Abstract
In their article, “The ‘Ought-Is Problem:’ An Implementation Science Framework for Translating Ethical Norms into Practice,” Sisk et al. correctly draw a distinction between aspirational norms (“broad claims that are easily agreed upon”–e.g. “Everyone should have their goals of care met at the end of life”)–and specific norms (claims that provide “direct guidance” about specific actions that should ensue–e.g. “Doctors should complete Advance Health Care Directives with every patient to ascertain their goals of care for the end of life”). They further argue that, because there is a moral imperative to enact normative claims once they are developed, ethicists working in the healthcare sphere should make use of tools and frameworks from the field of implementation science to enact, sustain, and disseminate specific norms. Indeed, if specific norms are unattainable in practice, they argue, they will fail to achieve any real behavior change and thus “[fail] the overarching purpose of ethics.” Conversely, specific ethical norms that are successfully implemented can be studied to develop best practices, which can then be disseminated to improve ethical practice as a whole.