Lec 69: Introduction to Ethical Analysis

Question 1

Traditional Approach

Answer 1

uses moral reasoning. Clinicians must recognize the ethical dilemma, assess this situation, decide what they want to do and then use several approaches to double check this decision.
7 steps

Question 2

Adujunctive Approach

Answer 2

1. Casuistry
2. Care Perspective
3. Narrative Ethics
4. Feminist (and Communitarian) Ethics

Question 3

Casuistry

Answer 3

What other cases they know of in which the same ethical values are at stake?

Question 4

Care Perspective

Answer 4

How will what they do affect their relationships with their patients?

Question 5

Narrative Ethics

Answer 5

Is there more about the patient and persons like the patient that the care provider needs to know?

Question 6

Feminist (and Communitarian) Ethics

Answer 6

Are there people involved but more “on the periphery” whose needs should be taken into account?

Question 7

Traditional Approach Step 1

Answer 7

Recognize that a conflict exists

Question 8

Traditional Approach Step 2

Answer 8

Decide what additional data are needed

Question 9

Traditional Approach Step 3

Answer 9

Make the decision

Question 10

Traditional Approach Step 4

Answer 10

Test the consistency of the decision by comparing it with comparable situations

Question 11

Traditional Approach Step 5

Answer 11

Consider how this problem can be prevented in the future

Question 12

Traditional Approach Step 6

Answer 12

Review past experiences to check for biases

Question 13

Traditional Approach Step 7

Answer 13

Assess how the decision to be made could affect the patient/care provider relationship

Question 14

Libertarian Model

Answer 14

Unfortunate, not unfair.

Neglect of history

Question 15

Egalitarian

Answer 15

Veil of Ignorance.

Decent minimum

Question 16

Utilitarian

Answer 16

Assessing values (maximize utility/benefits, minimize suffering/negatives)

Question 17

Balancing Approach

Answer 17

Balance utility and dignity

Question 18

Fourth Theory

Answer 18

Reduce pain (pain is an evil which leads to harm) since its perception provides the status of sentience (a moral status) to an organism.

Question 19

Fifth Theory

Answer 19

Relationships provide moral status (e.g. patient-physician, each patient interaction is unique and provides moral frame of reference).
Social reciprosity/relationships > strangers/outsiders
More social interaction = greater moral status (“Social Networks”)

Question 20

Norm

Answer 20

Prima Facie (impermissible) standard, e.g. don’t break it. Tabulated in guidelines.
Guideline 1: All sentient beings have level of moral status. Non-sentience = no moral status (e.g. anencephalic individuals).
Guideline 2: “competitive” in that mere sentience (e.g. fetus) = no moral status also
Case: Guideline 2 supports stem cell therapy if proven to work
Guideline 3: “Sentience (Theory 4) and cognition (Theory 2)” increase moral status
Guideline 4: “moral agency (T3) and human species properties (T1)” says if human has moral agency then they have equal basic rights, and vice versa.
Guideline 5: “Theory 4 and 5” shows that animals’ moral rights scale with potential for pain. If potential for pain increases then moral status also increases. (Pain proportional to moral status)

Question 21

Vulnerable populations

Answer 21

deserve more protection (unable to protect their own interests). E.g. elderly.
Outcome 1. Policy of full prohibition on activities involving such groups
Outcome 2. Allow practice without conditions (fully permissible)
Outcome 3. Conditional practice (partial permissibility)

Most studies utilize outcome 3, though this outcome may diminish benefit of research to such groups. Compromise: If certain groups cannot be treated equally then establish levels of risk/harm.

Question 22

Sympathy

Answer 22

concern for welfare, not preferential responsiveness.
Limited when bias/partiality affect reasoning of those distant and dissimilar (strangers) to us.
Hume  exercise “calm judgments” and be impartial