The “Ought-Is” Problem: An Implementation Science Framework for Translating Ethical Norms Into Practice

Abstract

We argue that once a normative claim is developed, there is an imperative to effect changes based on this norm. As such, ethicists should adopt an “implementation mindset” when formulating norms, and collaborate with others who have the expertise needed to implement policies and practices. To guide this translation of norms into practice, we propose a framework that incorporates implementation science into ethics. Implementation science is a discipline dedicated to supporting the sustained enactment of interventions. We further argue that implementation principles should be integrated into the development of specific normative claims as well as the enactment of these norms. Ethicists formulating a specific norm should consider whether that norm can feasibly be enacted because the resultant specific norm will directly affect the types of interventions subsequently developed. To inform this argument, we will describe the fundamental principles of implementation science, using informed consent to research participation as an illustration.

KEYWORDS:

• Ethics
• empirical ethics
• normative ethics
• implementation science
• applied ethics

This article is referred to by:

Using Implementation Science to Enact Specific Ethical Norms: The Case of Code Status Policy

The Feasibility of Implementing Normative Claims That Are Especially Strong and Important

An “Implementation Mindset” in Normative Bioethics Will Have Unintended Consequences

Responsible Innovation For and From Ethical Integration

Bioethical Ideals, Actual Practice, and the Double Life of Norms

Translational Ethics and Challenges Involved in Putting Norms Into Practice

Making Ethics Happen: Addressing Injustice in Health Inequalities

Implementation Science Can Do Even More for Translational Ethics

Mind the Gap: How Should We Translate Specific Ethical Norms Into Interventions?

Beyond Translating Ethical Norms Into Practice: Integrating Implementation and Assessment Mindsets

Implementation Science and Bioethics: Lessons From European Empirical Bioethics Research?

Ethical Training Can Turn an “Ought” to a “Can”

Implementation in Bioethics: A Plea for a Participatory and Dialogical Approach

DISCLOSURE STATEMENT

The authors report no conflicts of interest.

Notes

1 Hereafter, when we refer to “norms” we refer to social norms generated by policy makers or applied ethicists.

Additional information

Funding

The present work was financially supported by NIH National Center for Advancing Translational Science [UL1 TR002345 (BAS)] and National Human Genome Research Institute [K01HG008990 (ALA)].