From Ethical Theory to Practice

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					From Ethical Theory to
       Robert Scott Stewart, Ph.D.
         Professor of Philosophy
  Chair, Philosophy & Religious Studies
          Cape Breton University
        Different Levels of Ethical
   Meta-Ethics: Defining the meaning of moral
    concepts. E.g., Are ethical claims relative or
    universal? What does the term „good‟ mean? What
    role does reason play in ethical judgments?
   Normative Ethics: What principles ought to guide us
    making ethical decisions?
   Practical Ethics: An examination of particular issues
    in ethics. E.g., Is euthanasia defensible? Are clinical
    drug trials involving children acceptable? Should we
    allow genetically modified foods on the market?
             Methods for ethics
   Name the issue(s)
   Collect and analyze the facts (all stakeholders
    + law and administrative policies)
   Ethical analysis of the issue(s) given the facts
   Suggestion of alternatives
   Implementation and follow-up (Handbook for
    Bioethics Committee Members)
    Ethical Theories: Utilitarianism
   The greatest happiness principle:
   “Actions are right in proportion as they tend to
    promote happiness; wrong as they tend to
    produce the reverse of happiness.” -
       John Stuart Mill (1806-1873)
   A “consequentialist” theory of value. Actions
    aren‟t right or wrong in themselves: it always
    depends on the context and the (expected)
            Utilitarianism: Pros
   Straightforward: provides one principle as the
    moral test of all actions (monistic theory of
   Intuitive appeal: we all seek happiness
   Has particular appeal with respect to „public‟
    morality or law. I.e., Social programs ought to
    aim for the biggest bang for the buck – high
    satisfaction, low cost (cost-benefit analysis:
           Utilitarianism: Cons
   How do we measure happiness (or pleasure)?
    Is my happiness (or unhappiness) comparable
    to yours?
   Possibly inconsistent with individual rights.
    E.g., in cases where trampling of my rights
    would produce overall utility.
   Possibly inconsistent with other things of value
    like loyalty and friendship.
   Kant and the first version of the categorical
   “Act as if the maxim of your action were to
    become through your will a universal law of
          Immanuel Kant (1724-1804)
          A secular version of the golden rule: “Do onto others as
           you would have them do onto you.”
          I.e., universalize your actions
   Kant‟s second formulation of the categorical
   “Always treat humanity, whether in your own
    person or that of another, never simply as a
    means but always at the same time an end.”
          Kant (1724-1804)
          Persons vs. things or mere objects
          Dignity and autonomy
             Deontology: Pros
   Straightforward: provides one principle (with
    two formulations) as the moral test of all
    actions (monistic theory of value).
   Intuitive appeal: humans do typically feel
    special and hence deserving of respect by not
    being used and by being allowed to make
    decisions over their own lives.
   Good ground for individual rights.
             Deontology: Cons
   Too restrictive and context independent.
   Is it always wrong to lie? Are there no
   Should we never assess the morality of our
    actions by their consequences?
   Offers no clear path when we have conflicting
    The impact of Utilitarianism and
   Despite their problems, utilitarianism and
    Kantian deontology provided the two main
    ethical theories in use until the late 20‟th
    century (and are still tremendously influential
   Alternatives:, (1) care rather than justice, (2)
    virtue ethics, (3) case studies (casuistry), (4)
    Theories of Care and Feminism
   Carol Gilligan (Harvard), In a Different Voice, 1982
   Attacked Kohlberg‟s theory of moral development as biased
    toward a male perspective who prefer abstractness and
    universals over the concrete and relationships .
   While males prefer abstract principles (like utilitarianism and
    Kantian deontology), females show a preference for
    relationships with specific people.
   Led to much feminist thought including the “ethics of care.”
   Feminism and care have been particularly influential in
    biomedical ethics since at the core of health care are special
    kinds of relationships b/w health care workers and patients.
                   Virtue Ethics
   Whereas utilitarianism and deontology emphasize
    whether a particular action is right or good, virtue
    ethics emphasizes the person making the judgments
    or doing the actions. I.e., a virtuous person will make
    virtuous decisions and act virtuously.
   Has its roots in Aristotle (384-322 BCE): stress on
    moral education, moderation, and relationships.
    Virtue in Greek is arete, which literally means
   Don‟t worry so much about theory. Look at
    actual cases and formulate principles on the
    basis of these.
   But is this possible with no guidance from
    principles at all?
   W.D. Ross (1877-1971) complained that
    utilitarianism and Kantian deontology erred in
    claiming that there was only one ethical principle (the
    greatest happiness principle or the categorical
    imperative). This was the main reason why neither
    had been able to secure complete acceptance.
   Utilitarianism too forward looking
   Deontology too backward looking
   A need for plurality of ethical principles which would
    incorporate elements of the two main theories.
   An increasing interest in applied ethics
    through the 1980‟s and 90‟s.
   Recognition (by some) that ethical theory as it
    stood not adequate to the task of applied
   Tom Beauchamp (Georgetown) and James
    Childress (Virginia), Principles of Biomedical
    Ethics (1979, 5‟th ed., 2001)
               Four Principles
   Autonomy
   Nonmaleficence
   Beneficence
   Justice

   Application and use various contexts: e.g.,
    codes of ethics and research ethics.
     Tri-Council Policy Statement
   Respect for Human Dignity
   Respect for Free and Informed Consent
   Respect for Vulnerable Persons
   Respect for Privacy and Confidentiality
   Respect for Justice and Inclusiveness
   Balancing Harms and Benefits
   Minimizing Harm
   Maximizing Benefit
    CNA Code of Ethics for Registered
   Safe, Competent, and Ethical Care
   Health and Well Being
   Choice
   Dignity
   Confidentiality
   Justice
   Accountability
   Quality Practice Environments
           Concluding Remarks
   No single paradigm for ethics: principalism is
    one attempt to incorporate various strands into
    one comprehensive system
   Not meant to be algorithmic
   Hardest decisions are ones where principles
    clash and we have obligations pointing in
    different directions.
   Sound judgment and humility required