/EDUCATION-OVERVIEW-April4.pdf
.
Ethics, Cambridge Dictionary, accessed September 1, 2016,
http://dictionary.cambridge.
org/dictionary/english/ethics
.
Faure, E., et al. 1972.
Learning to Be: The World of Education Today and Tomorrow
. Paris: UNESCO.
Gert, B. 2005.
Morality: Its Nature and Justification
, (Oxford; New York: Oxford University Press), eBook &
Streaming Video Collection (Gumberg Library), EBSCOhost (accessed September 3, 2016).
Gordijn, B., and H. ten Have. 2013. Quandaries of ethics education.
Med Health Care and Philos
1
–
2.
Gottlieb, M.C., M.M. Handelsman, and S. Knapp. 2008. Some principles for ethics education: implementing
the acculturation model.
Training and Education in Professional Psychology
2(3): 123-128.
Grob, C., J. Leng, and A. Gallagher. 2012. Educational responses to unethical healthcare practice.
Nursing
Standard
26(41): 35-41.
Gutmann, A. 1999.
Democratic Education: With a New Preface and Epilogue
(Princeton; Chichester:
Princeton University Press, eBook & Streaming Video Collection (Gumberg Library), EBSCOhost
(accessed September 12, 2016).
Handelsman, M.M., M.C. Gottlieb, and S. Knapp. 2005. Training ethical psychologists: an acculturation
model.
Professional Psychology: Research and Practice
36(1): 59-65.
Hirst, P.H., and R.S. Peters. 2012.
The Logic of Education
. New York: Routledge.
144
E. Avci
Hsu, L.-L. 2011. Blended learning in ethics education: a survey of nursing students.
Nursing Ethics
18(3):
418-430.
Jensen, G.M., and B. Greenfield. 2012. Ethics education: developing habits of mind through the use of
pedagogical content knowledge.
Physical Therapy Reviews
17(3): 149-156.
Juckett, G. 2005. Cross-cultural medicine.
American Family Physician
72(11): 2267-2274.
LaFollette, H. 2014. Theorizing About Ethics, in
Ethics in Practice: An Anthology
, ed. Hugh LaFollette, 3-10.
Hoboken: Wiley-Blackwell, eBook Collection (EBSCOhost), EBSCOhost (accessed September 1, 2016).
Lapsley, D. K. and Narvaez, D. 2006. Character Education in
Handbook of Child Psychology
, 6th ed, volume
four: Child Psychology in Practice, volume ed. K. A. Renninger and I. E. Sigel, 248-296. Hoboken:
Wiley.
Lau, C.L.L. 2010. A step forward: ethics education matters!
Journal of Business Ethics
92(4): 565
–
584.
Morality, Cambridge Dictionary, accessed September 1, 2016,
http://dictionary.cambridge.
org/dictionary/english/morality
.
Narvaez, D. 2006. Integrative Ethical Education. In
Handbook of Moral Development
, ed. M. Killen and J.G.
Smetana, 703-72. Mahwah: Lawrence Erlbaum Associates Publishers.
Park, M. 2012. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing
students.
Nursing Ethics
19(4): 568-580.
Peters, R.S. 2010. What is an educational process? In
The Concept of Education
, ed. R.S. Peters, 1-16. New
York: Taylor & Francis e-Library.
Rachels, J. 2003.
The Elements of Moral Philosophy
, 4th edition. New York: McGraw-Hill.
Rich, K.L. 2016. Introduction to Ethics. In
Nursing Ethics: Across the Curriculum and into Practice
, 4th
edition, ed. J.B. Butts and K.L. Rich, 3-30. Burlington: Jones & Bartlett Learning.
Robichaux, C. 2012. Developing ethical skills: from sensitivity to action.
Critical Care Nurse
32(2): 65-72.
Sanders, S., and K. Hoffman. 2010. Ethics education in social work: comparing outcomes of graduate social
work students.
Journal of Social Work Education
46(1): 7-22.
Schowengerdt, C. G. 2014.
Ethics.
Zanesville: Y-City Publishing LLC, eBook & Streaming Video Collection
(Gumberg Library), EBSCOhost (accessed September 5, 2016).
Schwitzgebel, E., et al. 2012. Ethicists
’
courtesy at philosophy conferences.
Philosophical Psychology
25(3): 331-
340.
Tawil, S. Cougoureux, M. 2013. Revisiting learning: the treasure within assessing the influence of the 1996
Delors report.
UNESCO Education Research and Foresight Occasional Papers
.
Ten Have, H. 2008. Unesco
’
s ethics education programme.
Journal of Medical Ethics
34(1): 57-59.
Ten Have, H.A.M.J. 2014. Bioethics Education. In
Handbook of Global Bioethics
, ed. H.A.M.J. ten Have and
B. Gordijn, 447-466. Dordrecht: Springer Science+Business Media.
Ten Have, H. 2016.
Global Bioethics An Introduction
. London: Routledge Taylor & Francis Group.
The Rise of Results-Based Financing in Education 2015, World Bank Group, accessed September 5, 2016,
http://www.worldbank.org/content/dam/Worldbank/Brief/Education/RBF_ResultsBasedFinancing_v9_
web.pdf
.
Thornton, B.C., D. Callahan, and J.L. Nelson. 1993. Education expanding the circle of participants.
The
Hastings Center Report.
23(1): 25
–
29.
Tikly, L., and A.M. Barrett. 2011. Social justice, capabilities, and the quality of education in low income
countries.
International Journal of Educational Development
31: 3-14.
UNESCO Education Strategy 2014
–
2021, UNESCO, accessed September 7, 2016,
http://unesdoc.unesco.
org/images/0023/002312/231288e.pdf
Universal Declaration on Bioethics and Human Rights. 2009. In
UNESCO Universal Declaration on
Bioethics and Human Rights: Background, Principles and Application
, ed. H.A.M.J. Ten Have and
M.S. Jean, 360
–
365. Paris: UNESCO Publishing.
Weber, M. 2004. trans. Rodney Livingstone. In
The Vocation Lectures Science as a Vocation Politics as a
Vocation
, ed. D. Owen and T.B. Strong. Indianapolis: Hackett Publishing Company.
World Bank Group. 2011.
Learning for All Investing in People
’
s Knowledge and Skills to Promote
Development Learning
. Washington: The World Bank.
Wright, M. 1995. Can moral judgement and ethical behaviour be learned?
Management Decision
33(10): 17
–
28.
Determining the goals of ethics education
145
Dostları ilə paylaş: |