Wk4 Why Tell The Truth? Flashcards
What is utilitarianism?
Maximise happiness for the most people possible, minimize suffering
- Whether an action is right or wrong depends on its outcome, not the act itself
- Eg. the railroad problem
- We should tell the truth if it will lead to a good outcome
- We should lie if it would lead to a better outcome than the truth
- ‘Act’ vs ‘rule’
- Act : each act evaluated separately
- Rule : extrapolate rules such that you could be happy that if people generally
behaved in this way, it would lead to the best outcomes
Advantages of utilitarianism
- Seems pretty intuitive, and marries up with how at least some of us think about morality
- Is considered a form of distributive justice (distribution of welfare / wellbeing in this case) and therefore can deal with the good of societies, not just individuals
- Flexible - considers the particulars of a situation, not just rigid rules
- Although, with rule utilitarianism, that’s what you might end up with - albeit rules which are designed to achieve optimal welfare
Problems with utilitarianism
- Consequences can be pretty difficult to predict
- If you predict a good outcome, but get a bad one - does that mean it was a morally wrong
decision? - Consequences can also be far-reaching, or impossible to measure - How do you weigh up benefits / detriments?
- People have no intrinsic value in this system
- People are a means to an end - one individual would be expendable in the interests of many
- In this system, one person might feasibly be considered as more valuable than another, depending on their ability to lead to more happiness
What are deontological ethics?
- We are rational beings
- Rational beings are capable of reason
- From our reason, we can decide what our moral duties are, and from that
decide what actions are right and what actions are wrong - Actions are inherently right or wrong - it is not about the outcome of those
actions - eg. lying is wrong, even if it helps someone - From our reason we can generate a list of rules which apply universally,
regardless of the situation, and which will allow us to always be ‘in the right’
What are the advantages of deontology?
- accords human beings moral worth
- People are not expendable. They are not ‘a means to an end’ - eg. they should not be
sacrificed for the happiness of others - reflects how at least some people perceive morality
- it places value on intention
- if you do something that you believe to be right, you are in the right even if it leads to a bad
outcome - offers certainty
- don’t have to worry about the probability of certain outcomes
- decision making is massively simplified - in a way the decision is already made, if you live by a
rigid moral code
What are the disadvantages of deontology?
- Too rigid
- there are always going to be cases that don’t fit
- … so you end up with huge lists of exceptions
- allows acts that cause immense suffering in the defence of a principle
- classically, the ‘railroad track’
- But also small things - “did he suffer, doc?”
- duties often conflict
- Ross (1930) discussed ‘balancing duties’ to find the ‘actual duty’
- …. however this is often difficult to do
- how rational are we really?
Ethical pluralism: what are Ross’ seven duties?
- fidelity (promise keeping)
- reparation (making up for past harm)
- gratitude
- justice
- beneficence (doing good to others)
- self-improvement
- non-maleficence (avoiding harm)
What are the 4 principles of medical ethics?
- beneficence
- non-maleficence
- justice
- autonomy
What is the myth of objectivity?
- None of us are really objective
- We all arrive at each decision we make with a pre-existing set of values
- Evidence suggests that this is one of the most important factors influencing decision-making
- Often when we say ‘objective’ or ‘rational’ what we mean is ‘without emotion’
- The Greeks disagreed
- Aristotle - emotion is the guide of reason
- Many cultures across the globe have associated emotions with insight and wisdom, as have
modern philosophers - Emotion flags something morally pertinent - unpick it
- Believing you are objective makes it harder to see that you are wrong
What is Aristotle’s model of ethics called?
Virtue ethics
Cultivating a moral character (cultivating right values) and phronesis - practical wisdom
What would a good person do in this situation?
Oftener based around mentor or role-model
What are the advantages of virtue ethics?
- Phronesis does seem to describe pretty accurately many people’s experience
of the decision-making process - Acknowledges the complexity of decision-making, and the influence of our previous
experiences - Most people do report that they have role-models that they emulate
- Developmental model - it doesn’t expect us to be perfect, but acknowledges
the imperative to improve
What are the problems with virtue ethics?
- nebulous - doesn’t help with decision-making - imagine what an ‘ideal’ doctor would do
- What is virtue, or who is virtuous?
- are you just picking a role model whose values you already share?
- virtuous character takes years to develop - what about now?
- self-centred - the HCP is central in this model - so where is the patient?
- virtues are exercised in the interests of the patient
- however, the patient is still denied agency - they are something to be ‘acted on’
- encourages perfectionism - continual comparison to a fictional ‘perfect’ doctor
- role-model based - so it can perpetuate ‘problem’ norms and values
So why tell the truth?
Utilitarianism : if it increases happiness, or diminishes suffering Deontology : because it’s your duty
Virtue : because it’s what a good person would do
What is supporting trust?
- Without trust we can’t function as a society - and that is ethics’ ultimate point
- Honesty is required for that trust
- Being dishonest leads to a net decrease in the trustworthiness of the system - therefore it is unethical
What are problems with the trust model?
- Like utilitarianism, decision-making can be very complex - How do you quantify trust?
- What if something would increase trust, but would be detrimental to meeting social needs?
