Health Ethics Midterm Exam Study Guide Recently Dominant Theories:

Teleological (Consequentialist) Theory Def: any ethical theory that claims the rightness and wrongness of human action is exclusively a function of the goodness and badness of the consequences resulting directly from that action. Utilitarianism Act Utilitarianism: a person ought to act so as to produce the greatest balance of good over evil, everyone considered. Understood as a form of situation ethics because the act utilitarian has no sympathy for the notion that certain kinds of actions are intrinsically wrong; thus, the morality of the action is a function of the situation confronting the agent. Makes a direct appeal to Utility Greatest Happiness Principle=only rule-says you should always act in a way that the result is more happiness than unhappiness;everyone considered. Mill (happiness:intrinsic value; unhappiness:intrinsic disvalue) Hedonic Calculus= Benthams idea of pain or pleasure (pleasure:intrinsic value; pain:intrinsic disvalue) Process of Utilitarian Decision Making: 1. Identify alternative course actions 2. Foresee consequences of each action 3. Evaluate the consequences by weighing the good and bad-place value Rule Utilitarianism: a person ought to act in accordance with the rule that if generally followed, would produce the greatest balance of good over evil; everyone considered.

Follows a set of rules to maximize happiness (commonsense rules of morality: do not kill, steal, lie, break promises) The rules can be broken if it maximizes happiness (ex: Killing Bin Laden) Involves an indirect appeal for the principle of utility which is determined by Utility itself.

Ethical Egoism: a person ought to act so as to promote his or her own self interest An action is morally right if when compared with possible alternatives, its consequences are such as to generate the greatest balance of good over evil for the agent. Deontological (Non-Consequentialist) Theory Def: The rightness and wrongness of human action is not exclusively a function of the goodness and badness of an action- Places limits on the importance of consequentialist considerations. Kantian Ethics Kant says morality must not be rooted in the circumstances of the world or in the particular circumstances of my own life, but reason alone. Focus is on RATIONALITY My motive for acting must be the right thing-duty The duty is Moral Law(expression of Reason-it must therefore be logically consistent and free from internal contradiction)=Categorical Imperative Categorical Imperative: universal/unconditional command 1. Universal Law Version=test the basis (maxim) underlying ones actionif the reasoning cant be universalized without some logical inconsistency or contradiction, then it does not pass the test. 2. Respect for Persons= act in such a way that you never treat other persons as a means only, but always as an end in themselves. 3. Kingdom of Ends Perfect Duties: those that requires us to do (or refrain from) certain specific things.

To Self: requires me to always treat myself as an end and never as a means to some other end. Ex: must avoid drunkenness, and I may never end my own life. To Others: requires me to always treat other persons as ends and never as a means to some other end. Ex: I may never lie or kill innocent; I will honor my promises to others. Imperfect Duties: those that require us to generally do things to promote certain ends (only if it doesnt bring us into conflict with any perfect duties) To Self: requires me to promote certain general ends regarding myself, essentially to live in such a way that I improve and cultivate my capacities and talents. (duty to personal development) To Others: requires me to promote certain general ends regarding others, essentially to commit myself in a general way to improving the welfare or happiness of others. (duty of beneficence) The two main schools of normative ethics have a top-down, deductive approach to moral decision-making. Both Kantian and Utilitarian theories begin with an allimportant moral rule, and correct moral behavior is deduced from the rule. For Utilitarians the all-important rule is the Greatest Happiness Principle and for Kantians it is the Categorical Imperative. So even though the former is consequentialist and the latter deontological (non-consequentialist), they share the top-down, rule-oriented approach. Some are critical of this general approach; they argue that ethics ought to have a more bottom-up approach, in other words, an approach that is rooted more in the persons and situations involved and less on the abstract moral rules.

Act Utilitarianism

Strengths Happiness is goal Considers effects and consequences Happiness is goal Very practical way of thinking about ethics Everyone is considered which makes everyone love it Confidence comes from knowing what is right is going to be clear

Rule Utilitarianism

Weaknesses Thought process is really long More difficult-not obvious and clear Does not lead us to conclusions as easily

Kantian Ethics

They do not talk about consequences Conflict of duties

Alternative Directions and Methods: Virtue Ethics: Thinking about morality should focus on persons rather than actions; so we should strive to cultivate in ourselves moral virtues like compassion, integrity, and honesty. Agents=focus. Shift of Emphasis= In addition to actions, switch to hat virtues we should possess as individuals. Ex: Honest Abe in Gecko commercial/ I love Lucy Character vs Action: Someone running for office who randomly starts donating money to school shows bad character; but someone who lies to protect a loved one shoes good character. Moral Agency vs Moral Rules: m.a.(anyone who has to make a moral decision) and m.r.(need to have right virtues and character, not just action) Ethics of Care: Thinking about morality should focus on relationships, and our aim should be to have a caring and nurturing attitude towards the persons with whom we are socially involved. Emphasis on Emotion:

Emphasis on Relationships:

Moral Experience of Women:

Feminist Ethics: Thinking about morality should take seriously the moral experience of women, and should emphasize the value of ending all forms of oppression (including the oppression of women). Value of ending Oppression:

Upholding Womens issues in Healthcare:

Casuistry: Thinking about morality should be rooted in particular cases; moral rules should be derived from clear-cut, landmark cases, and then applied to any new cases that bear similarities to the landmark. Case-orientation:

Bottom-Up Approach:

Landmark/Paradigm Cases:

Precedent (maxim):

Confronting Ethical Relativism: Ethical Relativism Relativism:theory about where morals come from. Derived from cultures.

Relativisms Challenge to Traditional Ethics: points out a contradiction

Influence of Multiculturalism:

Arguments Against Ethical Relativism Tolerance Argument:

Implausibility Argument:

Moral Progress Argument:

Internal Challenges Argument:

Fundamental Concepts and Principles: Autonomy Def: self governing ex: Good Conscience For an action to be autonomous: Intentionality: has to do with ones intent to act(my action must have some intent behind it to be autonomous) ex: actor uses real instead of fake gun Understanding: threshold, matter of degree(partial understanding). Simple idea that in order for my action to be autonomous, I need to understand what I am doing. Ex: little boy in florida who kills kid by body slam Freedom from External Constraints: physical. 1. Occurent: use of force to force someone to do something against will

2. Dispositional: the source of constraint is a threat. Ex: Moving out of line wasnt autonomous; it was an act of coercion because of the threat. Freedom from Internal Constraints: mental. Originate inside ones mind ex: alcoholism Mental illness-may be off the hook because it wasnt my own autonomy who made me act that way Undermining autonomy Mills Views: persons possessing individuality are autonomous in a very strong sense, reflectively choosing their own plans of life, making their own decisions without force or manipulation by others, and exercising determination and self-control in acting on their decisions.

Kants Views: Persons, unlike things, must always be accorded respect as selfdetermining subjects. He says that the fundamental principle of morality, respect for persons as moral agents, entails respect for personal autonomy.

Liberty Limiting Principles Harm principle: a persons liberty is justifiable restricted to prevent that person from harming others Offence principle: a persons liberty is justifiably restricted to prevent that person from offending others The principle of paternalism: a persons liberty is justifiably restricted to prevent that person from harming himself or herself The principle of extreme paternalism: a persons liberty is justifiably restricted to benefit that person The principle of legal moralism: A persons liberty is justifiably restricted to prevent that person from acting immorally The social welfare principle: a persons liberty is justifiably restricted to benefit others

Paternalism Def: interfering with a person's freedom for his or her own good. Legal vs Moral Paternalism: Legal moralism says its legitimate to interfere with a person from performing an immoral act. Legal moralism focuses on preventing immoral actions. Moral paternalism focusses on the agents moral character

Moral paternalism would say that any action that degrades the moral character of the agent, resulting in a degraded moral character, is something that the state is justified in forcibly preventing Legal paternalism is the view that it is permissible for the state to legislate against what Mill calls self-regarding actions when necessary to prevent individuals from inflicting physical or severe emotional harm on themselves

Kantian views:

Mills views:

Diminished Autonomy:

Strong Paternalism vs Weak Paternalism: A weak paternalist would argue that it legitimate to interfere with a persons actions if that persons means run counter to their best interests. A strong paternalist would argue that it legitimate to interfere with a persons actions if that persons goals involve an end, which is not in their best interests (according to the governing body).