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CHAPTER 26 Gladys L. Husted and James H. Husted 525

represents an integration of the agent’s awareness of the This understanding makes negotiation and cooperation
facts of the situation and her preexisting knowledge among individuals possible.
about how to most effectively deal with these facts
(Husted & Husted, 2008). Ethical Standards
Ethical standards have been the benchmarks of ethical
behavior. The standards include terms familiar to health
Theoretical Assertions care professionals such as beneficence, veracity, and
Symphonology is classified as a grand theory because confidentiality. However, the authors have conceived
of its broad scope. Grand theories structure goals new meanings for ethical standards that correspond to
related to a specific view of the discipline (Walker & the foundational concepts of Symphonology: the per-
Avant, 2011). Grand theories are broader than con- son as a unique individual, and the use of insight and
ceptual models and may be used as a model to guide discernment in addition to reason and rationality in
practice and research (Fawcett & Garity, 2009). The order to achieve a deeper understanding.
authors developed Symphonology Theory not from Traditionally, bioethical concepts have been used to
natural progression of other work, but from the rec- guide ethical action by mandating concrete directives
ognition of a need for theoretical guidelines related to for action. For instance, the concept of beneficence
the ethical delivery of health care. The understanding conventionally maintains that one must see that no
and use of this theory are based on a fundamental harm comes to a patient. However, it is not always pos-
ethical element that describes the rational relation- sible to predict how and when harm will occur, mak-
ship between human beings: human rights. ing adherence to this directive an unrealistic goal. The
concept of beneficence, viewed as a mandate, could
Rights also imply that defending yourself against a physical
The Husteds describe rights as the fundamental ethical attack is unethical. Similarly, veracity, or truth telling,
element. Traditionally, rights are viewed as a list of holds that one must always speak the truth regardless
options to which one is entitled, such as a list of items of the consequences. Therefore, it is unethical to with-
or actions to which one has a just claim. Symphonology hold potentially harmful information, regardless of
holds rights as a singular concept. It is the implicit, the consequences. Adhering to veracity may interfere
species-wide agreement that one will not force another with one’s commitment to beneficence. Clearly, ethical
to act, or take by force the products of another’s actions. standards taken as concrete directives do not allow for
Rights are viewed as the critical agreement among ratio- the consideration of context.
nal people, the agreement of nonaggression (Husted & The authors have redefined the ethical standards,
Husted, 1997a). This agreement emerged as humans not as concrete rules, but as human qualities or char-
became rational and developed a civilized social struc- acter structures that can and must be recognized and
ture. A nonaggression agreement is preconditional to all respected in the individual (Husted & Husted, 1995b).
human interaction. It serves as a foundation on which For example, in Symphonological terms, beneficence
all other agreements rest. The formal definition is as includes the idea of acting in the patient’s best inter-
follows: “the product of an implicit agreement among est, but it begins with the patient’s evaluation of what
rational beings, held by virtue of their rationality, not to is beneficial. In this way, ethical standards are presup-
obtain actions or the products of actions from others positions in the health care professional–patient
except through voluntary consent, objectively gained” agreement and ethical guides to decision making. The
(Husted & Husted, 2001, p. 4). The operation of this is participants work together with the implicit under-
evident in human interaction. standing that each is possessed of human characteris-
According to the Husteds, Symphonology Theory tics. The description and names of the bioethical
can ensure ethical action in the provision of health care. standards have changed over time based on feedback
Agreement is the foundation of Symphonology. Agree- from practitioners. Symphonological theory holds
ments can occur based on the implicit understanding of that patients have a right to receive the benefits speci-
human rights. The understanding of nonaggression that fied in the bioethical standards. Box 26–1 provides
exists among rational persons constitutes human rights. definitions and examples of bioethical standards.