2. Ethical Theories (do) Flashcards
How do individuals decide what is ethical?
Obedience
Imitation
Feeling or desire
Intuition
Habit
What is the aim of ethical theories?
Aim to help us think clearly about ethical dilemmas
* Orientation for justified options
* Answers for Justified course of action
Name 3 ethical theories
- Consequentialism (Utilitarianism)
- Deontology
- Virtue Ethics
What is Consequentialism?
An action is right if it promotes the best consequences
* The Internet Encyclopedia of Philosophy definition of consequentialism:
* Of all the things a person might do at any given moment, the morally
right action is the one with the best overall consequences.
* In bioethical terms, such an
approach is evident in discussions
of likely risks vs benefits.
What does a consequentialist believe?
A consequentialist (one who believes in this theory) will find that the
best way to proceed in ethical dilemmas resides in the best outcome.
* whatever choices increase the Good, are the choices that it is morally right to
make (The Good in that sense is said to be prior to “the Right.”)
* In other words attention is focused on the end product as opposed to
what means is used to achieve that end. The ‘means’ to achieve this end may be viewed as ethical or
unethical….
* Depending on your moral code.
What are the limitations of consequentialism?
- Future consequences are difficult to predict
* We cannot predict every outcome of an event - Measuring and comparing the ‘goodness’ of consequences
is very difficult
* what should be assessed in calculating good consequences? - Choosing different time periods may produce different
consequences
* eg. An intervention may offer good short-term results, but in the
long-term it may lead to the development of other health
conditions - It ignores things we regard as ethically relevant
* For example, the intentions of the person doing the act;
* the character of the person doing the act;
* the fairness of the result
What is utilitarianism?
A BRANCH OF CONSEQUENTIALISM
* Utilitarianism is an ethical theory that determines right from
wrong by focusing on outcomes
* Utilitarianism holds that the most ethical choice is the one
that will produce the best outcome for the MOST PEOPLE
* ‘consists of consequentialism together with the identification
of the best state of affairs in which there is most happiness,
most pleasure, or the maximum satisfaction of desire’.
Explain Utilitarianism in Philosophy
Utilitarian concepts are said to derive from the work of Jeremy
Bentham and John Stuart Mill
* It is “the greatest good to the greatest number of people” which is
the measure of right and wrong.
* “Nature has placed mankind under the governance of two sovereign
masters, pain and pleasure”
* “actions are right in proportion as they tend to promote happiness,
wrong as they tend to produce the reverse of happiness” -
What is Utility and Welfare maximisation?
Utilitarianism states that people should maximise human
welfare or well-being or health (principle of ‘utility’).
* It seems sensible to base ethics on producing happiness and
reducing unhappiness
* It seems sensible to base ethics on the consequences of what
we do, since we usually take decisions about what to do by
considering what results will be produced
* It seems easy to understand and to be based on common
sense
What is the decision-making method?
Utilitarianism offers a relatively straightforward method for
deciding the morally right course of action
* To discover what we ought to do in any situation,
1. we first identify the various courses of action that we could
perform.
2. we determine all of the foreseeable benefits and harms that
would result from each course of action for everyone affected by
the action.
3. we choose the course of action that provides the greatest
benefits (for the majority) after the costs have been taken into
account.
What are the principles of utility?
In act utilitarianism the principle of utility is directly used to guide
actions [assess and promote the consequences of specific actions]
* In rule utilitarianism, the principle of utility is used to formulate general
rules which in turn are used to guide actions [best rules to follow overall]
Utilitarianism in healthcare?
The greatest amount of quality healthcare for the maximum number of
patients possible.
For a utilitarian, the ethically correct action will be that which
results in the maximum overall benefit.
* in making decisions about health care this theory requires
consideration of the benefit to be gained from the various
competing options in terms of the improvement in health for
an individual and also the number of individuals who could
benefit.
What are the criticisms for utilitarianism?
Several criticisms of consequentialism apply for the utilitarian approach
* Because we cannot predict the future it is difficult to know with certainty
whether the consequences of our actions will be good or bad
* the utilitarian calculation requires that we assign values to the
benefits/harms resulting from our actions and compare with other
actions
* But it’s often difficult, if not impossible, to measure and compare
the values of certain benefits and costs.
* How do we go about assigning a value to life?
* And do we compare the value of money with, eg the value of life?
* Utilitarianism faces severe limitations accounting for values such as
justice and individual rights
Ethical issues associated with costing healthcare?
Today utilitarians often describe benefits and harms in purely economic terms of
monetary benefits over monetary costs.
* Resource allocation (money, time, equipment, organs etc)
* Who will choose?
* The patient
* The doctors
* The government
How is healthcare resource allocation determined?
Measure of QALYs - Quality-adjusted life year is a generic measure of disease
burden, including both the quality and the quantity of life lived
* Measure of DALYs - Disability-adjusted life year is a measure of disease burden,
expressed as the cumulative number of years lost due to ill-health/disability
What is deontological ethics?
- Deontological ethics is often seen as the opposite of consequentialist
ethics. - Where the consequentialist is concerned with the outcome of the
action, the deonotologist is concerned with the nature of the action
itself - the rule/law/reason for which an action was taken
- For the deontologist, some actions like murder are just inherently
wrong, no matter the ultimate result. - ‘Right’ has priority over the ‘Good’
What is the key focus of deontology?
An action is right if it is in accordance with a moral rule or principle
* Some actions are morally forbidden
* Some actions are morally permissible
Deontology in terms of duties and rights?
Deontology is a duty-based scheme of ethics
* Approaches framed around what people must do or must not do
[duties]
* others on what must be done or must not be done to people
[individual rights]
* In medical ethics this translates to duties/requirements/obligations that
should be followed and fulfilled without exception
What is a moral rule?
A moral rule is one that
* is laid on us;
* is required by reason;
* would be chosen by all rational beings
What two imperatives does deontology consist of?
Hypothetical imperative: do this in order to achieve that
Categorical imperative: do this! [unconditional command]
What are parameters of an ethical act?
- Self
– Are you ready to accept the same act on yourself? - Universalisability
– If you can universalise an act and still it is right, then it is ethical. - Means
– Any person should not be used as the means but always at the
same time as an end; (people are equal and deserve equal
respect)
What are deontology’s strengths?
- simple to apply; requires that people follow the rules and do
their duty. - tends to fit well with our natural intuition about what is or isn’t
ethical. - Unlike consequentialism, deontology doesn’t require weighing
the costs and benefits of possible consequences. This avoids
subjectivity and uncertainty
What does a rule-based ethical theory mean in medical practice?
-It would mean that the doctor attends to each patient with the same
set of rules
-Rules which are set before the consultation and are not permitted to
be broken
-the moral acts of the doctors are to be judged in terms of their
conformity to rules, duties or obligations.
What are the challenges with rule-based medical ethics?
- Each patient is a unique person with individual
health needs - one set of rules will inevitably not suit every patient or not apply to
any situation - Having a set of pre-set rules allows no much room for manoeuvre in
varying situations - Also, if rules or duties conflict, it may not be clear what one should
do
