Exam 1 Flashcards
Philosophy
The love of wisdom
Ethics
The study of morality using the tools and methods of philosophy
Metaethics
The study of the meaning and justification of basic moral beliefs
Normative ethics
The search for, and justification of, moral standards, or norms
Applied ethics
The use of moral norms and concepts to resolve practical moral issues
Bioethics
Applied ethics focused on health care, medical research, and medical terminology
Characteristics of moral norms
- Normative dominance
- Universality
- Impartiality
- Reasonableness
Moral obligations
Concern our duty - our actions
Moral values
Concern things we judge to be morally good, bad, praiseworthy, or blameworthy - character or motive
Absolute principles
Applies without exceptions
Prima facie principle
Applies in all cases unless an exception is warranted. Prima facie is latin for “first impression”
Autonomy
- Prima facie
- Self rule/free
- The right to self determination
- Basis for informed consent
- Paternalism severely restricts autonomy
Beneficence
- Doing good to others
- From Aristotle’s virtue ethics
Non-maleficence
- Above all do no harm
- From the Hippocratic oath
Justice
- Fairness
- Universal rule of justice: “treat equals equally and unequals unequally” (only morally relevant disparities are allowed)
Fidelity
Faithfulness
Veracity
Binds the provider to honesty
Shortcomings of principlism
- No objective foundations
- Subjective and realistic
- Does not foster personal moral integrity or function as a guide for ethical decision making
- The controversy of human life and personhood is impossible to decide using ethical principles
Subjective relativism
The view that right actions are those sanctioned by a person
Cultural relativism
The view that right actions are those sanctioned by one’s culture
Moral objectivism
The view that there are moral norms or principles that are valid or true for everyone
3 acts of the mind
- Understanding
- Judgment
- Reasoning
Understanding
- Term
- Good when clear or unambiguous
- What do you mean?
Judgement
- Proposition
- Good when true
- What is your point?
Reasoning
- Argument
- Good when valid
- Why?
Logic
The science of good and bad reasoning
Argument in logic
A set of statements including one or more premises and one main character
Deductive arguments
Strict proof
Inductive arguments
A generalization or extrapolation based on evidence, objective, science
Sound arguments
Valid and the premises are true
Valid arguments
The conclusion follows from the premises
Invalid arguments
The conclusion does not follow from the premises
Cogent argument
Premises establish probable support for the conclusion
Why use inductive arguments when they are invalid?
We cannot test all instances in the past/present/future
Appeal to common opinion
Urges acceptance of a position on the grounds that most or many people accept it
Appeal to pity
Urges acceptance of a position by appealing to sympathy instead of relevant evidence
Appeal to tradition
Urges acceptance of a position by appealing to one’s feelings of reverence or respect for some tradition instead of evidence
Circular reasoning
Uses its own conclusion as one of its stated or unstated premises
Is-ought fallacy
Assumes that because something is now the practice, it is ought to be the practice, or if something is not the practice, it ought to be the practice
Fallacy of the golden mean
Assumes that the moderate position between two extremes must be the best one
Arguing from ignorance
Argues that a claim is true because there is no evidence or proof that it is false, and vice versa
Post hoc fallacy
Assumes that a particular event B is caused by another event A simply because B follows A in time
Slippery slope argument
Urges acceptance of a position without appropriate evidence that a particular action or event is just one, usually the first, in a series of steps that will lead inevitably to some specific consequence
Ad hominem
Attacks the person making the argument as a means of ignoring or discrediting his or her position or argument
Straw man fallacy
The fallacy misrepresents an opponent’s point of view or argument usually for the purpose of making it easier to attack
Resort to humor or ridicule
Intrudes humor or ridicule into an argument in an effort to cover up an inability or unwillingness to respond appropriately to an opposing position
Why study ethical theories?
- They help us understand the ethical frameworks of other people
- They help us understand our own moral foundations
- Enable us to make the best rational ethical decision possible
- Useful when you need to explain your course of action
Utilitarianism
- The greatest good for the greatest number of people
Weakness: - No action in and of itself is wrong
- We cannot force the future
- Who are included in the number
Deontology
- Duty
- An act or class of actions is justified by showing that it is right with little regard to consequence
Weaknesses: - Relativism
- Rules matter more than people
Strengths: - Treats everyone the same
Teleology
- Goal
- Natural law theory: human reason enables us to know which acts we ought or ought no perform
- Everything has a purpose
Strength: Hope
Weakness: Complex
Virtue ethics
- A moral theory that focuses on the development of virtuous character
- Excellence is not tied to results
- If we have goos character people we won’t worry about rules/laws because they will do the right thing
- Weakness: subjective, pride - virtue vs vice
- Strength: power to do the right thing
Feminist ethics
- An approach to morality aimed at rethinking or revamping traditional ethics to eliminate aspects that devalue or ignore the moral experience of women
- Generally downplays the role of moral principles and traditional ethical concepts
- Moral reflection must take into account the social realities
- Ethics of care: the heart of the moral life is feeling for and caring for those whom you have a special intimate connection
Other ways of doing ethics
- Legal/social contract: moral or political theories based in the idea of a social contract or agreement among individuals for mutual advantage
- Casuistry: based on judgements about similarities and differences between cases
- Case and analogy rather than universal principles and thought
- practical judgements about similarities and differences between cases
Why involve religion in bioethics?
- Religion is important for the vast majority of people
- Trying to separate secular from religious is difficult because most people use a blend of secular and religious ethics and ideas
- The influence of religion on the development of medicine cannot be overstated
- One simply cannot talk about bioethics without reference to religion. Many of its formative voices were scholars from religious traditions
Christian ethics founded on the gospel
- A kind of virtue ethics: concerned with the character of the person and not just actions
- Teleological: guided by its end purpose, the hope of eternal life in heaven
Christian ethics founded on Law is
- Deontological: it says what’s right and wrong
- Teleological: guided by an end purpose, accountability on judgement day
Car analogy for describing the comprehensive nature of christian ethics
- Virtues are like the motor, giving us the proper motivation for ethics
- Rules are like the steering, keeping us from danger
- Having an intact car is useless unless we have a purpose for using it, a destination, a goal
5 step decision making process
- Collect all data pertinent to the case
- Determine legal and ethical standards applicable to the case
- Identify the ethical situation
- Options
- Make the decision and act
Double effect
- The object of the act is good or indifferent
- The evil effect is not directly intended but may be foreseen
- The good effect is not produced by means of the evil effect
- A proportionately good reason must exist for tolerating the evil effect
Material cooperation
- The more remote the cooperation, the better
- Extreme duress may justify cooperation
- Benefits from cooperation greatly outweigh the wrongdoing that will result
Concepts Christians contract with autonomy
- Autonomy is the dominant principle in today’s bioethics
- Christians contrast: the Community, the Church
- We are not truly autonomous; we are dependent
Secular view of personhood
- Humans with capabilities
Non-poersons: the unborn, those with disabilities PVS patients Alzheimer’s patients
Christian view of personhood
All humans are persons from beginning to end of life
Christian view on modern medicine
- God created medicine
- Health care providers can be means for God to provide blessings to us
Views of suffering
Secular: avoid suffering at all costs
Christian:
- Expect suffering because it is due to sin
- God can bring about good from suffering
- Christians normally do not like it and can avoid suffering, but they do not do sp by violating clear biblical moral laws
Evolving Concern
Page 48
Nuremberg code
page 50
Declaration of Helsinki
- Recommendations guiding medical doctors in biomedical research involving human subjects
- It recognizes the need to do research on non-consenting subjects such as infants, children, the developmentally disabled, and the critically ill
Belmont report
- Respect for persons
- Beneficence
- Justice
Institutional review board
- Established to give peer and ethical review of human subject research
- Main purpose: to review research and determine if the rights and welfare of human subjects involved in research are adequately protected
- Secondary roles: to protect researchers, institution, and the Church
Oversight of human subject research
- Office for human research protections (OHRP)
- 45 CFR 46 - basic ploy for protection of human research subjects
- All government departments adopt same rules on human subject research
- Applicable state laws
- Institutional policies and procedures
Two questions IRBs need to ask
- Is the project human subject research?
- If yes, what level of human subject research does this protocol fall under?
Levels of IRB review of studies
- Full board review: studies involving greater than minimal risk or deception
- Expedited review: not greater than minimal risk, 9 categories defined
- Exempt: still reviewed by IRB
Ways consent can be given without a written consent form
- Describes study on first page
- A script is read before the survey is distributed
Cautions of human subject research
- Research on children and those who cannot give informed consent
- Research on human embryos and fetuses
Stages of clinical trials
- Tests the drug in a few people for safety and adverse reactions and ascertains safe and unsafe doses
- Investigators give the drug to larger groups of subjects to get a preliminary indication of its effectiveness and to do more assessments of safety
- Researchers try to finally establish whether the drug is effective, determine how it compares with other proven treatments, and learn how to use it in the safest way
Justification for clinical trials
- Therapeutic trials are usually justified by the potential good to the subjects and to the future patients or society
- Non-therapeutic trials are often justified by significant potential good to society
Ethical questions regarding animals in research
- Should they be used?
- How should they be used
Left off on number
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