Download Ethics

There are more things in heaven and earth,
Horatio, than are dreamt of in your philosophy.
Hamlet, Act 1, Scene V.
2013
Marek Vácha
INTRODUCTION TO MEDICAL
ETHICS
HTTP://WWW.YOUTUBE.COM/WATCH?V=YIZT79UKUFQ
Gyges´ ring
 Plato in The Republic has one of his characters
ask us to engage in a though experiment. He
tells the story of Gyges´ring, whose effect was to
make its wearer invisible. What would prevent
the possessor of the ring from commiting any
crime he felt like committing? He could never be
caught. Would we not all be tempted, if we had
such a ring, to do whatever our heart desired,
knowing we would not, could not, be found out?
 there are two ways
how to create
order:
 by use of power
 by use of self-
restraint
 when only police or
army stand
between order nad
riots, freedom itself
is at risk
Tottenham,
august 2011
Science
 The composition of mammalian blood is
plasma 55% and cellular elements 45 %
 leukocytes are: basophils, eosinophyls,
neutrophils, lymphocytes, monocytes
 IgE antibodies are produced in response
to initial exposure to an alergen bind to
receptors an mast cells
 blood glucose level is about 90mg/100ml
Ethics
 when, if ever, is possible to take a gift or
gratuity from a patient?
 Is it permissible to lie to a patient if it is for
his or her good?
 what obligations do I have to a colleague
and fellow practitioner when I suspect that
the colleague I am working with is abusing
alcohol or appears chemically impaired
while on duty?
Science x Ethics
 science investigates what is
 ethics investigates what ought to be
Ethics
 …and what about
the Bodies
exhibition?
 Is this show
ethically neutral?
 …or good?
 …or bad?
"Friendly embryos"
http://www.cuni.cz/IFORUM-9834.html
There are more complicated questions...
 Is there any sort of pursuit of knowledge that
might be forbidden?
 is there a category of a "forbidden knowledge"?
 Is there any sort of research that should not
be publicly funded?
 Is there any sort of genetic knowledge that it
might be better not to know?
 Is any basic research ethically mandatory in
some way?

http://www.youtube.com/watch?v=HkW0C-NyNtQ
There are more complicated questions...
 should the use of cloning by somatic cell
nuclear transfer (the technique used to
produce Dolly) be allowed in order to help
as infertile couple have a child?
 should the entire UK population and all
visitors to Britain be compelled to provide
DNA samples as a means of enabling the
police to detect the perpetrators of
criminal acts?

(Mepham, B., (2008) Bioethics. An Introduction for the Biosciences. 2nd ed- Oxford University
Press, Oxford. p. 3)
There are more complicated questions...
 Is it possible to say that
 future benefits justify the present
practices?
 future abuses do not disqualify present
uses?
There are more complicated questions...
 Is a goal of the medicine painless,
suffering-free and, finally, immortal
existence?
Ethics, too, are nothing but reverence for life. This is what
gives me the fundamental principle of morality, namely, that
good consists in maintaining, promoting, and enhancing life,
and that destroying, injuring, and limiting life is evil.
Albert Schweitzer
SCIENCE AND ETHICS
Science x Ethics
Science
 Methodological Naturalism:
 what natural world contains
 how it arrived at its current state
 laws that regulate its behavior
 Ontological Naturalism:
 nothing else exists
 Martin Heidegger: science is the theory of
the real.
 what does real really mean and to what
degree that scientific reality presents a
comprehensive worldview?
 what is included, and, more importantly, what
is left out?
 and considering that which is omitted, what is
the cost of its lost?

Tauber, A.I., (2009) Science and the Quest for Meaning. Baylor University Press, Waco, Texas. p.34
 From how the world is, we cannot infer
how it ought to be. For that we need
another kind of knowledge entirely.
SCIENCE AND PHILOSOPHY
Philosophy
 Ontology = a theory of what is real
 Epistemology = a theory of how we
perceive and organize data
 Ethics = a theory how to live a righteous
life
Science and Philosophy
Philosophy
Science
Science is only half the story
 Science can analyse
the chemical
composition of a
great painting but it
cannot tell us what
makes it great
painting.

(Sacks, J., (2011) Letters to the next generations 2.
Office of the Chief Rabbi. p. 29)
Rembrandt van Rijn
(1606 - 1669)
Science is only half the story
 Science can tell us how our instinctual
drives were formed but it cannot tell us
which of those drives to yield and which to
resist.

(Sacks, J., (2011) Letters to the next generations 2. Office of the Chief Rabbi. p. 29)
Science
 The materialism of science asserts its
limits, not its universality. The methods
and scope of science remain within the
world of matter. It cannot make assertions
beyond that world. (Francisco Ayala)
http://www.guardian.co.uk/science/blog/2010/may/28/religion-science-richard-dawkins
The Idea of Science
 Science becomes instrumental in several
senses, as an authoritative instrument for
describing nature, as a powerful
instrument for the technical mastery of
nature, and as a personal instrument for
understanding the world and navigating it.
(Tauber, A.I., (2009) Science and the Quest for Meaning. Baylor University Press. Waco, Texas. p. 36-37)
The Idea of Science
 science as a tool to promote human well-being,
namely an intellectual and technological
enterprise to understand and control nature
 objective knowledge is appplied to make things or
propose generalizations (laws, hypotheses) about
nature.
 science as a framework for building existential
and metaphysical formulations
 facts, laws and scientific inferences are translated into
personal knowledge to place humans in nature.
 interpretation of Darwin´s theory etc.

(Tauber, A.I., (2009) Science and the Quest for Meaning. Baylor University Press. Waco, Texas. p. 36-37)
 For science can only ascertain what is, but
not what should be, and outside of its
domain value judgments of all kinds
remain necessary... (Albert Einstein)
 „Scientists are well aware of how much
they don´t know, but this is a different kind
of problem – not just of acknowledging the
limits of what is actually understood but of
trying to recognize what can and cannot in
principle be understood by certain
methods.“

Nagel, T., (2012) Mind and Cosmos. Why the Materialist Neo-Darwinian Conception of Nature Is Almost
Certainly False. Oxford University Press, Oxford. p. 3
ETHICS
Ethics and Morality
 Ethics is primarily a matter of knowing
 Morality is a matter of doing
 morality is what people believe to be right
and good
 ethics is the critical reflections about
morality and the rational analysis of it.
Ethics and Morality
 Ethics is primarily a matter of knowing
 Morality is a matter of doing
 Éthos/Ethics = Place for pasture of
animals, or indications for a stable, the
behavior of animals (ethology).
 Metaphorically: place for living and all habits
common to it. The ways of behaving, thinking
Good ethics start with good facts!
1. Defining the problem
2. Descriptive – defining what is going on,
description of who the patient is, who the
family is, what is their moral world; what
the options are in terms of diagnosis,
therapy, prognosis, goals, what can be
done, weighting the risks and benefits.
3. Normative – ethics arises from value
conflict – concerns itself with the „should“
questions
Descriptive Ethics and Normative
Ethics
 Descriptive Ethics
 What do people think is right?
 philosophical schools, religions etc.
 Normative Ethics
 identification of values
 what behavior is good and why
 supported by arguments
 what should I do and why?
 Whereas descriptive ethics attempts to
describe and explain those moral views
that in fact are accepted,
 normative ethics attempts to establish
which moral views are justifiable and thus
ought to be accepted.
Normative Ethics
 Normative ethics is the attempt to
determine what moral standards should
be followed so that human behaviour and
conduct may be morally right.
 Normative ethics is concerned with
establishing standards for conduct and is
commonly associated with theories about
how one ought to live.
OTHER REMARKS...
The position of the teacher
 the teacher is not in „God-like position“
 the teacher is not
 a harbinger of an ultimate truth
 a opinion-maker
 the teacher doesn´t say „how things are“
 his/her task is more complicated
 to tell to the students what is known about the
problem
 and then he/she try to moderate the discussion
The Scandal of Philososphy
 We have moved forward in medicine during
the past 2 000 years
 we now know much better the human body than
Hippocrates knew
 ..but have we move forward in philosophy?
 is our contemporary philosophy better than the
philosophy of Aristote?
 maybe not!
 the philosophy might be somewhere between
art and science
The Problems of teaching Philosophy
 the notions are generally not so clear as in
science
 there is no such thing like „hard data“
 different people could have different opinions
 „there is only one science but many philosophies“
 everyone has his/her own philosophy
 a philosophy is joint to the person of the
philosopher and his/her epoch
 …but is it true?
What is the difference between a
postmodernist and a member of
the Mafia?
The Mafia makes you an offer
you can´t refuse. A posmodernist
makes you an offer you can´t
understand.
Ethical relativism
 there is no goodness or badness
 there is no rightness or wrongness
 ....there are only opinions
 Dostojevskij: if God does not exists, all is
permitted.
Why to start with Philosophy?
 In the history of the human spirit I distinguish
between epochs of habitation and epochs of
homelessness. In the former, man lives in the
world as in the house, as in a home. In the
latter, man lives in the world as in an open
field and at times does not even have four
pegs with which to set up a tent.
 In the former epochs anthropological thought
exist only as a part of cosmological thought.
In the latter, anthropological thought gains
depth and with it, independence.

(Martin Buber: Between Man and Man)
 ...taught us the paradoxical truth that
nations survive not by wealth but by the
help they give to the poor, not by power
but by the care they extend to the weak.
Civilisation become invulnerable only
when they care for the vulnerable.

Sacks, J., (2011) The Great Partnership. God, Science and the Search for Meaning. Hodder & Stoughton,
London. p.290