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Transcript
Introduction To Bioethics
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We know Bio = life
Ethos = behavior/character
….but what is that really?
Ethics is quite complicated.
How do you define Ethics?
Many varied definitions…
What does it mean to you?
• Ethics - sometimes used as synonyms for
“morally correct” or justified - set of justified
moral principles of obligation, rights, and ideals
• Ethics - can be particular beliefs or attitudes
concerning morality
• Ethics - area of study or inquiry – an activity of
understanding moral values, resolving moral
issues, and justifying moral judgments
Values, Morals, Ethics
• Values signify what is important and
worthwhile. They serve as a basis for moral
codes and ethical reflection.
• Morals are codes of conduct governing
behavior. They are values put into practice as
actions.
• Ethics provide a systematic, rational way to
work through dilemmas and to determine the
best course of action in the face of conflicting
choices.
Ethics is related to morals and values.
What are moral values?
What is morality?
• Dictionary says – concerns right and wrong, good and bad,
the rules that ought to be followed.
• Latin MOS = custom
• Morality – about reasons centered in respect for other
people as well as ourselves, reasons that involve their good
as well as our own.
• Are everyone’s morals the same? (Guantanemo)
• Different cultures? (Persian King) Different times? (slavery)
Tuskeegee Experiment
This study began with good
intentions; it shifted from
being about helping those
afflicted with the disease to
becoming a study about the
effects of untreated syphilis
on live patients.
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•
Free medical care, food and
transportation, burial stipend
(if autopsy was allowed),
• 1932 to 1972 !! (penecillin
invented in 1947
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Nazi experimentation and
Eugenics movement
• Nazi scientists and
doctors did all sorts of
experiments done,
mostly on Jews, to
show effects of freezing,
poisons, head trauma,
malaria, and others
involving twin studies.
• Eugenics was trying to
make the genes of
humans “better”, more
“pure”.
DDTpesticide
• Banned in U.S.
• Concentrates in food
chain (biological
magnification
• Nerve toxin
• Causes cancer and
other diseases
• Silent Spring by Rachel
Carson
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Why is bioethics important?
• Realization that ‘not everything goes’:
– Tuskegee Syphilis Experiment (1932-1972)
– Nazi human experimentation (Nuremberg Trials,
1945-1949)
– Eugenics
– DDT (Rachel Carson’s ‘Silent Spring’)
• Scientists did not necessarily feel they were being
unethical in these incidences at the time.
• Therefore: need for justifications and shared guidelines
How are ethics and law related?
Illegal &
Ethical
Illegal &
Unethical
Legal &
Ethical
Legal &
Unethical
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Developing a WellReasoned Response
to a Moral Dilemma
• Moral dilemmas are situations in which two or more
moral obligations, rights, or ideals come into conflict with
one another.
• Figure out:
Who are the stakeholders.
What are the options?
What are your justifications? Are they weak or strong
reasons?
• How does one decide whether a response is wellreasoned? What criteria apply? How can we reliably
judge?
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Roles of Codes of
Conduct
• Shared Standards
• Positive Support to Act Ethically
• Guidance Concerning Obligations
• Motivation to be ethical
• Education to be ethical
• Deterrence to being unethical
• Personal Discipline
• Professional Image
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Basic Principles to be taken into
consideration (can be at odds with
each other)
• Non-maleficience (do no harm)
• Beneficence (do good)
• Justice (be fair)
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• Truthfulness
• Confidentiality (doctor/patient)
• Autonomy (capacity of a rational individual to
make an informed, un-coerced decision)
How to solve an ethical
problem….
• Consensus?
–
–
–
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Based on reason
Genuine debate
Takes ethical traditions into account
Open to criticism, refutation and the possibility of
change and exchange of ideas
– It is not majority opinion as it often needs to
protect the minority
– Takes time
– NOT SOLVED IN ISOLATION!
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What is an Ethical Question?
And what is not?
Ethical questions have the following
components:
• Ethical questions often involve the
words ought or should.
• There are several alternate solutions,
none of that is without some challenging
or problematic aspect.
• They contain conflicting moral choices and
dilemmas, and the underlying values of the
people involved may clash.
• They have no right or wrong answer which
satisfies all parties, but better or worse
answers based on well- reasoned
justifications.
Are the following questions of law,
science, personal preference,
culture, religion, or ethics?
• a) Is it legal to sell human kidneys in the
United States?
• b) How does a kidney function inside the
body?
• c) What does my religion say about whether
or not it is acceptable to donate a kidney?
• d) Should individuals who donate a kidney
choose who their organ should go to?
• e) What type of diet allows for the best
athletic performance?
• f) Is killing someone always illegal?
• g) Should people select the sex of their child
in advance?
• h) Are same-sex marriages constitutional?
• i) What is the most appropriate way to
worship?
• j) Do kidneys taste good?
Practicing Reasoning and
Justification
In-Class Discussions
• How should we decide who receives
organ transplants?
• Should a terminally ill patient be allowed
to end his/her life with physicianprescribed medication?
• Who should get the limited flu
vaccination? (worksheet)
Sample Cases
• Small Group Discussion:
– Using the sample cases provided, fill out the
in-class discussion worksheet and write any
comments on the back
– After groups have completed this exercise,
groups will report back to the class on their
findings
After the cases,
•
can you define ethics and bioethics?
•
have you tried one approach to developing
a well-reasoned response to a moral
dilemma?
•
choose a bioethics topic and present
information about it. Due Monday, January
14…see instructions with rubric