PHL281 Bioethics Lecture 1

What is ethics?

The idea whether an action is morally permissible (not ideas since ideas
are harder to determine)
The search for objective principles for resolving ethical dilemmas
The study of morality from a philosophical critical point of view (this does
not mean that the ethical principles cannot be grounded in religion)

Philosophical ethics (also called moral philosophy) OUGHT:

Normative ethics: search for moral standards or norms (How should we

live?)
Metaethics: study of what moral beliefs mean and how theyre justified
(What do we mean by right? How did we get those standards?)
Applied ethics: Application of norms (from normative ethics) to actual
moral problems bioethics is ethics applied to biological situations
o Difficult to do since there is no unified view about what moral
principles should hold in each case

Descriptive ethics: describe how people actually behave (usually done by

psychologists, sociologists etc) (How do we live? What do we believe?) IS
Moral principles in bioethics

A general guideline for determining more specific rules of right action

What happens if these principles conflict with each other?
How should we interpret these principles, e.g. what is the best for the
patient vs what the doctor thinks is best for the patient?

Principle of beneficence: We should act so as to benefit others and avoid

doing them harm

E.g. of more specific rules: It is wrong to hit someone; it is wrong to

steal
Application of principle varies between circumstances: its usually
wrong to push someone unless a car is about to hit them
Originates in the Hippocratic Oath from Ancient Greek: I will apply
dietetic measures for the benefit of the sick according to my ability
and judgment; I will keep them from harm and injustice
Two components:
o Active beneficence: We should actively advance the welfare of
others and prevent harm (make an effort to save the drowning
child)
o Non-maleficence: We should refrain from intentionally or
unintentionally harming others (just dont push the child into pond)
Violated if a physician deliberately harms patients but also if
patient is hurt as a result of recklessness or negligence

Health professions must exercise due care should cause

no more pain than necessary
Some people argue that we all have a duty of non-maleficence but
not active beneficence
o Active beneficence is supererogatory, i.e. beyond call of duty
o Unless you are from certain professions e.g. healthcare
practitioners, police officers
o Good Samaritan act: one is not held legally responsible for
consequences of ones action to help someone but laws arent
the focus of this course

Principle of autonomy: Persons should be allowed to exercise their

autonomy, i.e. their rational capacity for self-determination

Need to have capacity to make decisions (mentally and physically

rational, adults etc.)
E.g. of specific rules: We shouldnt treat patients against their will,
conduct experiments on someone without their consent, deceive
patients by withholding relevant information
What happens if autonomy is compromised, e.g. drug addicts,
alcoholics, people with severe psychiatric illness, children and
infants?
o Who should make decisions?
When can autonomy be limited?
o Usually to prevent harm to others, e.g. by quarantining the ill
o In cases of paternalism? (Paternalism is the overriding of a persons
decision-making for their own good)
Principle of utility: We should act to produce the greatest amount of
benefit and the least amount of harm for everyone

Requires us to weigh the goods and harms of our actions AND/OR

o E.g. in medical therapeutic decisions between surgery and
lifestyle changes
Requires us to consider everyone affected by our actions
o E.g. Killing one person to save 30 other people
o E.g. vaccinate 400,000 children even though 2 will die from
reaction to the vaccine
o For the sake of argument, assume that all lives are seen to be
equal
Benefit and harm are open to interpretation
Assumes that we know the consequences of our actions
E.g. of cases where we have to consider both: choose between
developing cure for rare, deadly heart disorder or common but nonfatal skin reactions

Principle of justice: Equals should be treated equally

Two types:

Retributive justice: fair punishment for wrongdoing

punishment matches the crime
o Distributive justice: fair distribution of societys resources
People should be equal based on their moral decisions
o Okay to treat criminal but not based on skin colour
Two theories:
o Libertarian theories: individuals have the right to pursue their
own well-being in a free market limited role for
government; distributing resources equally would violate the
liberty of those who have wealth (US healthcare system)
o Egalitarian theories: only an equal distribution of resources is
just, even if individual liberties is restricted (UK healthcare
system)
o

What happens when moral principles conflict?

What if what someone would choose to do harms her? E.g. Blood

transfusion for someone who refuses on religious grounds (principle of
autonomy vs principle of beneficence)
Possible argument: no one knows what is best for the person except for
them themselves, in that case principle of autonomy does not conflict
principle of beneficence
Goldmans theory: theory that physically ill patients are not fully
autonomous; doctors should restore their autonomy
How to weigh principles against one another? Which ones are most
fundamental?

Argument fundamentals

An argument consists of one or more premises (reasons for believing the

conclusion) and a conclusion(your opinion/position on a matter)
Validity of an argument: argument has the right structure
Soundness of an argument: argument is valid and the premises are true
Deductive argument: If premises are true, the conclusion MUST be true
o Valid if and only if the truth of the premises guarantees the truth of
the conclusion
o Sound if and only if it is valid and the premises are true check
truth of if and thenthan act
P1: All men are mortals
P2: Socrates is a man.
C: Therefore, Socrates is mortal.
o Valid
P1: If Amy studies, she will pass the course
P2: Amy passes the course
C: Therefore, she studies.
o Invalid because it is possible for her to pass the course even if she
didnt study
o In general, valid arguments have the form:
P1: If X, then Y
P2: X

C: Y
Inductive argument: if premises are true, the conclusion MAY be true
o The strength of an inductive argument depends on how likely the
premises make the conclusion to be true
P1: Most students who study pass the course
P2: Amy studies
C: Therefore, she will pass the course.
o It is possible for Amy to fail the course even if she studies if shes
not clever etc.
Moral vs Nonmoral norms

Normative dominance: moral norms presumed to take precedence over

other types of norms
Impartiality: everyone is treated the same unless there is a morally
relevant difference
Reasonableness: moral judgements should be more than mere personal
taste or emotional responses and should be obtained through careful
reasoning
Universality: applies in all relevantly siimiar situations (applies to both
moral and nonmoral norms)

Objectivism vs Relativism (under metaethics)

Moral objectivism: moral norms apply universally; same for everyone

there is objective morality
Ethical relativism: moral standards are relative to individuals or cultures
(note cultures in the past vs present); there are no objective moral truths
moral standards are created by individuals or cultures not discovered
o Subjective relativism: morality is relative to individuals
Right and wrong is based on your own beliefs
We can agree to disagree! BUT
It conflicts with fundamental moral intuitions, e.g. Rwandan
genocide, Holocaust will not be objectively wrong
Disagreeing about moral facts amounts to expressing
personal tastes theres no point in arguing for any
particular moral standard
We shouldnt accept subjective relativism.
o

Cultural relativism: morality is relative to cultures

Right and wrong depends on which culture one belongs to
Individuals may not hold the same moral beliefs as the one
accepted in the culture (reformers will always be wrong)
Argument for ethical relativism:
P1: If moral judgements vary between cultures, then moral
norms are relative to culture (there is no objective morality)
P2: Moral judgments vary between cultures
C: Therefore, moral norms are relative to culture.
Valid argument!
Sound? P1 is not necessarily true

The fact that peoples judgments vary doesnt by itself

imply that there is no objective morality (same
problem with subjective relativism) it only shows
that different cultures do not know objectively what
should be right
Conflict between moral beliefs does not always mean a
conflict between fundamental moral norms might be
due to othe differing non-moral beliefs
Recall moral principle: general principle for determining more
specific rules of right action.

Consequences:

If Nazi Germany (a culture within a time period) says mass

murder is right, then it is right! we cannot criticise other
cultures since each culture makes its own moral principles
There will be no such thing as moral progress.
Social reformers are always wrong since
What if you belong to multiple cultural groups?
Cultural relativism doesnt necessarily cultivate tolerance
since tolerance is not an objective norm

Fallacies

Straw man fallacy: misrepresentation of a persons views so that they can

be dismissed
Appeal to the person (ad hominem) fallacy: rejecting the statement cos it
comes from a particular person
Appeal to ignorance: arguing either
o A claim is true cos it has not been proven false
o A claim is false cos it has not been proven true
Begging the question: proving the conclusion by using the same
conclusion to support, i.e. X is true because X is true
Slippery slope fallacy: arguing that a particular action should not be taken
because it will lead to other actions resulting in some dire outcome when
there is no reason to believe that the predicted chain of events will happen