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Introduction to Ethics Jody Blanke Distinguished Professor of Computer Information Systems and Law Mercer University What is Ethics? Ethics is the branch of philosophy that seeks to understand the nature, purposes, justification, and founding principles of moral rules and the systems they comprise deals with values relating to human conduct focuses on the rightness and wrongness of actions, as well as the goodness and badness of motives and ends Scope of Ethics Micro-ethics individual’s view of right and wrong Macro-ethics global view of right and wrong Ethics from Various Perspectives The term “ethics” is used in 3 different but related ways Philosophical ethics inquiry about ways of life & rules of conduct General pattern or way of life for example, religious ethics Set of rules or “moral conduct” for example, professional codes for ethical behavior Why Study Ethics? To make sound judgments, good decisions, and right/better choices To understand the goodness and badness of motives and ends Morality Morality describes a class of rules held by society to govern the conduct of its individual members It implies quality of being in accord with standards of right and good conduct Morals Morals are ideas about what is right and what is wrong Morals are deeply ingrained in culture and religion What is considered morally right can vary from nation to nation, culture to culture, and religion to religion Code of Conduct Generally prescribes standards of conduct, states principles expressing responsibilities, and defines the rules expressing duties of professionals to whom they apply Codes of Ethics Provide for Standards – are used to guide human conduct by differentiating between desirable and undesirable traits Ex. Honesty v. dishonesty Principles – describe responsibilities that do not specify specific conduct Rules – specify specific conduct. They do not allow for individual judgment Moral Judgments Moral judgments are those judgments concerned with what an individual or group believes to be right or proper behavior in a given situation Making a moral judgment is being able to choose an option from among choices Morality Legislated Law is distinguished from morality in that law has explicit rules, penalties laws are created to set boundaries for societal behaviour laws are enforced to ensure that expected behavior happens Moral Dilemmas Moral dilemmas arise when values, rights, duties, and loyalties conflict Many such dilemmas arise in the area of health care Ethical Theories Ethics seeks to understand and to determine how human actions can be judged as right or wrong Ethical theories or principles introduce order into the way people think about life They are the foundations of ethical analysis and provide guidance in the decision-making process Normative Ethics Normative ethics is prescriptive in that it attempts to determine what moral standards should be followed so that human behavior and conduct may be morally right It is primarily concerned with establishing standards or norms for conduct and is commonly associated with investigating how one ought to act It involves the critical study of major moral precepts, such as what things are right, what things are good, and what things are genuine Descriptive Ethics Descriptive ethics, also known as comparative ethics, is the study of what people believe to be right and wrong and why they believe it Descriptive ethics describes how people act, whereas normative ethics prescribes how people ought to act Applied Ethics Applied ethics is the philosophical search for right and wrong It is the application of normative theories to practical moral problems, such as abortion, euthanasia, and assisted suicide Consequential Ethics The consequential theory of ethics emphasizes that the morally right action is whatever action leads to the maximum balance of good over evil The rightness or wrongness of an action is based on the consequences or effects of the action The goal of a consequentialist is to achieve the greatest good for the greatest number Utilitarian Ethics The utilitarian theory of ethics involves the concept that the moral worth of an action is determined solely by its contribution to overall usefulness It describes doing the greatest good for greatest number It is a form of consequential ethics Deontological Ethics Deontological ethics focuses on one’s duties to others and others’ rights Ex. Telling the truth and keeping your promises Often referred to as “duty-based” ethics German philosopher Immanuel Kant This theory differs from consequentialism in that consequences are not the determinant of what is right; therefore, doing the right thing may not always lead to an increase in what is good What matters is “doing your duty” Non-Consequential Ethics The nonconsequential ethical theory denies that the consequences of an action are the only criteria for determining the morality of an action The rightness or wrongness of an action is based on properties intrinsic to the action, not on its consequences Right or wrong depends on the intention, not the outcome Ethical Relativism Morality is relative to the norms of one's culture Actions can be considered right or wrong depending on the accepted norms of the society in which they are practiced What is acceptable in one society may not be considered as such in another Ex., slavery, human sacrifice Principles of Ethics Universal rules of conduct, derived from ethical theories that provide a practical basis for identifying what kinds of actions, intentions, and motives are valued Principles of Ethics – Autonomy The principle of autonomy recognizes the right of a person to make one’s own decisions Each person has a right to make his or her own decisions about health care Right to refuse treatment Right to refuse to take medications Right to refuse invasive procedures Principles of Ethics – Beneficence Beneficence describes the principles of doing good demonstrating kindness showing compassion helping others Paternalism is a form of beneficence Medical paternalism involves making decisions for patients who are capable of making their own choices This directly violates patient autonomy A Spouse’s Grief Leads to Withholding the Truth Example, page 15 Neither Dr. Brown, her surgeon, nor Daniel, her husband, tell Anna that her cancer surgery was not successful and that she is dying Ethical dilemmas? Principles of Ethics – Nonmaleficence Nonmaleficence is an ethical principle that requires individuals to do no harm to others Physicians today still take the Hippocratic oath: “First do no harm” Physician assisted suicide? Principles Ethics – Justice Justice is an obligation to be fair and to treat persons in similar circumstances similarly Distributive justice is a principle requiring that all persons be treated equally and fairly A great part of the discussion about the rationing of health care Age and Justice Should an 89-year-old patient get a heart transplant, rather than a 10-year-old girl because he or she is higher on the waiting list? Should an 39-year-old single patient get a heart transplant, rather than a 10-year-old boy because he or she is higher on the waiting list? Should an 29-year-old mother of three get a heart transplant, rather than a 10-year-old girl because she is higher on the waiting list? Should an 29-year-old pregnant woman with two children get a heart transplant, rather than a 10-year-old boy because she is higher on the waiting list? Emergency Care and Justice Two patients arrive in an emergency room in critical condition. Who gets treated first? First patient who arrives? Younger patient? Patient most likely to survive? Patient who can pay for services? Patient with most serious condition? Economic Reality The cost of coronary bypass surgery Self-pay: between $70,000 and $133,000 With insurance: 60% of that Medicare: $18,609 In Thailand: $22,000 In India: $7,000 Virtue Ethics and Values Virtue ethics focuses on the inherent character of a person rather than on the specific actions he or she performs A virtue is a positive trait of moral excellence Virtues are those characteristics that differentiate good people from bad people Virtues such as courage, honesty and justice are abstract moral principles A morally virtuous person is one who does the good and right thing by habit, not merely because of a set of rules of conduct Moral Value A moral value is the relative worth placed on some virtuous behavior Values may change as needs change The relationship between abstract virtues (principles) and values (practice) is often difficult to grasp. The virtuous person is the one who does good, and his or her character is known through the values he or she practices consistently by habit Pillars of Moral Strength Courage Wisdom Temperance Commitment Compassion Conscientiousness Discernment Fairness Fidelity Freedom Honesty Integrity Kindness Respect Hopefulness Tolerance Pillars of Moral Strength Courage Is the mental or moral strength to persevere and withstand danger Is the strength of character necessary to continue in the face of fears and the challenges in life Pillars of Moral Strength Wisdom Is the judicious application of knowledge Temperance Involves self-control and restraint Embraces moderation Commitment Is the act of binding oneself intellectually or emotionally to a course of action Is an agreement or pledge to do something Pillars of Moral Strength Compassion is the deep awareness of and sympathy for another’s suffering Conscientiousness A conscientious person is one who has moral integrity and a strict regard for doing what is considered the right thing to do Discernment Is the ability to make a good decision without personal biases, fears and undue influences from others Pillars of Moral Strength Fairness Is the ability to make judgments free from discrimination, dishonesty or one’s own bias It is the ability to be objective without prejudice or bias Fidelity Is the virtue of faithfulness, being true to our commitments and obligations to others Pillars of Moral Strength Freedom Is the quality of being free to make choices for oneself within the boundaries of law Honesty/Trustworthiness/Truth-Telling Honesty and trust involve confidence that a person will act with right motives Integrity Involves a steadfast adherence to a strict moral or ethical code and a commitment not to compromise this code Pillars of Moral Strength Kindness Involves the quality of being considerate and sympathetic to another’s needs Respect Is an attitude of admiration or esteem Hopefulness Involves looking forward to something with the confidence of success Pillars of Moral Strength Tolerance Positive tolerance implies that a person accepts differences in others and that one does not expect others to believe, think, speak, or act as he or she does Tolerant people are generally free of prejudice and discrimination Negative tolerance implies that one will reluctantly put up with another’s beliefs Cooperation and Teamwork Cooperation is the process of working with others “If we do not hang together, we will all hang separately.” Benjamin Franklin Forgiveness Forgiveness is the willingness to pardon someone who has wronged you in some way Religious Ethics Religious ethics serve a moral purpose by providing codes of conduct for appropriate behavior The prospect of divine justice may help us tolerate the injustices in life, where goodness is no guarantee of peace, happiness, wellness, or prosperity Secular Ethics Secular ethics is based on codes developed by societies that have relied on customs to formulate their codes Ex., Code of Hammurabi Situational Ethics Situational ethics is concerned with the outcome or consequences of an action in which the ends can justify the means. It refers to those times when a person’s beliefs and values can change as circumstances change Why do good people behave differently in different situations? Why do good people sometimes do bad things? High in the Andes On October 13, 1972, an airplane crashed high in the Andes Mountains. 72 days later, 16 of the 40 passengers were rescued How did they survive? How did their values change? Absence of a Moral Compass “The world is a dangerous place. Not because of the people who are evil; but because of the people who don’t do anything about it.” Albert Einstein Health Care Dilemmas Ethical decision making is the process of determining the right thing to do in the event of a moral dilemma, with alternative choices limited resources varying legal or regulatory requirements differing values among patients, family members, and caregivers