Biomedical Ethics Quiz (Ch.1-4)
List the moral rules and their significance and those of the moral ideals
-A moral system that all impartial rational persons could accept as a public system that applies to all moral agents is a justified moral system. Bernard Gert means starts by defining 5 harms: (1) Death (2) Pain (3) Disability (4) Loss of Pleasure (5) Loss of Freedom This theory also provides a list of goods or benefits. These are: (1) Consciousness (2) Freedom (3) Ability (4) Pleasure Moral rules: -Each of the first five rules prohibits directly causing one of the five harms and evils. (1) Do not kill. (2) Do not cause pain. (3) Do not disable. (4) Do not deprive of freedom. (5) Do not deprive of pleasure. -The second five rules are those that when not followed in particular cases usually cause harm, and general disobedience of which always results in more harm being suffered. (6) Do not deceive. (7) Do not cheat. (8) Keep your promise. (9) Obey the law. (10) Do your duty. -Saying that someone has broken a moral rule does not necessarily mean that someone has done anything wrong-it is only saying that some justification is needed.
Explain the relationships among moral value judgments, moral rules or ideals, the principles of biomedical ethics, and ethical theories
-Areas of moral agreement: there is general agreement that everyone knows what kinds of behavior morality prohibits, requires, discourages, encourages and allows. -See below
List and explain the principles of biomedical ethics
-Bioethics principles as established by the Belmont Report, 1974: (1) Respect for persons: Individuals must be treated as autonomous agents and that persons with diminished autonomy are entitled to protection. Autonomous person=an individual capable of deliberation about personal goals and of acting under the direction of such deliberation. To respect autonomy, therefore, is to give weight to an autonomous persons' considered opinions and choices while refraining from obstructing their actions (unless detrimental to others). Some individuals without the capacity for self-determination- due to illness, mental handicap, etc.- may require protection as they mature or while they are incapacitated. I.e. research. (2) Beneficence: relates to acts of kindness or charity that go beyond strict obligation. Two general rules: do not harm (Hippocratic oath) and maximize possible benefits and minimize possible harms. I.e. physician oath upon graduation. I.e. research (3) Justice: who ought to receive the benefits ("fairness in distribution" or "what is deserved") and bear its burdens. An injustice occurs when some benefit to which a person is entitled is denied without good reason or when some burden is imposed unduly. Another conception of justice: equals ought to be treated equally. Widely accepted ways to distribute burdens and benefits: (1) to each person an equal share (2) to each person according to individual need (3) to each person according to individual effort (4) to each person according to societal contribution (5) to each person according to merit.
Ch. 2. Principles of Biomedical Ethics Understand the relationships among moral value judgments, moral rules or ideals, the principles or biomedical ethics, and ethical theory
-Biomedical ethics, or principlism-> focus of chapter. -Principle: a basic truth or general law that is used as a base of reasoning or a guide to action or behavior.
Distinguish: moral opinion developed by classical philosophy and the dismissal of opinion by modern philosophy
-Classical philosophy-> i.e. Descartes-> focused on the scientific method; science=served as a practical benefit for the public as a the most secure kind of human knowing. This respect for science as the most authoritative form of human knowledge reshapes how we now face the philosophical investigation of the moral opinions we inherit. Descartes' method involved the doubt of any opinion as uncertain, however probable, unless it could be proved in accord to his method. Classical approach overall: ordinary moral judgments are understood to be in need of more rigorous rational support. -Locke believed that science can claim to be a knowable truth, recognized by all, whereas moral beliefs remain uncertain, controversial, and without authority to command deference. Science=objectivity, universality, whereas moral beliefs=represent personal values or private commitments. Science occupies what may be described as a fixed point of reference around which competing moral beliefs must orient themselves.
Ch. 1. Theory in Bioethics Define: bioethics
A discipline devoted to the articulation of good decisions in the practice of health care
Define competency and decisional capacity
-Competency (or decisional capacity) refers to one's ability to make a particular decision. Dependent on the circumstances (i.e. age). A person is labeled competent if (1) he or she has an understanding of the situation and consequences of the decision and (2) the decision is based upon rational reasons.
Recognize situations in which beneficence is obligatory as opposed to ideal
-For the most part, general beneficence is ideal beneficence-although moral ideals encourage us to act affirmatively so as to help others with whom we do not find ourselves in a special relationship, we are not obliged to do so by the moral rules. -A person X owes an obligatory duty of beneficence toward a person Y if each of the following conditions is true: (1) Y is at risk of significant loss of or damage to life or health or some other major interest. (2) X's action is needed (singly or in concert with others) to prevent this loss or damage. (3) X's action (singly or in concert with others) has a high probability of pre- venting it. (4) X's action would not present significant risks, costs or burdens to Y. (5) The benefit that Y can be expected to gain outweighs any harms, costs, or burdens to X that is likely to occur.
Understand: why it is important to consider various ethical theories in bioethics
-Four theories-> describes how any attempt to appreciate the role of theory in bioethics must address the prominence and authority of science.
Define impartiality, rationality, reasons, and the concept of a public system, and explain how they relate to a common morality.
-Impartiality (fair-handedness): a principle of justice holding that decisions should be based on objective criteria, rather than on the basis of bias, prejudice, or preferring the benefit to one person over another for improper reasons. To fully understand what it means to be impartial involves knowing both the group with regard to which her impartiality is being judged and the respect in which her actions are actions are supposed to be impartial with regard to that group. E.g. the referee -Rationality: reasoning correctly in order to discover truth (scientific rationality); related to avoiding harms and gaining benefits. People act irrationally when they act in a way that they know or should know will significantly increase the probability that they, or those they are for, will suffer death, pain, disability, loss or freedom or pleasure, and they do not have an adequate reason for so acting. -Reasons: a fact or rational belief that one's actions will help anyone, not merely oneself or those one cares about, avoid a harm or gain some good, namely, ability, consciousness, freedom or pleasure. A reason is adequate if a significant group of otherwise rational people regard the harm avoided or benefit gained as at least as important as the harm suffered. -Public system: a system that has the following two characteristics. In normal circumstances, (1) all persons to whom it applies (i.e. those whose behavior is to be guided and judged by that system) understand it, that is know what behavior the system prohibits, requires, discourages, encourages, and allows. (2) It is not irrational for any of these persons to accept being guided and judged by that system. I.e. a poker game or basketball. Morality is a public system that applies to all moral agents, however, no one can quit being governed by morality. All people who understand morality and can guide their behavior accordingly are subject to moral judgments simply by virtue of being rational persons who are responsible for their actions.
Explain the etiology of moral disagreements
-In order for moral disagreement to be a problem for moral realism, it can't be susceptible to these "defusing explanations", as they're called by John Doris and Alexandra Plakias (2008). Moral disagreement is only a problem for moral realism if it's fundamental moral disagreement. It's only really disagreement if the respective sides are ideally situated, ideally rational and have access to all the salient non-moral facts.
Define paternalism and distinguish between weak (soft) and strong (hard) paternalism
-Medical paternalism: refers to the association with physicians telling patients what is good for them, without regard to the patient's own needs and interests. -In weak paternalism, an agent intervenes on grounds of beneficence. . . only to prevent substantially [nonautonomous] conduct....[Such conduct] include[s] cases of consent or refusal that is not adequately informed, severe depression that precludes rational deliberation, and addiction that prevents free choice and action.... -Strong paternalism, by contrast, involves interventions intended to benefit a person, despite the fact that the person's risky choices. . . are informed, voluntary and autonomous. -A weak paternalist believes that it is legitimate to interfere with the means that agents choose to achieve their ends, if those means are likely to defeat those ends. So if a person really prefers safety to convenience then it is legitimate to force them to wear seatbelts. A strong paternalist believes that people may be mistaken or confused about their ends and it is legitimate to interfere to prevent them from achieving those ends. If a person really prefers the wind rustling through their hair to increased safety it is legitimate to make them wear helmets while motorcycling because their ends are irrational or mistaken.
Define moral virtue and explain the relationship existing among the moral virtues
-Moral ideals encourage one to do actions that lessen the amount of harm suffered or decrease the risk of people suffering harm. As long as one avoids violating a moral rule, following any moral ideal is encouraged. -Five specific moral ideals involved in preventing harm (one for each of the five harms). -Utilitarian ideals: actions that involve promoting goods (i.e. abilities and pleasure) for those who are not deprived -Religious ideals: promoting activities, traits of character, and so forth, that idiosyncratic to a particular religion or groups of religions -Personal ideals: promoting some activities, traits of character, and so forth, that are idiosyncratic to particular persons (e.g. ambition) about which there is not universal agreement. -Important difference between moral rules and ideals: rules must be impartially obeyed all of the time. Moral ideals provide goals for one's behavior-> not supposed to be followed all of the time.
Apply the procedure discussed herein to distinguish between morally acceptable and morally unacceptable solutions to moral problems
-Morally relevant features-> allow application of the moral system to a situation, resulting in a conflict with one's moral intuitions that can be eliminated by adding that feature. Are such that all moral agents understand and can apply them in describing a situation (no biases allowed). -I.e. what moral rules are being violated? What harms are being avoided, prevented or caused? What benefits are being promoted? -If all impartial rational persons would estimate that less harm would be suffered if this kind of violation were publicly allowed, then all impartial rational persons would publicly allow this kind of violation and the violation is strongly justified; unjustified=opposite.
Recognize and distinguish between specific and general beneficence
-Specific beneficence: obligatory beneficence-> refers to positive obligations (i.e. duties to act) we owe to others to further their important and legitimate interests. Occurs in special relationships (e.x. to children, patients, etc). Under law, must act. -General beneficence: directed beyond special relationships. Not obligated to help under law or moral rules.
List and recognize the requirements for autonomous choice
-Specific rules to follow to respect autonomous choice: (1) tell the truth (2) respect the privacy of others (3) protect confidential information (4) obtain consent for interventions with patients (5) when asked, help others make important decisions. In order to be an autonomous choice, a patient's choice must be voluntary (free from constraint), informed, and the patient must have decision-making capacity (i.e. he or she must be competent, incapable of autonomous choice). -Requirements for autonomous choice: (1) Voluntariness- action without being under control of another's influence. Three types of influence: (1) coercion: a person uses a credible and severe threat of harm or force to control another person. (2) persuasion: a person comes to believe in something through the merit of reasons another person advances; influence by appeal to reason. (3) manipulation: swaying people to do what the manipulator wants by means other than coercion or persuasion (i.e. informational) (2) Information and informed consent- adequate disclosure that allows the patient the opportunity to weigh the content of the disclosure in his or her decision-making-> informed choice. Contains an information (disclosure of info. and comprehension of what is disclosed) and consent (voluntary decision and an authorization to proceed) component. (3) Competency or decisional capacity- refers to one's ability to make a particular decision. A person is competent if (1) he or she has an understanding of the situation and consequences of the decision and (2) the decision is based upon rational reasons.
State the formal principle of justice
-The principle of formal justice is common to all theories of justice, and is traditionally attributed to Aristotle. -Definition: it holds that justice requires that equals be treated equally, and unequals be treated unequally, but in proportion to their relevant inequalities.
Recognize and distinguish nonmaleficence and beneficence
-The principle of nonmaleficence refers to the duty to refrain from causing harm, saying that "one ought not to inflict evil or harm." Where harm=an adverse effect on one's interests. Supports a number of moral rules, including the following: do not kill, do not cause pain or suffering, do not incapacitate, do not cause offense and do not deprive others of the goods of life. -The principle of beneficence refers to the duty to help others further their important and legitimate interests. Specific rules the principle supports: (1) one ought to prevent harm or evil (2) to remove evil (3) to do good or promote good (4) protect and defend the rights of others (5) prevent harm from occuring to others (6) remove conditions that will cause harm to others (7) help persons with disabilities (8) rescue persons in danger.
Explain how utilitarian, egalitarian and libertarian views of justice differ
-Under utilitarian theories (see Chapter 1), "justice is merely the name for the obligation created by the principle of utility," under which we should "strive to produce as much overall happiness as possible." Thus, for utilitarians a just distribution of benefits and burdens would be one that produces the most overall happiness. -"Egalitarian theories of justice hold that persons should receive an equal distribution of certain goods. . . . Qualified egalitarianism requires only some basic equalities among individuals and permits inequalities that redound to the benefit of the least advantaged [italics added]." John Rawls's "justice as fairness," as described in his work. A Theory of Justice, is probably the foremost modern version of such a qualified egalitarianism. Rawls argues that the principles of justice are those principles that would be chosen by persons behind a metaphorical "veil of ignorance"—that is, persons who "would not know their own race, sex, degree of wealth, or natural abilities." According to Rawls, those principles of justice to which persons would agree would be as follows: First: each person is to have an equal right to the most extensive basic liberty com- patible with a similar liberty for others. Second: social and economic inequalities are to be arranged so that they are both (a) reasonably expected to be to everyone's advantage, and (b) attached to positions and offices open to all. -libertarian conceptions of justice tend to emphasize the importance of "the unfettered operation of fair procedures." There are three principles of justice under Nozick's theory of justice: (1) the principle of justice in acquisition, which deals with the appropriation by persons of previously unheld things; (2) the principle of justice in transfer, which deals with the appropriation by persons of holdings from other persons; and (3) the principle of rectification, which, as the name suggests, deals with what may be done in order to rectify past injustices that have shaped present holdings.
Explain the determinants of a justified violation of moral rules
-Widespread agreement on several features that all justified exceptions possess-> (1) impartiality- all justified violations of the rules are such that if they are justified for any person, they are justified for every person when all of the morally relevant features are the same (i.e. the Golden Rule, Kant's categorical imperative). (2) There is a general agreement that a violation is justified only if it is rational to favor the violation even if everyone knows that this kind of violation is allowed; that is, it is rational to publicly allow the violation. I.e. it might be rational to favor allowing a HCP to deceive a patient about his diagnosis if that patient were likely to be upset by knowing the truth.
Ch. 3 The Common Moral System Define morality
-principles concerning the distinction between right and wrong-> provides a way of distinguishing between morally acceptable solutions and morally unacceptable solutions. -An adequate moral theory must recognize that neither consequences nor moral rules, nor any combination of the two, are the only matters that are relevant when one is deciding to act in a morally acceptable way or in making moral judgments.
Tenets of Aquinas' philosophy and application to bioethics
Aquinas (Summa Theologica): -Like Aristotle, he conceives of happiness as an end that is independent of the particular purposes or desires that human beings happen to have. There is, in his view, a natural desire for happiness or a natural inclination toward human perfection, but this primarily means that human beings are oriented or ordered toward a particular end as their fulfillment, not that the content of human happiness can be discovered by simply heeding whatever appetites and desires one happens to have spontaneously. A natural inclination- an orientation toward some sort of perfection of one's nature. He mentions natural inclinations in his presentation of natural law, where natural law is a "participation of the eternal law in the rational creature." Eternal law- the providential rule by which God governs all creation. A rational creature is subordinated to providence in a more excellent way. Natural law is, then, the rational or human grasp of God's providential governance of all creation-- achieved through moral experience. Natural law-> not relevant to the goodness or badness of particular acts, more for the emphasis on the nonsectarian view of moral goodness. -Three fonts: (1) the moral object- The moral object answers the question "what?" in the question "What is going on here morally?" The moral object determines what kind of an act it is. (2) the intention- Your intention is the purpose or goal for which the act was chosen. But for this font to be moral, all that you intend must be moral. It is not moral to intend to achieve a good end by an immoral means. (3) the circumstances of the action- Circumstances can quantify (greater or lesser) the moral species of an act but cannot change the kind of act it is generically. -In Aquinas' view, all our choices and intentions ultimately must be integrated into the pursuit of a final human end: happiness. Thus, all elements of each moral action must be good or at least neutral. -Aquinas' approach: emphasis on individual actions in their goodness and badness that is more amendable to customary questions in bioethics (i.e. abortion, euthanasia, sterilization, organ transplantation, etc.) -The principle of Double Effect-> When an unintended effect occurs as a result of an intended action. Aims to provide specific guidelines for determining when it is ethically permissible for a human being to engage in conduct in pursuit of a good end with full knowledge that the conduct will also bring about bad results. According to the principle of double effect, sometimes it is permissible to cause a harm as a side effect (or "double effect") of bringing about a good result even though it would not be permissible to cause such a harm as a means to bringing about the same good end. One must be sure to do, on balance, more good than harm-> we are obliged not to choose or intend what is evil and we are obliged not to permit too much evil to arise through our actions. Theses of the principle of double effect: (1) the act chosen must be morally good or neutral (indifferent) (2) the intention aimed at must be good (3) the good effect must not be accomplished by means of the bad effect (4) the good effect (or intention) must be at least as serious as the evil effect that may result
Tenets of Aristotle's philosophy and application to bioethics
Aristotle (Nichomachean ethics): -Understands happiness as the proper fulfillment of human beings. All agree on wanting to achieve happiness, but do not agree on the contents of that happiness. To some, it is being honored, experiencing pleasure, etc. What genuinely completes human life? For Aristotle, happiness is the specifically human completion. Conceives happiness as the excellent or virtuous performance of properly human activities or the excellent operation of reason (what we don't share with plants and animals). -Two classes of virtues: (1) Moral virtues: habitual dispositions to feel and act rightly with respect to characteristically human concerns. Examples: Courage (virtue needed to act well in the presence of feelings of fear and confidence), Temperance/moderation (virtue that enables people to act well under the influence of bodily pleasures and pains)-> the several virtues involve a specific harmony between the irrational, appetitive part of the soul (seat of emotions) and the rational, thinking part of the soul. Prudence/practical wisdom (the virtue or perfection of the rational part of the soul). Thus, a morally virtuous person is characterized by habitually correct desire, which mean=reason and desire both incline the person together to the same virtuous deed. (2) Intellectual virtues: perfect human beings insofar as they know and understand. Theoretical wisdom involves the contemplation of necessary and universal truths. Aristotle=regards as highest human activity and the activity that most fully completes human beings as human beings. Twofold doctrine of human happiness- involves both morally virtuous activity and intellectually virtuous activity. Therefore, the "end" of human life is happiness where end means the proper fulfillment or completion of a thing according to its nature. Purpose=anything that can be the target of human choosing. Aristotle believes that the human being has an end that is independent of the various purposes one might pursue in life. Distinction between end and purpose-> useful in bioethics in discriminating appropriate limits to the use of medical expertise. Medical knowledge->open to multiple purposes for HCPs. Physician and medicine have same end-> production, preservation and restoration of health. Therefore, some purposes of the HCP can be incompatible with the nature of the medical profession (i.e. the morality of euthenasia). -Aristotle presents his moral philosophy as practical (rather than theoretical)-> pursued in order to improve our lives. The starting point for his ethics is being raised in good habits, which conveys the essential awareness of morally decent action. -Aristotle's concentration on moral character over particular acts-> speaks of the character of a human being as constituted by the repetitive performance of virtuous or vicious actions. -The standard for moral goodness is the virtuous human being. A person's character, the settled way in which the passions are habitually structured, permits him or her to see the moral truth of things.
Understand two contrary pressures brought to bear by Descartes on moral reasoning
First pressure: stems from the distinction between science and what science establishes on the one hand against moral beliefs on the other. Moral beliefs or maxims were relegated to the realm of uncertain opinion by Descartes-> code of morality= useful, although uncertain. This attitude survives in our present-day reinterpretation of moral beliefs as commitments or values that derive their authority from having been accepted or endorsed by us. No knowable moral truth. Good is not knowable in the way that scientifically accessible facts are knowledge. Second pressure: tends in the opposite direction; inclines us to refashion ethics in the imitation of modern science. Thus, there has been a tremendous interest in securing the foundations of bioethics as a way of overcoming the endless controversy and disagreement that characterizes morality.
Understand that science does not exist and occupy a place of importance in our lives independent of moral judgement about the good
In contemporary bioethics, moral opinion contains a critical attitude toward it because of the centrality of science to modern medicine. Insofar as medicine is scientific, it tends to carry with it the suspicion or doubt of all opinions that are not scientifically known.* The problem is the existence of a very powerful science of nature, including medical science, in the absence of a correspondingly powerful knowledge of how to use that power well.
Compare and contrast: Private vs. Public Moral Justification
In the area of bioethics, personal decisions are decided on the basis of reasoned arguments, religious beliefs, personal preferences or any other grounds that are persuasive to the people making the decision. There is no outside assessment of the merits of these decisions. Personal decisions=> in health care are regarded as private (freedom from scrutiny and any other burden of justification). By contrast, public moral justification is required in public policy in appropriate and morally good decisions that are thoroughly rational in approach.
Tenets of John Stuart Mill's philosophy and application to bioethics
John Stuart Mill (Utilitarianism): -A specific reaction to Kant and his apparent unconcern for the consequences of our willing. Mill= emphasis on the end or the consequences of human activity (therefore, called consequentialist). -The greatest happiness principle: the end of all human action and the first principle of morality as argued by Mill. The greatest happiness principle holds that "actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure, and the absence of pain; by unhappiness, pain, and the privation of pleasure." Pleasure and the absence of pain are, by this account, the only things desirable as ends in themselves, the only things inherently "good." Thus, any other circumstance, event, or experience is desirable only insofar as it is a source for such pleasure; actions are good when they lead to a higher level of general happiness, and bad when they decrease that level. The end in question is the greatest amount of happiness for all. -"It is better to be a human being dissatisfied than a pig satisfied"-> Mill appeals to a standard of judgment or level of competency for happiness, and some (pigs) are not competent to judge. -Mill emphasizes the importance of doing a good action and does not think that an act can be corrupt if the motive is impure (where motive= the feeling that brings us to will as we do, rule of action=what we will or what it is right for us to will, intention=what the agent wills to do-> creates moral goodness or badness). -Cultivation of regard for the happiness of others must compete with the naturally much stronger selfish feelings-> the general happiness might sometimes require renunciation of one's own happiness. I.e. treatment of subjects in medical research
Tenets of Kant's philosophy and application to bioethics
Kant (Foundations of the Metaphysics of Morals): -In contrast to the previous philosophers, Kant separates the demands of morality from the search for happiness. Conflict between our wishes and inclinations, the full satisfaction of happiness, and on the other hand, the stern commands of our moral duty (the fulfillment promises nothing to our needs and desires). Rational selfishness= using morality as a way to obtain happiness or subjective satisfaction-> corrupts morality. Morality= highest human pursuit. -The role of philosophy is to protect ordinary moral attitudes regarding one's duty from threats that would undermine our efforts to do what we all know we ought to do. First threat: reinterpretation of morality as a calculation of the path to satisfaction of one's desires. Second threat: arises from modern natural science. The idea that the future is rigorously determined by prior causes. Nature=deterministic. We cannot know that we are in fact free moral agents. To be a moral agent, must act out of respect to moral law and not out of self-interest. Moral agency=rational autonomy (reason is the law or the source of the law by which one lives). -Categorical imperative: It is an imperative because it is a command (e.g., "Leave the gun. Take the cannoli.") More precisely, it commands us to exercise our wills in a particular way, not to perform some action or other. It is categorical in virtue of applying to us unconditionally, or simply because we possesses rational wills, without reference to any ends that we might or might not have. It does not, in other words, apply to us on the condition that we have antecedently adopted some goal for ourselves. One must treat humanity as an end. -Hypothetical imperative: A hypothetical imperative is a command that also applies to us in virtue of our having a rational will, but not simply in virtue of this. It requires us to exercise our wills in a certain way given we have antecedently willed an end. A hypothetical imperative is thus a command in a conditional form. But not any command in this form counts as a hypothetical imperative in Kant's sense. For instance, 'if you're happy and you know it, clap your hands!' is a conditional command. But the antecedent conditions under which the command 'clap your hands' applies to you does not posit any end that you will, but consists rather of emotional and cognitive states you may or may not be in. - A HYPOTHETICAL IMPERATIVE [i.e., an imperative based on inclination or desire] represents "the practical necessity of a possible action as means to something else that is willed (or at least which one might possibly will)."(294). A CATEGORICAL IMPERATIVE [i.e., an imperative based on reason alone] is one that represents "an action as objectively necessary in itself apart from its relation to a further end"(294).
Recognize instances in which strong (hard) paternalism might be justified
Normally, strong paternalism is appropriate and justified in health care only if the following conditions are satisfied: 1.A patient is at risk of a serious, preventable harm. 2.The paternalistic action will probably prevent the harm. 3.The projected benefits to the patient of the paternalistic action outweigh its risks to the patient. 4.The least autonomy-restrictive alternative that will secure the benefits and reduce the risks is adopted.
Understand necessity of critically examining one's moral opinion as it relates to competing opinions.
Ordinary moral discussions proceed by appeal to uncritically accepted distinctions and opinions we find ready-made for us in discourse we learn from others. The study of moral philosophy serves first of all as a critical reflection on uncritically accepted moral discourse. This reflection-> helps to illuminate the content of our own moral thinking, speaking and acting. It can lead us to clarify what we think and also refine and improve our opinions. If we do not take for granted the impossibility of knowing the truth, it seems necessary to examine the truth of the competing opinions.
Explain the rule of the double effect and recognize instances in which it does and does not apply
The principle of the double effect: a set of ethical criteria which philosophers have advocated for evaluating the permissibility of acting when one's otherwise legitimate act (for example, relieving a terminally ill patient's pain) may also cause an effect one would normally be obliged to avoid (sedation and a slightly shortened life). Double-effect originates in Thomas Aquinas' treatment of homicidal self-defense, in his work Summa Theologica. An unintended effect that occurs as a result of an intended action-> one is not held morally responsible. -This set of criteria states that an action having foreseen harmful effects practically inseparable from the good effect is justifiable if the following are true: the nature of the act is itself good, or at least morally neutral; the agent intends the good effect and not the bad either as a means to the good or as an end itself; the good effect outweighs the bad effect in circumstances sufficiently grave to justify causing the bad effect and the agent exercises due diligence to minimize the harm.
List several material principles of justice
The question that naturally arises is, When is an inequality a relevant inequality? The various answers to this question constitute the material principles of distributive justice. Thus, Philosophers...have proposed each of the following principles as a valid material principle of distributive justice. . . . 1.To each person an equal share 2.To each person according to need 3.To each person according to effort 4.To each person according to contribution 5.To each person according to merit 6.To each person according to free-market exchanges -The material principle of justice that one applies will depend on the theory of justice to which one subscribes.
Recognize and distinguish the various types of controlling influences that undermine voluntariness
Three types of influence: (1) coercion: a person uses a credible and severe threat of harm or force to control another person. (2) persuasion: a person comes to believe in something through the merit of reasons another person advances; influence by appeal to reason. (3) manipulation: swaying people to do what the manipulator wants by means other than coercion or persuasion (i.e. informational, "This treatment is usually successful" when it is only so 51% of the time)
