Ethics Test
2. A legal term used to describe a civil or personal wrong leading to legal liability is: a) Sin b) Tort c) Culpability d) Exoneration
b) Tort
1. A mistaken belief based on unsound judgment is an example of a. An argument b. A fallacy c. An ontology d. An epistemology
b. A fallacy
10. The ethical principle that describes the doing of good, demonstrating kindness, and helping others is referred to as: a. Autonomy b. Beneficence c. Paternalism d. Nonmale e. Justice
b. Beneficence
1. What term best describes the voluntary agreement by a person who possesses sufficient mental capacity to make an intelligent choice to allow something proposed by another to be performed on himself or herself? a. Assent b. Consent c. Agreement d. Agreement
b. Consent
4. True or False: In general, high intelligence is a good marker for high ethical behavior. a. True b. False
b. False
5. Our values are almost always our own. They are unique to us as individuals. a. True b. False
b. False
5. True or False: Express consent must always be written. a. True b. False
b. False
6. The importance of choice in ethics means that we choose our values and that values are largely subjective. a. True b. False
b. False
2. True or False: If one wants to be a better person and leader, it is best to start with ethics as a simply theoretical construct. a. True b. False
b. False. We became better people and leaders and leaders by embracing virtues.
6. The form of consent that is determined by some act of silence, which raises a presumption that consent has been authorized is known as: a. Express b. Implied c. Statutory d. Remote
b. Implied
6. By the term synthesis, we are referring to... a. Deductive reasoning b. Inductive reasoning c. Hypothesis testing d. None of the above
b. Inductive reasoning
1. Seeing the inner nature of things is conventionally referred to as: a. Meaning b. Insight c. Consent d. Assen
b. Insight
⁎ The term, transformational insight, is used by who
⁎ The term is used by the business consultant, Jim Collins, in articles like "Building your Company's Vision" and in his books Good to Great and Built to Last.
No one person can do everything; but an effort is made to create many transformative experiential opportunities. Among the qualities we aim to cultivate in students and practitioners through these efforts is that they will be seen as:
"Socially poised, outgoing and cheerful, not prone to fearfulness or worried rumination, with a capacity for commitment to people and causes, for taking responsibility, for a having an ethical outlook, for being sympathetic and caring in their relationships, comfortable with themselves, with others and with the social universe they live in" Does this description fit you? If not, would you like it to? If so, the College will provide many opportunities to cultivate and refine these skills
Consider the biblical Book of Daniel written circa 164 BC and referencing a story dating back to 538 BC. The story reads as follows: o "Daniel was resolved not to defile himself with the king's food or wine; so he begged the chief chamberlain to spare him this defilement. Though God had given Daniel the favor and sympathy of the chief chamberlain, he nevertheless said to Daniel, 'I am afraid of my lord the king; it is he who allotted your food and drink. If he sees that you look wretched by comparison with the other young men of your age, you will endanger my life with the king.'" o "Then Daniel said to the steward ...'Please test your servants for ten days. Give us vegetables to eat and water to drink. Then see how we look in comparison with the other young men who eat from the royal table, and treat your servants according to what you see.'" o "...after ten days they looked healthier and better fed than any of the young men who ate from the royal table. So the steward continued to take away the food and wine they were to receive, and gave them vegetables."
-This is probably the first recorded example of a study using an experimental (test) group and a control group. Whether the story is factually true—whether Daniel ever existed at all—is irrelevant. -The point is that the logic underlying the scientific method was already well known in the 2nd Century BC as evidenced by an authenticated text dating to that period. Thus experimentation using test and control groups as the centerpiece of the scientific method is nothing new—it is simply a product of rational human thought and long preceded the Enlightenment of the 17th Century.
Lack of trust in institutions—governmental, academic, professional, corporate, ecclesiastic, and philanthropic—and an accompanying decline in ethical norms cause what?
-prevents social institutions from regulating themselves. which induces a compensatory increase in external regulation by the state. -Such regulation may be heavy handed because of the inherent nature of the bureaucratized state, defined by Joseph Tainter as that entity within a society that has an absolute monopoly on legal violence.
From a moral perspective, three things are required to consent to an act:
1. Knowledge 2. Freedom 3 . Full assent of the will
How does Yankelovich describes laws and norms ?
1. Norms are social values—unwritten rules that dictate what sorts of behavior are acceptable or unacceptable 2. A coherent set of norms constitutes an ethic: a generalized way of understanding one's relation to others
What are interpretations of Trolley problem ?
1. Strong inclination to Utilitarianism (70%) 2. Strong opposition to personal physical involvement (60%) 3. Technology makes things antiseptic (65-72%) and more acceptable15 4. Inclined to accept the stated framework; not inclined to recognize all options, especially if it questions authority (100%) 5. Rationality doesn't necessarily change minds (60%) 6. Slippery slope phenomenon (40%)
4. Plato identified four essential virtues of the good citizen. What are they? (Indicate all that apply, there may be more than one correct response) a. Wisdom b. Temperance c. Courage d. Justice
All of them is what Plato think : Virtues in a good citizen: Wisdom , Temperance , Courage, and Justice
Thus the trolley problem is a useful tool in the study what?
Study of philosophy and ethics. - The examples in used in class come from the book by David Edmonds entitled: Would You Kill the Fat Man? The trolley problem and what your answer tells us about right and wrong.
Nicomachean Ethics (Aristotle)
The Nicomachean Ethics (pronounced nih - kuh - muh - KEE - uhn) is Aristotle's best known work on ethics. In it he describes four categories of persons from an ethical perspective: the virtuous, the continent, the incontinent, and the vicious.
Sin changes us as much as it harms others.
We hurt others with full knowledge, with full freedom, and with full internal assent of the will. And we adapt, often with difficulty, to this new and regrettable reality until it becomes comfortable.
In Jim Collins's book Good to Great the author makes the point that the difference between good and great isn't very much. What does that mean?
What he is actually describing is an exponential relationship. Just a small amount of additional effort can convert being good at something to being great at it. The problem is that most people are simply unwilling to put in that small amount of extra effort. ex: The vine Bridge. See below
12. True or False: In some jurisdictions laws may require someone at the scene of an emergency to offer assistance if they have the knowledge and competence to do so. a) True b) False
a) True
18. How did Aristotle define virtue? a. "A mean between two extremes, with both ends potentially fraught with peril." b. "Always putting others first, even at your own expense." c. "Taking the most difficult and challenging course of action." d. "Helping others when it is convenient to do so."
a. "A mean between two extremes, with both ends potentially fraught with peril."
2. In philosophy and logic, what is an argument? a. A series of statements used to persuade someone of something or to present reasons for accepting a conclusion b. A disagreement in which people raise their voices or resort to violence because of opposing viewpoints c. Both of the above d. Neither of the above
a. A series of statements used to persuade someone of something or to present reasons for accepting a conclusion
21. What word best describes "taking others as you find them and accepting them for who they are and what they are, despite what you may regard as their faults or flaws?" a. Acceptance b. Justice c. Courage d. Autonomy
a. Acceptance
2. A thought that has sufficient impact to change a person's life occurs when they experience a/an ... a. Epiphany b. A deduction c. An analysis d. Life change is not possible after age 5
a. Epiphany
10. True or False: Regarding proof of consent: Oral consent is acceptable and is as binding as written consent a. True b. False
a. True
11. True or False: Oral consent is harder to corroborate should a question arise over the existence or validity of the consent. a. True b. False
a. True
18. As a leader of an organization or unit, if you are to demonstrate and epitomize the virtue of charity, you must learn to serve the people you lead. a. True b. False
a. True
25. When the leader of another unit needs your cooperation to fulfill some task or assignment, one's default mode, in situations like this, may be to give in to competitive urges and allow that person to fail because his or her failure is not our fault (or so we rationalize) and, anyway, it makes us look better. a. True b. False
a. True
26. If you treat people as if you have forgiven them, eventually you will find you have in fact forgiven them. a. True b. False
a. True
29. A key concept involved in achieving balance is being where you are supposed to be, when you are supposed to be there, doing what you are supposed to be doing. a. True b. False
a. True
7. Most of ethics involves decisions between already-established possibilities and already established reasons. a. True b. False
a. True
30. According to Stephen Covey, setting priorities should involve constructing a four-fold table in which tasks are designated as (A) urgent and important, (B) urgent but not important, (C) not urgent, but important, (D) not urgent and not important. How should actions be undertaken in order of priority? a. A, B, C, D b. A, C, B, D c. A, B, D, C d. D, C, B, A
b. A, C, B, D
3. Dentists must possess both transactional and relational skills. A key to success in dental practice, regardless of the circumstances, is known as "The 3-A's." Which of the following is not considered one of "The 3-A's?" a. Availability b. Acceptability c. Amiability d. Ability
b. Acceptability
2. Without consent touching a patient for the purpose of performing a dental procedure may qualify as: a. Treatment b. Assault c. Therapeutic intervention d. All of the above
b. Assault
31. In the Ultimatum Bargaining Game, Adam is given £100 in cash and told to share it with Bob. Adam must say how much he intends to give Bob and, if Bob refuses the offer, neither will get anything. If Bob accepts, then he gets what Adam has offered while Adam gets to keep the rest. a. Typically, Adam offers Bob the derisory sum of £1 and keeps the remaining £99 for himself. When such offers are made, Bob inevitably accepts the offer because if he declines he will get nothing and getting £1 is better than getting nothing. b. Because people care about fairness as well as self-interest, they do not expect to be offered a derisory sum of £1 by someone in Adam's position so they refuse it because irrational obstinacy is a good way of telling people so. c. When playing Adam, by far the most common offer is a 70:30 split because Adam wants to show how fair and trustworthy he is should future opportunities arise that depend on trust. d. All of the above
b. Because people care about fairness as well as self-interest, they do not expect to be offered a derisory sum of £1 by someone in Adam's position so they refuse it because irrational obstinacy is a good way of telling people so.
22. Which statement about courage is true? a. Courage cannot exist in the presence of fear b. Courage cannot exist without fear c. Fear cannot exist without courage d. Courage is a blend of arrogance and narcissism
b. Courage cannot exist without fear
3. A form of reasoning that moves from a/an hypothesis or theory to confirmation through experimentation is known as... a. Inductive reasoning b. Deductive reasoning c. Ethics d. Morality e. All of the above
b. Deductive reasoning
14. True or False: Consent can be given by someone who lacks sufficient knowledge to know what they are consenting to. a. True b. False
b. False
15. True or False: Coercion (force) is an effective way of securing consent from someone who would otherwise refuse to grant consent. a. True b. False
b. False
8. Yankelovich differentiates "laws" and "norms." What are norms? a. Written requirements for behavior sanctioned by the state and monitored by the police or other branches of the government b. Social values—unwritten rules that dictate what sorts of behavior are acceptable or unacceptable c. Both of the above d. Neither of the above
b. Social values—unwritten rules that dictate what sorts of behavior are acceptable or unacceptable
During World War II, Abraham Wald was hired by the U.S. Army to determine where American bombers should be reinforced with added armor based on where returning planes had the most bullet holes. Counterintuitively, Wald discovered that the places with the fewest bullet holes were the places that actually needed reinforcement. What Wald recognized was the phenomenon of: a. Confirmation bias b. Survivorship bias c. The ad hominem fallacy d. The cum hoc, ergo propter hoc fallacy
b. Survivorship bias
30. What is the term used to describe a condition in which everybody as individuals tries to take advantage of a common resource causing demand to exceed supply and preventing everyone from fully enjoying the benefits of the resource? a. The trolley problem b. The tragedy of the commons c. The nature of insight d. All of the above
b. The tragedy of the commons
21. Vision without humility is...? a) Fantasy b) Vision c) Humility d) Arrogance
d) Arrogance
13. In class, two cases were presented in which moral distinctions were made between people we like versus people we do not like even though the distinction may be unjustified or irrational. This phenomenon is known as: a) The Law of Diminishing Returns b) The Peter Principle c) The Doctrine of Natural Law d) The Knobe Effect
d) The Knobe Effect
11. Daniel Yankelovich attributes a decline in ethical norms to three successive waves of mistrust permeating Western society over the last 90 years. These include: a. The Great Depression of the 1930s b. The Vietnam War and Watergate c. The social revolution of the 1960s d. All of the above
d. All of the above
11.It is the obligation of the health-care provider to explain which of the following to patients regarding potential treatment? a. Risks b. Benefits c. Alternatives available d. All of the above
d. All of the above
12. From a moral standpoint, consent requires: a. Knowledge b. Freedom c. Full assent of the will d. All of the above
d. All of the above
13. In Yankelovich's view, which of the following is (are) outcomes of the social revolution of the 1960s? a. Increase in pluralism and tolerance b. Emphasis on individualism and different lifestyles c. Decline in social morality d. All of the above
d. All of the above
14. Which of the following have historically been understood to be foundational to morality—any one of which can be the basis of a moral life? a. Natural Law b. Metaphysics c. Divine Revelation d. All of the above
d. All of the above
16. What we think we know is based on: a. Personal experience b. Scientific experimentation c. Trust in those who teach us d. All of the above
d. All of the above
18. Among the confirmatory methodologies used to differentiate what is true from what is not true are: a. Science b. Natural Law c. Metaphysics d. All of the above
d. All of the above
30. Eminent NYU philosopher, Thomas Nagel, makes which of the following claims in his book Mind and Cosmos: Why the materialist neo-darwinian conception of nature is almost certainly false: a. One cannot really understand the scientific world view unless one assumes that the intelligibility of the world, as described by the laws that science has uncovered, is itself part of the deepest explanation of why things are as they are. b. Intelligibility is itself part of the explanation. That is, intelligibility is "baked into" the nature of the universe in its deepest essence. c. When we prefer one explanation of the same data to another because it is simpler and makes fewer arbitrary assumptions, that is not just an aesthetic preference: It is because we think the explanation that gives greater understanding is more likely to be true just for that reason. d. All of the above
d. All of the above
32. Possible solutions for the "Tragedy of the Commons" problem include(s): a. Privatizing the resource b. Regulating the resource by law and, if necessary, by force c. Cultivating a privileged position for morality d. All of the above
d. All of the above
9. Among the formal elements for informed consent in a written document are the patient's right to know: a. Nature of the illness or injury b. Purpose of proposed treatment c. Probability of success and attendant risks d. All of the above
d. All of the above
4. The two forms of consent discussed in class are: a. Intentional and unintentional b. Statutory and remote c. Regular and emergency d. Express and implied
d. Express and implied
According to the Law of Comparative Advantage proposed by the 18th Century English Economist, David Ricardo, differentials in the efficiency of production of goods and services (among countries or among dental practitioners) favor the exchange of goods and services rather than doing everything within one's technical capacity. The Law of Comparative Advantage focuses on increasing efficiency (and profitability) in the delivery of a product or a service. Efficiency here means minimizing both the cost and the time of production. It assumes that the quality of the product or service is the same between different practitioners. In the case of dental practice, application of the Law of Comparative Advantage would mean that: a. If two practitioners offer the same quality of service but differ in their efficiency of production, the more efficient of the two should do everything for himself or herself rather than ever referring cases to a less efficient (but equivalent quality) practitioner. b. General dentists should occasionally do some orthodontics as a strategy for increasing efficiency of practice, enhancing income, and promoting referral to and from other practitioners. c. In order to maximize efficiency of practice, oral and maxillofacial surgeons should practice the full range of the field, including dentoalveolar surgery, implant surgery, orthognathic surgery, craniofacial surgery, rhinoplasty, and hair transplants. d. Assuming quality is the same, Dentist A benefits by performing those procedures that he/she is most efficient at doing and then referring cases to another practitioner (Dentist B for those things that Dentist A is less efficient at doing even if Dentist A is relatively more efficient than Dentist B in doing the procedure in question.
d. Assuming quality is the same, Dentist A benefits by performing those procedures that he/she is most efficient at doing and then referring cases to another practitioner (Dentist B for those things that Dentist A is less efficient at doing even if Dentist A is relatively more efficient than Dentist B in doing the procedure in question.
14. Assuming ethical development and continual improvement can occur across the entire lifespan, who remarked that "to live is to change, and to be perfect is to have changed often?" a. Thomas Aquinas b. Augustine of Hippo c. Elizabeth Anscombe d. John Henry Newman
d. John Henry Newman
33. Dentists do relatively well in assessments of honesty and ethical standards as gauged by the public in Gallup polls. In the example given in class, dentists ranked better than... a. Nurses b. Pharmacists c. Physicians d. Lawyers
d. Lawyers
16. The ancient Greeks viewed which of the following as a mean between two extremes? a. Loyalty b. Honesty c. Self-esteem d. Virtue
d. Virtue
What is at the center of the Scientific Method
is the notion of testing a hypothesis with an experimental procedure. -Doing so was not a discovery of the 17th Century Enlightenment as often presumed. Much of what passes for the scientific method is simply human logic that has been applied at all times in all places by all people—not a unique intellectual advance of the 17th Century. Why there was an explosion of science and technology in the west at that time most likely depended on a diversity of factors including economics, politics, and culture.
Stewardship ethics relies on what?
it relies on a deeply felt commitment (referred to as a Credo) and, at the corporate level, on the concept of CSR (Corporate Social Responsibility).
At the very least, a written consent document should include what? (for patients)
o Nature of illness or injury o Name of proposed treatment or procedure o Purpose of proposed treatment o Probability of success and attendant risks o Alternatives available along with their attendant risks and benefits o Risks and prognosis without treatment o Indication that the patient understands the above o Signature of patient, doctor, and witness o Date
what is Insight?
⁑A conventional dictionary definition might describe insight as the power of seeing the inner nature of things with an impact that startles even you when you become aware of it. ⁑Thus, new insights can provoke transformational changes in the most dramatic way possible. When that happens the person experiences an epiphany, with the result being a change in one's life's direction. ⁑Many such epiphanies are hoped for in the course of professional education as one makes one's way from lay person to professional person
What other transformative opportunities in the College of Dentistry that students can do?
☆ Outreach activities both domestically and abroad ☆ service on the Peer Review Board (PRB) ☆ leadership experiences including the annual leadership retreat ☆ participation in the semi-annual Plenary Councils for students, faculty and staff ☆ obtaining a certificate in Global Public Health ☆ obtaining an MBA degree from the Stern School of Business ☆ most importantly, gaining the valuable clinical skills required to really help people in need, particularly by providing care for patients in our Oral Health Center for People with Disabilities, and in "The Brooklyn Project "
What are thoughts?
✩ They seem entirely evanescent and insubstantial—and yet, our perception of the world is based entirely on the thinking going on in our heads. ✩It defines our reality. ✩Thus, issues such as intent, consent, and insight—mere thoughts—have tangible real-world consequences in law, ethics, and morality. ✩This is why much of this course is devoted to the nature of our thinking.
What is one reason for the strong deference to authority ?
✫ the presumption that those in charge know best. This is often true, but not always. NYU social psychologist, Jonathan Haidt, describes 5 moral intuitions that have been present in almost all people, in all places, and in all times in history. Among these is respect for authority. This tendency is one among 4 other moral intuitions (avoiding doing harm; fairness; in-group loyalty, a sense of the sacred, as well as respect for authority).
Dentists must possess Which two skills?
✫ transactional skills (that is, getting the job done) ✫ relational skills (that is, having the emotional intelligence needed to interact well with other people) ✫ a key insight is that "people may forget what you tell them but they never forget how you make them feel."
Differing opinions exist over when a person's ethical formation is definitively established
✬ some guess 5 years of age ✬ others speculate that ethical development is finalized when a person leaves their parent's home. ✬ However, the premise of this course is that ethical development and improvement can continue throughout a person's life. ✬ Theologian and poet, John Henry Newman, remarked that "to live is to change, and to be perfect is to have changed often."
When do we use the deontologic approach?
✬When comparing and contrasting various codes of ethics. for instance, the code of ethics of the American Dental Association and that of the American College of Dentists.
When do we use virtue ethics approach ?
✬when attempting to inspire through the model of good people who elicit in others an aspiration to be like them.
Yankelovich describes the existing ethical hierarchy consisting of the following:
✴ "Staying within the law;" a very low standard; ✴ "Passing the smell test"—a colloquialism for a Natural Law standard of ethics ✴"Stewardship Ethics" envisaged as the highest ethical standard
The four Fallacies that LEAP will focus on are:
✵ The Appeal to anonymous authority fallacy ✵ The Appeal to authority fallacy ✵ The Ad hominem fallacy ✵The Cum hoc ergo propter hoc fallacy—
What is a Fallacy ?
✺ A fallacy is a mistaken belief based on unsound judgment. ✺It represents a failure in reasoning that renders an argument invalid. ✺We can think of it as faulty reasoning that is misleading or leads to an unsound argument.
Express consent
may be verbal or written.
Understanding consent from a moral standpoint is also important—and not only in terms of the relationship between the practitioner and the patient, but also from the perspective of the interior life of the practitioner.
From a moral perspective, we can ask whether we consent to our own actions? At first, the question seems foolish: If we engage in some act (either an act of commission or an act of omission) it can be presumed that we have consented to it. But the mental or psychological state of a person engaged in an action is not so easily dismissed. To accost the question of consenting to our own actions, we have to ask, what are the elements of consent from a moral standpoint? What were we thinking when we engaged in actions that were wrong? What determines our objective culpability for immoral acts? Did we really, internally, consent to the wrongdoing? Were there mitigating factors?
acts that are unethical but not immoral or illegal, give examples?
(for instance, a dentist who uses advertising not compliant with a given dental association's standards for size of lettering on his or her office sign).
What is law?
1. Positive Law (as distinguished from Natural Law) is whatever the state says it is.
o A real-life example of an exponential benefit is the power of compound interest.
Albert Einstein is supposed to have said that "the most powerful force in the universe is compound
Why it is not a good idea to become on the corrupt (the vicious in Aristotle's categorization)?
Among other obvious reasons, The corrupt make themselves extremely vulnerable. If none of the other justifications presented for virtuous behavior are convincing to you, then at least the desire not to expose yourself to continuing vulnerability should be persuasive. To say this is to make a claim that is part of a consequentialist argument favoring ethical behavior—why make yourself continually vulnerable to those who are willing to hurt you?
In essence, Informed Consent consists of certain formal elements.
Among these are that the patient is aware of the nature of the treatment proposed, the risks and benefits of the proposed treatment, any alternatives available and the risks and benefits of the alternatives. The patient must have the opportunity to ask questions.
The right to control the integrity of one's body reflects the principle of ------------
Autonomy
What are Blue Laws?
Blue laws prohibit retail activity on days such as Sunday. Some states prohibit selling alcoholic beverages for on- and off-premises sales in one form or another on Sundays. Over a period of 50 years, most such laws have been repealed, but not all: For instance, in Bergen County, New Jersey, Blue Laws are still in effect and ban the sale of clothing, shoes, furniture, home supplies and appliances on Sundays. These laws have been approved several times by county-wide referendum and their legality confirmed by the U.S. Supreme Court.
Haden and Jenkins then go on to say that "Virtue ... as we define it has more to do with what a person is and with what he or she does, inasmuch as actions shape character. Virtue is not a list of rules for living, but rather a way of life: a set of deeply ingrained personal habits that together form a prism through which one sees the world. The virtuous person will act in a morally praiseworthy way because he or she is a good person, not because of knowing a lot of theories of ethics...Much of our modern focus on ethics treats the subject as a set of rules, principles, systems, behaviors, and attitudes that can be memorized and applied to certain situations, much as a medical student learns what drug to use to treat a certain disease."
Haden and Jenkins refer to this as "formula-based ethics"—and it doesn't work. Dr.Bertolami agrees with them. In fact, in 2004, I published a paper entitled "Why our ethics curricula don't work."
What are the Three specific transformational insights are mentioned that characterized the successful companies by Collin's.
He called these insights: o Sexy vs. Snoresville; o The Difference between Good and Great (it's not much); o Seeing things as simple
2. What is the "state?"
Here we are not talking using the word "state" in the sense of provinces within a larger nation—like the 50 states within the United States. Rather we are talking about that entity in a society that provides the basis for legitimacy, autonomy and sovereignty. 3. According to Joseph Tainter in his book The Collapse of Complex Societies, the state has certain distinctive qualities. The state is not a family, a tribe, or a kingdom. States are much larger than that. The characteristic most relevant to our discussion is that the state is that entity within a society that has an absolute monopoly on legal violence.
In addition to Knowledge and Freedom however, moral consent requires "full assent of the will" which is an entirely internal state of mind and thus very difficult to define. In day-to-day life the question doesn't usually arise:
If you sign an informed consent document or if you engage in an action evident to others and if there is no question of a lack of knowledge or a lack of freedom, then a reasonable presumption is that you consented to the act.
Robert P. George's book entitled, In Defense of Natural Law. Statment
Importantly, George is using friendship as just one example of the power of Natural Law— many other such examples of "practical reason" could also be described.
Simply identifying these qualities as consciously perceived needs accomplishes much toward achieving them. In Material Dreams: Southern California by Kevin Starr, the author describes the story of the writing of the Wizard of Oz by L. Frank Baum in 1900.
In it he makes the following statement: The tin woodman, the scarecrow, and the cowardly lion found their dreams—a heart, a brain, courage—in the very act of envisaging them as needs." ✷ What this means is that consciousness of a deficiency sensitizes us to those occasions when that particular deficiency is likely to manifest itself. ✷This consciously congeals for us the moment of decision. ✷Without the pre-existing consciousness, the moment would pass without recognition and without action. ✷ When a moment of choice is consciously perceived and when there has been a preexisting awareness of and desire to rectify a known deficiency, then actions can follow that are more likely to be virtuous.
The strong tendency of people to follow the dictates of an authority figure has been the subject of much psychological analysis.
In one famous experiment , volunteers were asked to participate in a serious psychological study in which a volunteer would use a rheostat to gradually increase the voltage of an electrical shock delivered to another unseen person in an adjacent room. Unknown to the volunteers, the person in the adjacent room was actually an actor who was told to voice discomfort as the pretend voltage was increased. As the volunteers began to hear screams of pain, they hesitated to increase the "voltage" any higher. But when instructed by the researcher (the authority figure) that the validity of the experiment required it, many volunteers continued increasing the voltage despite shrieks of pain coming from the other room. Some continued to increase the voltage to the theoretical maximum shown on the dial—such is the power of authority and the failure of people to see that they often have more options than they recognize. In this case, the volunteers could have refused to increase the voltage or they could have simply walked out of the experiment. Here's the point to remember: You always have a choice.
How the Five Negative Emotions related to our prehistoric ancestors?
In prehistoric human development, these negative emotions were protective over the short term (e.g., anxiety protected our ancestors from trying to pet the sabre toothed tiger). But when these negative emotions become one's "preferred attentional stance"—that is, the way a person is most of the time—they can become paralyzing and problematic. Because of our prehistoric mental programming, modern humans can interpret non-physical threats as a surrogate for true physical ones of the sort our ancestors faced. When we respond accordingly, the outcome can be highly negative and inappropriate.
Dental graduates are sometimes disappointed that professional education does not turn out to be the transformative experience they were expecting it to be. How is LEAP gonna change that?
LEAP is one of several experiences at NYU/Dentistry aimed at fulfilling the expectation by providing a transformative experience that can promote the qualities of emotional intelligence
In the book The 9 Virtues of Exceptional Leaders: Unlocking your leadership potential, authors N. Karl Haden and Rob Jenkins make the point that "A quick scan of contemporary writing on ethics yields definitions such as 'the moral correctness of specified conduct'; 'the rules of conduct recognized in respect to a particular class of human actions'; 'the study of proper business policies and practices regarding potentially controversial issues.'
Note that all of these definitions focus on conduct, actions, and practices in the context of some theoretical framework. In other words, what constitutes a morally correct action is determined by the ethical system in which or by which it is interpreted."
In the practice of dentistry our goal and our calling?
Our goal in welcoming and treating patients is strictly neutral accepting, in principle, that different people look at things differently. And, whatever their perspective and however much we may disagree with it, our calling is to provide the finest oral health care we can to everyone.
The primary interest of this course will be?
Our primary interest will be professional ethics, with much less of an emphasis on either legality or morality.
What is the difference in tone between the ADA Code (legalistic) and the American College of Dentists' document (ethical/moral). ?
The ADA Code does not mention the words "consent" or "moral." The American College of Dentists document mentions "consent" 8 times and "moral" 12 times. But it also underscores the need for the dentist to subordinate his or her own philosophic, religious, political viewpoints in the interest of the care of the patient
Who famously remarked "I am the state, the state is me."
The king of France, Louis XIV (1643-1715) said that. -He erred in saying so. What he meant by the comment becomes clear in Joseph Tainter's definition of the state—Louis was simply expressing his view that he was an absolute monarch with the power of life and death.
Analysis vs. Synthesis
The point will be to argue that analysis tells us how things work; synthesis tells us what things mean. Both systems of reasoning are needed, though both can go wrong when taken to an extreme. In the extreme of deductive analysis, nothing can be definitively shown to mean anything. Without meaning, all kinds of depravity can emerge. Correspondingly, inductive reasoning, taken to the extreme, can lead to accepting prejudice and bias as acceptable norms.
16. True or False: The degree of culpability (guilt) associated with wrongdoing may be mitigated (decreased) by the state of mind of the perpetrator. a. True b. False
a. True
26. True or False: Logic and rational thought sometime lead to actionable conclusions that are simply not directly testable by the scientific method. a. True b. False
a. True
Consider marriage: Marriage has certain contractual, legal, and possibly religious significance to individuals and to the state. However, think about marriage from a purely moral perspective: The fundamental essence of marriage is the consent of the participants.
This means that the parties to a marriage must have knowledge of what marriage is and an awareness of what they are consenting to: 1. A billionaire on his death bed may be in no position to consent to marriage based on a lack of knowledge of what he is experiencing if he is in an altered state of consciousness due to illness or medications. (Yes, such things have actually happened). 2. The same would be true if the parties to a marriage are inebriated or otherwise in no position to consciously know what is happening. 3. The validity of a "shotgun wedding" can be questioned because coercion limits an individual's freedom. Without freedom, consent is not possible. 4. A legally contracted marriage may not be morally valid if the parties involved lack understanding concerning the essential nature of the married state (lack of knowledge), i.e., the person was incapable of understanding what they were agreeing to.
17. True or False: It becomes easier to accept knowledge as true when we rely not only on those we trust, but also on an explanation that can be given to us that we can understand and that seems so rational that we intuitively accept the hypothesis as true—even if only tentatively and provisionally unless proven otherwise. a. True b. False
a. True
19. Anger and resentment, over time, turn us into the worst versions of ourselves: bitter and cynical, the kind of people no one wants to be around, much less follow. a. True b. False
a. True
19. True or False: Hypothesis-driven science is considered the gold standard for discerning what is true from a strictly physical standpoint. a. True b. False
a. True
20. Experience shows that others are much more likely to forgive us if we have previously demonstrated a forgiving spirit. a. True b. False
a. True
21. True or False: Nobel laureate Robert A. Millikan selected a relatively small number of oil drops in order to calculate the electrical charge of an electron. a. True b. False
a. True
22. As a leader, you must have the wisdom and discernment—not to mention the humility—to differentiate between things that actually are harmful to others or to the organization and things you just do not like. a. True b. False
a. True
One of the goals of professional education is to move people toward which categories in Nicomachean Ethics?
the virtuous (paragon) end of the bell curve. Why?
We see this in everyday life when people use their "job" as a justification for allowing someone to be harmed.
Thus a photographer who sees someone being harmed (drowning in a newsworthy flood for instance) but does not put down the camera to help (escaping from the scenario) and justifies the outcome out of loyalty to the authority who has established the parameters of the photographer's job.
Law-making authority may be distributed or delegated among many levels of the state.
Thus, the federal government, the state government, the city government and other jurisdictions may enact legally binding laws as well.
✵ If Virtue Ethics appeals to------, then the consequentialist approach appeals to ----
Virtue Ethics appeals to the heart consequentialist approach appeals to the mind.
Who said this "There is nothing either good or bad but thinking makes it so."
William Shakespeare, Hamlet,
What are the Three approaches to teaching ethics?
❇deontology ❇consequentialism ❇virtue ethics
Informed consent is based on the premise that
"an individual's right to make decisions vitally affecting his private life according to his own conscience...is difficult to overstate...because it is, without exaggeration the very bedrock on which this country was founded."
Elsewhere in this course, we make a distinction between things such as
(1) "look easy and are easy" vs. (2) things that "look hard but are really easy" vs. (3) things that "look hard and are hard" vs. (4) things that "look easy but are hard" I think it's safest to assume that cultivating trust with patients is something that looks easy but is really hard. Increasingly the trust of patients in their dentist must be earned continually. You will recall the statement discussed earlier from Stuart Diamond's book on negotiation (Getting More: How to negotiate to achieve your goals in the real world) that once trust is lost it is nearly impossible to regain.
Why it is very easy to move from a discussion about ethics to one about morality.
-These words mean very different things and the distinction is emphasized throughout this course especially in differentiating legality, morality, and ethics.
The different philosophic perspectives—Utilitarianism and the Categorical Imperative—are very deep subjects far beyond the scope of this introductory course; but the basic issues involved do pertain to everyday life and everyday dental practice. These extreme examples may seem irrelevant, but consider the following case from a moral perspective
1. A patient comes into your office in extreme pain. 2. After a thorough examination, you come to the conclusion that the maxillary right central incisor has a severe pulpitis causing the pain. 3. The tooth is restorable and you recommend endodontic treatment (root canal therapy) which you can begin immediately and remove the patient from pain. 4. You inform the patient that the root canal therapy and the subsequent restoration with a crown will cost several thousand dollars. 5. The patient has no money and informs you that he cannot pay. Barely getting by in supporting his family, he can't even afford to have you arrange a payment plan for him. 6. Among the alternatives are: Extracting the right central incisor now, despite the fact that it is restorable. This removes the cause of the pain which is of immediate concern. In doing this, however, you have made yourself a source of social impairment for the patient and perhaps even diminished his prospects for future employability. Extirpating (removing) the pulp now to eliminate the pain, placing a temporary restoration, hoping that the patient does not return to your office. Knowing that your treatment is strictly temporary, will you set up an appointment for follow-up in order to either complete the root canal therapy/crown or, alternatively, to replace the extracted tooth at even greater expense? Will you proactively ask your assistant to call the patient to set up an appointment? 7. Assuming you are a busy practitioner with every appointment slot filled, does it make any difference if you decline the needed treatment for this particular patient knowing that somebody else in equal need, but who can pay, will fill that slot and so you will still be helping another human being in need? What's the difference between this particular patient in pain and that particular patient in pain? 8. If you complete the entire, ideal treatment for this patient (who cannot pay) at your own expense, will you develop a reputation as the dentist who "doesn't charge" and therefore develop through word-of-mouth a clientele exclusively of patients who are unable to pay? 9. If your patients cannot pay you, will you be able to remain in practice? If not, how will you be able to help anybody -Points #8 and #9 are examples of "catastrophizing" and "rationalizing" and have high relevance to the subject of emotional intelligence. Dentists' speculations about the impact of charitable care on their practices and on their ability to earn an income can lead to their refusal to provide such care yet may be entirely unjustifiable. Why not try it and see what happens? You can always change your strategy.
Jonathan Haidt is an NYU professor who has written extensively on the foundations of morality. He is a sociologist, not a philosopher, ethicist, or theologian; therefore, his approach is sociological: He asks, when it comes to morality, what do most people think? Haidt identifies 5 moral intuitions. What are the 5 moral Intuitions?
1. Providing care rather than harm 2. Practicing fairness and justice 3. Acknowledging in-group loyalty 4. Respecting legitimate authority 5. Having a sense of the sacred ❇ It is clear that his arguments reflect Natural Law philosophy, not directly, but rather by considering what all human societies at all times and places have considered to be moral.
Give an example on how consciousness of deficiency might push us to act to change this deficiency
An example might be courage: A person is more likely to act with courage if they have previously experienced the shame of cowardice and if they learn to recognize the circumstances under which the courage/cowardice dichotomy may happen again. This is especially true if the feelings that followed the episode of cowardice have been intense.
What are the five negative emotions that drive people toward the corrupt end of the bell curve in Dental school and life?.
Anxiety, Anger, Depression, Embarrassment, and Guilt.
Maintaining ethical norms is especially important in the case of the healing professions that, historically, have been granted great latitude in self-regulation—a privilege increasingly uncommon for intermediary institutions like the dental office. The behavior of each individual becomes critical in defining the face presented by the profession to the public as a whole. Give a metaphor to explain this idea.
As a metaphor, I have used the image of a fractal—a geometric figure each individual part of which has the same configuration as the pattern as a whole. The pattern recurs at smaller and smaller scales with the overall pattern continually replicating itself no matter how closely one examines it. That is, the macrocosmic scale is simply an amplified version of the microcosmic scale with each individual practitioner (in this analogy) contributing to the overall configuration of the profession as a whole.
15. What we know and how we know it falls within a branch of philosophy known as: a. Ethics b. Logic c. Epistemology d. Metaphysics
Epistemology
Who wrote the ethical hierarchy hypothesis?
Daniel Yankelovich In Profit with Honor - He is considered one of the most influential people of the 20th Century
Consent comes in two forms:
Express and Implied
4. True or False: If one wants to be a better person and leader, the answer is simply to start with ethics—with simply a theoretical construct. a. True b. False
False. Start with Virtues by embracing and practicing them!
Morality has three primary foundations. What are they?
Morality has three primary foundations —any one of these foundations is sufficient as the basis of a moral life. Some people may accept all three foundations, some will accept only one. The foundations of morality are: 1. Natural Law 2. Metaphysics 3. Divine Revelation
What are the principles of Natural Law?
Principles of Natural Law include: ✼ That human choice and action are directed toward intelligible purposes ✼ That there exists basic human goods that are intrinsic aspects of human wellbeing and fulfillment ✼ That there are reasons for human actions whose intelligibility as reasons does not depend on more fundamental (sub-rational) motives ✼That all of these qualities of human moral actions are self-evident
Referring to the collapse of the Ottoman empire, Bernard Lewis writes:
Social change, and the breakdown of old social relationships and obligations, brought great harm to ... society and created new and gaping contrasts, which modern communication made all the more visible. As far back as 1832, an acute British observer, a young naval officer called Adolphus Slade, noted this difference between what he called the old nobility and the new nobility. The old nobility, he said, lived on their estates. For the new nobility, the state was their estate [emphasis added].
Nevertheless there are acts that are indeed illegal, immoral and unethical—this is where the three circles in the Venn diagram do overlap .
Sometimes what is at issue is just a matter of etiquette—hurting someone's feelings, for instance. Yet it is always possible for etiquette to be transformed into law. In past decades, expression of hatred for someone might qualify as impolite or crude, but if such speech did not incite violence, it was not illegal. Today, in some jurisdictions, so-called hate speech—a relatively recent innovation—qualifies as illegal and may be subject to criminal or civil legal action
True or False: In the Trolley Problem scenario known as "Spur," a large majority (70%) of people would push the lever diverting the trolley and saving the 5 people tied to the main line; but at the cost of killing the one man tied to the spur. a) True b) False
a) True
What motivated the posing the the trolley problem?
We all have certain moral intuitions. -These intuitions usually stem from Natural Law hardwired into every person (as introduced on page 52). But a problem arises when we try to translate these intuitions into clear-cut principles as a basis for moral behavior and for establishing rules that apply to everyone everywhere as embodied in codes of ethics and in positive law.
18. According to Haden and Jenkins, a sustained emphasis on pragmatism over optimism may be a first step toward...? a) Cynicism b) Honesty c) Loyalty d) Faith
a) Cynicism
14. According to Haden and Jenkins, as a leader, you have to earn and be worthy of people's... (Choose the one best answer). a) Faith b) Hope c) Charity d) Love
a) Faith
20. Hope without wisdom is...? a) Fantasy b) Vision c) Humility d) Arrogance
a) Fantasy
7. The legal concept referring to a patient's right to know the risks, benefits and alternatives to a medical intervention is known as: a. Informed consent b. Alternative consent c. Implied consent d. Express consent
a. Informed consent
17. An extreme and unhealthy form of self-love that we often equate with arrogance and lack of humility is: a. Narcissism b. Self-loathing c. Justice d. Diligence
a. Narcissism
23. Peers and employees will be inspired to follow you when you exhibit which of the following qualities? (Choose all that apply). a) Give people both a voice in the decision-making process and a stake in the outcome b) Accept responsibility and deflect credit (rather than the other way around) c) Show faith in others by the way you treat them and faith in the organization by the way you talk about it Consistently project an attitude of confidence and realistic optimism in the future of the organization
a) Give people both a voice in the decision-making process and a stake in the outcome b) Accept responsibility and deflect credit (rather than the other way around) c) Show faith in others by the way you treat them and faith in the organization by the way you talk about it Consistently project an attitude of confidence and realistic optimism in the future of the organization
deontology is based on -------------
an accepted moral or ethical code
What is clear is that hypothesis testing requires a means for formulating an hypothesis in the first place and doing so requires what?
an understanding of both inductive and deductive reasoning. -What will be seen is that inductive reasoning leads to generation of an hypothesis through synthesis, while testing of the hypothesis will be done through deductive reasoning through analysis. Non-scientists are often confused on this central point.
The lecture format is aimed not only at delivering content, but also
at creating a social experience that allows for gauging reactions, enabling new insights, imparting facts, modeling argumentation, responding to non-verbal cues, and practicing collective listening. Listening to a sustained, hourlong argument requires initiative, will, and focus.
As ethical norms erode, what increases?
authoritarianism
autonomy, beneficence, non-paternalism, nonmaleficence, and justice. principles are doubly abstract ..Why?
because it is not possible for anyone to actually be any of these things.
Informing people of the rules is important, but is not enough. Why?
because knowledge does not equate to acceptance of the rule at some deep internalized level. Being told the right thing is not the same as accepting the rule and living by it.
In all academic courses dealing with professional ethics, there are certain terms of agreement on basic principles. Among these are the concepts of autonomy, beneficence, non-paternalism, nonmaleficence, and justice. But this course does not emphasize these principles in this course why?
because they are abstractions that one can easily understand at a cognitive level but still not apply in professional practice or in life more generally. In other words, as praiseworthy as these concepts are, they are hard to internalize and apply when one confronts an actual situation at a moment of choice in dental practice or in life.
1. What does "LEAP" stand for? a. Leadership b. Ethics c. Accountability d. Professionalism e. All of the above
e. All of the above
20. Metaphysics is one way that scientific hypotheses are formulated based on inductive reasoning from physical observation. Which of the following statements is true? a. If a scientific hypothesis is not testable experimentally, the hypothesis must be false. b. Absence of evidence equates to evidence of absence. c. The everyday practice of science can be remarkably ambiguous and the boundary between fabrication and creative insight may not be obvious. d. When it comes to distinguishing data from experimental noise, an investigator's experience and intuition—in short, his or her creative insight—should never contribute to the final interpretation of experimental findings.
c. The everyday practice of science can be remarkably ambiguous and the boundary between fabrication and creative insight may not be obvious.
6. In the Nicomachean Ethics, persons are placed into distinctive categories. Among these are: a. The virtuous b. The continent c. The incontinent d. The vicious e. All of the above
e. All of the above
1. In understanding virtue, which of the following is true? a. Virtue is primarily an approach to management b. Virtue is a technique c. Virtue is a way of living developed over a lifetime d. Practicing virtue cannot make someone a better person
c. Virtue is a way of living developed over a lifetime
12. The obligation to be fair in the distribution of benefits and risks is an ethical principle known as: a. Autonomy b. Beneficence c. Paternalism d. Nonmaleficence e. Justice
e. Justice
4. Characteristics of ethical principles are that they are: a. Always directly related to the state and to law b. Seldom determined by professional societies having specialized expertise c. Well-founded, prescriptive and purposeful d. All of the above
c. Well-founded, prescriptive and purposeful
19. Haden and Jenkins define which of the following as a reality-based version of optimism...? a) Loyalty b) Pragmatism c) Cynicism d) Paternalism
c) Cynicism
3. The legal term used to describe a form of conduct caused by heedlessness or carelessness that constitutes a departure from the standard of care generally imposed on reasonable members of society is: a) Consent b) Immorality c) Negligence d) Insanity
c) Negligence
10. Justifying and exculpating (excusing) ourselves in order to achieve what we want at the expense of what is right is known as a) Atonement b) Redemption c) Rationalization d) All of the above
c) Rationalization
1. Something that legality, morality, and ethics all have in common is(are): a. They can be used interchangeably because they all mean the same thing. b. All are determined by the state c. All are frameworks for rightness and wrongness d. None ever change over time
c. All are frameworks for rightness and wrongness
34. Suppose you come upon the following situation: There's an abandoned trolley out of control and you notice that if nothing is done it will continue on its track to kill five persons tied to the track. You also notice that there is a lever and that if you were to push it, the trolley would be diverted to a side-track (a spur) where there is one person tied to it. You know that if you do nothing, five people will be killed by the trolley; you also know that if you push the lever, you will save the five from being killed by diverting the trolley to the side-track thereby killing one innocent person (who wouldn't have been killed otherwise). What would most people do? e. A large majority of people would push the lever f. A large majority of people would not push the lever g. Whether a person will push the lever depends on their cultural group h. None of the above
e. A large majority of people would push the lever
Words carry -------- content
emotional content: "Clean Air and Water"; "Dreamers"; "Choice"; "Life"; "Freedom of..."; "Equality"; "Justice" are all labels that carry positive connotations and, therefore, can be used to manipulate sentiments at a purely emotional level.
consequentialism is based on --------------
good or bad outcomes
Inevitably there are many grey areas and fine points. When taken to an extreme, the result can be interpreted as ------ or------
humorous or offensive, depending on your perspective—and what was funny in one era may be offensive in another (and vice versa) ex: ✳ Consider Mark Twain's rules of etiquette for "young gentlemen rescuing people from boarding house fires:" at Or ✳ consider philosopher Will Durant's description of Voltaire as a young man: "He took to staying up late at night, frolicking with the wits and roisterers of the town, and experimenting with the commandments." 5 Was Voltaire's behavior illegal or unethical? Probably not in most places today. Immoral? Probably. Imprudent? Definitely. Is Durant's making a joke of it funny or offensive?
What is the basis for generating scientific hypotheses
is an inductive exercise in metaphysics as presented subsequently.
When it comes to law, who decide what is and what is not the law?
legal jurisdictions decide what is and what is not the law. ❈ Today, when most people consider Saturday and Sunday a weekend, meaning nothing more than days off from school or work, there are no legal restrictions (in most places) but, of course, a religious moral obligation may still apply. Thus, law and morality have moved even farther apart in most places.
The trolley problem sounds to many like an impossible abstraction. And, for decades it has been, but it has always been extremely useful in discussing concepts such as
like intent and consent and, more broadly, philosophic ideas like utilitarianism (proposed by 18th Century English philosopher, Jeremy Bentham) and the categorical imperative (of German philosopher, Immanuel Kant). More recently, the trolley problem has found practical (and potentially scary) implications in the programming of autonomous vehicles.
Solution: In approaching the "Vine Bridge" problem,
most people obsess over the key disadvantage: someone who is going to take 10 minutes to cross, frittering away essential minutes. o By focusing on this individual, the approach taken is usually to use the 1-minute crosser to ferry the 10-minute person across the bridge (arriving on the far side at 10 minutes). o The 1-minute person returns the flashlight to the nearside (bringing the clock up to 11 minutes.) o The 1-minute person then ferries the 5-minute person across (arriving at the far side at 16 minutes). o The 1-minute person returns the flashlight to the near side in anticipation of ferrying the 2-minute person across. (Alas, this brings us up to 17 minutes, precisely when the bandits arrive at the near side, killing the 1- and 2-minute people and then crossing the bridge themselves to kill the 5- and 10-minute people).
Inductive reasoning (synthesis)
moves from making observations, to drawing generalizations, to generating a conclusion in the form of a paradigm or a theory.
Deductive reasoning (analysis)
moves in the opposite direction—from theory, to the making of predictions, and finally to the testing of predictions experimentally.
At issue may be a question over evidence for the proof of consent:
o Oral consent is acceptable and is as binding as written consent; however, oral consent is harder to corroborate should a question arise over the existence or validity of the consent. o If a patient is unconscious, consent can sometimes be presumed if the treatment is necessary and the patient would have consented if conscious and competent. Again, consent under these circumstances is subject to interpretation and may be contested.
The trolley problem seems very simple at first, but --------
probes the depth of our moral sensibilities. Here is a nice summary and review of Edmonds's book
The Ad hominem fallacy
❅this is a form of argumentation that does not address the relevant points of an opponent's argument, but rather simply calls him/her names. ❅In fact, insulting or disparaging language, whenever it is used should raise a suspicion that the argument may involve the ad hominem fallacy and is likely fallacious. ❅Name calling is resorted to when there is no real argument to be made
What we see in the Knobe Effect
that the distinctions we make may be unjustified or irrational. See if you agree after familiarizing yourself with the work of Joshua Knobe, a prominent advocate of a relatively new discipline known as "Experimental Philosophy."
Yankelovich sees greatly increased mistrust in our society—which of course means that professional people should not presume
that they have the benefit-of-the-doubt when dealing with patients. This represents a significant shift in public opinion over the past several decades—but one often missed by professional people themselves. This shift means that the trust relationship between dentists and patients should not automatically be presumed.
Positive emotions have been studied much less extensively than negative emotions and they function in a very different way from negative emotions. What is one of the few studies dealing with the benefits of positive emotions
the "Broaden and Build" hypothesis described by Barbara Fredrickson.
There is no requirement that dentists join the American Dental Association (ADA); however, if they choose to do so, they must accept what?
the ADA Principles of Ethics & Code of Professional Conduct and recognize that violations of that Code could result in expulsion from the Association.
Dr. Betrolmi updated the four catogeries of Nicomachean Ethics to fit for a more contemporary audience by categorizing individuals as paragons. What are the updated three categories of Nicomachean Ethics ?
the fully committed, the ambiguously committed, and the corrupt
Problems with the general definition of Consent in life
the problem that it offers extremely wide latitude for interpretation. For instance: o What does voluntary mean? What degrees of personal freedom are required for an act to be considered fully voluntary? o What does agreement mean? Does agreement imply full affirmation or does it admit some degree of mental reservation or hesitation? o What qualifies as sufficient? In other words, how much is enough? o Exactly how intelligent must a person be in order to give valid consent?
What is Beneficence?
—Describes the principle of doing good, demonstrating kindness, and helping others
What is Non-paternalism?
—In healthcare, it is concept that physicians (dentists) make decisions for their patients, whereas the more acceptable approach is autonomy, wherein the physician (dentist) informs the patient as to the risks, benefits, and alternatives to care and treatment, and then the patient makes the final choice as to what is best.
More recently, the trolley problem has found practical (and potentially scary) implications in where?
the programming of autonomous vehicles.
One type of corruption is the pursuit of what? How it is related to our prehistoric ancestors ?
the pursuit of extrinsic rewards—money, status, and grades -it can do the same thing as a surrogate for our roles as hunters and gatherers.
What is autonomy?
—Right of an individual to make his or her own decisions
What is Non-maleficence
—The ethical principle that requires caregivers to avoid causing patients harm.
What is Justice?
—The obligation to be fair in the distribution of benefits and risks
scientific hypotheses ?
—a central feature of the scientific method—
virtue ethics is about -------------
understanding and becoming inspired by what a good person is like
The trolley problem is useful in showing what?
us to ourselves as individuals (whatever the choices you make) because it cuts to the core of our moral thinking by stripping away anything irrelevant to moral decision making, especially all the uncertainties that are inevitably a part of real life. This allows us to focus our attention on what really counts from a moral standpoint. ✮While we will never encounter the exact circumstances of the trolley problem in daily life, we will (and have) encountered less extreme conditions requiring a decision on our part. When that happens, our thinking—from a moral standpoint—may well replicate the moral thinking, rationalizations, and justifications we made in the extreme case of the trolley problem.
All manner of actions—littering, plagiarism, copyright infringement, not busing one's own trash at McDonalds—can be viewed differently depending on what?
whether one is using a legal, moral, or ethical lens.
The term argument has a specific meaning in consequentialist approach , what does it mean?
—it doesn't mean a heated disagreement; rather, the term is used as it might be in law or philosophy; that is, marshalling facts in support of a particular position and responding to facts presented in favor of an opposite position.
Dentistry is not the only profession affected by increasing levels of mistrust
—mistrust permeates many levels of society.
Who is Daniel Yankelovich
— considered one of the most influential thought leaders of the 20th Century — has written on the high social cost of mistrust in society, especially when the public mistrusts the professions. — His thinking is embodied in the book Profit with Honor: The new stage of market capitalism
What is an argument, in the way we are using it in this course?
❇ is marshalling facts in support of a particular position and responding to facts presented in favor of an opposite position. ❇ We are not using the conventional or colloquial definition of an argument as "a heated or angry dispute." ❇ Rather we are saying that an argument consists of specified claims and counterclaims that in aggregate offer "a reason or set of reasons given with the aim of persuading others that an action or an idea is right or wrong"
17. Vision of another function of...? a) Faith b) Hope c) Charity d) Loyalty
b) Hope
The alternative strategy to the "Vine Bridge" problem, is as follows:
The alternative strategy is as follows: o The 1- and 2-minute people cross the bridge together at the outset, arriving at the far side in 2 minutes. Control of the far side of the bridge by a fast mover has now been established. o The 1-minute person returns the flashlight to the near side (bringing us up to 3 minutes). o A critical and essential risk now must be taken—a real leap of faith based on trust: The 1-minute person gives the flashlight to the two slowest movers (the 5- and 10-minute people) who cross together. They arrive at the far side of the bridge at 13 minutes where the 2- minute person is waiting for them. o The 2-minute person traverses the bridge with the flashlight to pick up the 1-minute person and arrives at the near side at 15 minutes. o The 1- and 2-minute people traverse the bridge together arriving at the far side at 17 minutes—just as the bandits arrive at the near side. o With all four people safely on the far side of the bridge, they are in a position to cut the vines and be completely free. They can no longer be pursued. o The data collected from our Top Hat audience response system for the Class of 2022 suggests that class as a whole did tend to obsess over obstacles rather than moving forward to the simple, wellthought through solution.
The Code of Ethics of the ADA is very much a legal document—not especially aspirational from a professional standpoint. The general flavor of the document is conveyed by the first paragraph of the Introduction:
"The dental profession holds a special position of trust within society. As a consequence, society affords the profession certain privileges that are not available to members of the public-at-large. In return, the profession makes a commitment to society that its members will adhere to high ethical standards of conduct." ❇ Dr. Bertlolam places special emphasis on the words: "as a consequence" and "in return." In other words, this Introduction has a contractual character—a social contract. This understanding of professional ethics implies that dentists behave ethically not because they are good people or as a matter of personal morality; but rather, because of a strictly business-type, contractual (if unspoken) social arrangement: In return for getting good things from the public (licensure, money, esteem), dentists will do good things in return for the public (provide dental care). This is known as a quid pro quo
"Trap Door" is very similar to "Fat Man;" but it adds a layer of technology—a lever that can open a trap door that causes the man to fall to the track killing him, but thereby stopping the train and saving 5 people. In "Fat Man" 60% of people decline to push the man physically off the bridge; but, in "Trap Door," only 35% decline to push the lever opening the trap door allowing the man to fall. There are two lessons here, which are?
(a) interposing technology (a lever) allows us to do things we would never do if we had to get physically involved, even if the outcome is identical (saving 5 people). (b) All four scenarios make us vulnerable to the "slippery slope" phenomenon. ✧In other words, once we make the decision to push the lever in "Spur," our rational faculties can now overcome our emotional inclinations. ✧That is, having decided in "Spur" that sacrificing 1 to save 5 is virtuous, we now feel obligated—rationally—to kill the man in each successive scenario having already decided to do so in "Spur." ✧Thus, 40-65% of us say we would cause the obese man to fall off the bridge because not to do so would be rationally inconsistent with the decision we've already made in "Spur." ✧ I suspect that if we were really confronted with the "Fat Man" scenario none of us would physically push him, but the way I've laid out these scenarios we've already committed to killing him in "Spur," making the decision to do so easier in the other scenarios.
While the scientific method may be the gold standard for investigating the natural world,, it is-----------
, it is extremely difficult to actually define what the scientific method is.
There are actions that are illegal but not immoral, Give examples?
-(arguably, driving 60 MPH in a 55 MPH zone); acts that are immoral but not illegal (say, not honoring one's mother and father— depending of course on the moral code being used);
The "Vine Bridge" scenario four of you are running through the woods at night being chased by bandits. If caught you will certainly confront a horrible fate. You have a 17-minute lead over the bandits when you come across a canyon that is 1,000 miles long and 1,000 feet deep. You cannot escape by going down or going around the canyon. The only escape is to cross the canyon. Luckily there is a bridge. Unfortunately, the bridge is rickety and unstable being made of only old vines and rotting wooden planks unable to support the four of you crossing at the same time. Only two people can cross simultaneously. Because it is night and there is no moon or stars you can't really see very well. Further, many of the planks on the bridge are broken or missing. Fortunately, you have one flashlight that is absolutely needed to cross the bridge. Given that only two can cross at a time (and there are four of you) and given that the bridge can only be crossed using the one flashlight, each time two people make the crossing to the far side, someone has to return the flashlight back to the near side so the others can cross in safety. Through all of this you have to maintain your 17-minute lead. An added complication is that among the four of you there are different abilities in crossing the bridge: One person can cross in 1 minute; another takes 2 minutes; another takes 5 minutes; and another takes 10 minutes to cross. In what order should people cross the bridge, two at a time, with one person always having to return the flashlight to the near side to allow the others to cross while maintaining the 17-minute lead ahead of the bandits.
-Depending on the choices made in the order of crossing, the outcome may be: o Everybody gets killed o Everybody crosses and the 17-minute lead is preserved o Everybody crosses with all four achieving complete safety and no longer having to worry about the bandits at all. -The last choice (being completely free) equates to the movement from good to great—achieved by recognizing that the difference between good and great isn't very much and embodies an exponential benefit. The difference between the three alternative outcomes relies on planning and thinking things through ahead of time—as is the case with the long-term benefit of ethical behavior in comparison with the illusory short-term benefit that attaches to unethical or immoral behaviors.
Moral consent takes things a step further and asks "what were you actually thinking at the time?"
-Were you, internally, in agreement with the action? If you were in agreement, you fully consented to the act. If you were not in agreement, your consent may have not been full—in other words, there may have been a degree of mental reservation that might mitigate full culpability. This fine point is even recognized legally when distinctions are made between the degrees of murder (first degree, second degree, manslaughter, etc.) based on the internal state of mind of the person committing the act.
Beyond the law, intent is also a factor in establishing moral culpability, but doing so can be complex. In the case of the trolley problem, if you decided to divert the trolley to kill the one man rather than the five, did you intend to kill the man? There are at least two ways of looking at it. One is as an (imperfect) syllogism and the other is an example of the Doctrine of Double Effect (DDE):
1. A syllogism is a logical argument that takes the form: If A = B; and B = C; then A = C. By way of example: A: "Everyone in my class is smart." B: "John is in my class." Therefore: C: "John is smart." 2. Applied to the trolley problem, one could argue: A: "I intend to save the lives of five people." B: "To do so, I must kill an innocent man." Therefore: C: "I intend to kill an innocent man." This understanding is what underlies the "Fat Man" and the "Double Push" variations of the trolley problem just to make the case that you really were trying to kill the guy (to be discussed in class). Not everyone can accept this simplistic, syllogistic understanding of intent. ✱An alternative is known as "The Doctrine of Double Effect." This allows that an outcome that can be "foreseen" that is not necessarily "intended." ✱Thus, it may be clear ahead of time that the man will die, but this was never your intent. The intent is to save the five and the only way to do so is by killing one innocent man.
Perhaps more relevant to our own lives is the role of technology in the use of the internet, e-mail, and the media. If, based on the trolley problem, we really do use technology to buffer ourselves from the moral implications of our actions, is it possible that we are more likely to:
1. Behave online, especially hurting others, in ways that we would never do in person? 2. Give bad news (say, firing an employee) by an e-mail rather than face-to-face? 3. Find morally acceptable the behavior of a news photographer or journalist who records someone drowning or being attacked without putting down the camera and helping the person in distress because of a supposed "greater good" in disseminating important information to protect? 4. Even when physically present, does the camera—seen as a technical interface between the actual event and the observer of the event—allow the photographer to convince himself/herself that they are really just watching the event on the (camera's) screen and that they are not a conniver in wrongdoing, or even a provocateur through the mere presence of the recording device or the media? 5. When seeing someone in distress, are we more likely to group around the victim taking video pictures with our cell phones versus doing whatever we can to help the person?
On the other hand, Virtue Ethics offers more direct opportunities for cultivating habits that lead to consistently ethical behavior. What are these behaviors? (9)
1. Courage 2. Humility 3. Honesty 4. Perseverance 5. Hope 6. Charity 7. Balance 8. Wisdom 9. Justice These are actual dispositions of character that can be cultivated, practiced, and incorporated into one's life if one wishes to do so
However, in the "Fat Man" scenario, the vast majority (60%) would not push the man off the bridge to achieve the identical result of saving 5 people at the expense of what?
1. One explanation seems to be that we differentiate direct physical interaction (analogous to hand-to-hand combat) from the more antiseptic approach of pushing a lever, maybe while even looking the other way. So, we're willing to save 5 people at the expense of 1 provided we don't have to get our hands dirty with direct contact. A possible reason for this outcome is 200,000 years of human evolution and, most especially, the corresponding impact of human emotion which, in an instant, is aimed at self-protection and the avoidance of violence if at all possible. At an intuitive level, human beings have learned to avoid the risk of harm that direct contact (violence) entails. Violence means risk of personal harm. A fuller explanation of the emotions, both positive and negative, as it pertains to both decision-making and personal wellness are considered with emotional intelligence
-An insight that often arises in consideration of the trolley problem is the role of technology in distancing ourselves from the decisions we make. -Thus, in public surveys, it is not uncommon for a person who would push the lever to divert the trolley to kill the innocent man, and who would push a lever to open a trap door to cause the man to fall off of a bridge thus blocking the trolley tracks and again saving the lives of five people, would not be willing to physically push the man off the bridge to accomplish the identical outcome. This was the outcome when the class of 2022 was surveyed. -The reason this is such a common outcome has to do with the nature of human emotions and 200,000 years of human evolution in relation to direct interpersonal physical violence. This will be discussed in class as well as in the lecture on emotional intelligence, but key points are:
1. Technology can distance us from our decisions. 2. We might, for instance, differentiate drone strikes from hand-to-hand combat. 3. Collateral damage might be deemed acceptable to some provided the intent is good
There are no right or wrong choices in Trolly Problems, but the decisions made by each individual can be revealing with implications for our understanding of the moral dimensions of what?
1. Use of technology 2. Connivance—just standing by and allowing others to be harmed 3. Intention—what does it mean to "intend" a given outcome 4. The Doctrine of Double Effect 5. The moral status of torture
What are the flaws with the basic set up of the trolley problem?
1. We know with absolute certainty things that no one could possibly know in real life. In the cases presented, we know that the trolley will kill whoever it hits and we know that we can save more people by killing one innocent man. 2. The extremeness of the whole set up is intrinsically absurd—runaway trolley cars, saving one by hitting others, etc. What are the chances of that ever happening in real life? Zero. That was true until the introduction of autonomous vehicles (to be discussed).
In Jonathan Haidt 's paper "When morality opposes justice: Conservatives have moral intuitions that liberals may not recognize" he makes two interesting points, which are?
1. While all people in all places and at all times have accepted these foundations, a change has taken place over the last 50 years, with everybody accepting the first two (Care/Harm and Fairness/Justice) intuitions but not the last 3. 2. Haidt, who identifies as a political liberal, finds that people who are on the liberal side of the political spectrum fully accept the "Care/Harm" and "Fairness/Justice" concepts but are less likely to embrace the other three; whereas, political conservatives tend to accept all five. 3. Restated, "Care/Harm" and "Fairness/Justice" are each 50% of the political liberal's moral universe; whereas for political conservatives, these each count for 20% of their moral universe.
Suppose you come upon the following situation: There's an abandoned trolley out of control and you notice that if nothing is done it will continue on its track to kill five persons tied to it. You also notice that you are the only person that is involved in this situation. But you also notice that there is a lever that if you were to pull it, the trolley would be diverted to a side-track (a spur) where there is one (other) person tied to it. You know that if you do nothing, five will be killed by the trolley; you also know that if you pull the lever, you will save the five from being killed by diverting the trolley to the side-track, but also be doing something that will kill another person (who wouldn't have been killed otherwise) in doing so. What would you do
A large majority of people, across cultural groups, answer that they would pull the lever. This itself may be problematic, but what makes things genuinely problematic is when this case (let's call it Spur) is contrasted with another case: Everything is the same as in Spur except that instead of there being a side-track (spur), there is a bridge on top of the track (where the trolley is loose) and you are present on it with a man with sufficiently large girth who, if you were to push him off the bridge, would derail the trolley and thereby save the five people on the track from being killed. (If I haven't described things in a politically correct way, then imagine that the man has a massively large enough purse that can't be detached from him, but would work to derail the trolley.) And so the question is: Would you push the (fat) man off the bridge? A majority of people answer this question with a "no." At this point, we have a real philosophical problem. If in the original case, Spur, most say "yes, pull the lever" and if in this case, Fat Man, most say "No, do not push the man over," and if it looks like in both there is a killing of one to save five, then we get the question of "What's the morally significant difference between the two cases such that it is permissible to kill in one but not in the other?"
Further, logic and rational thought sometimes lead to actionable conclusions that are simply not testable directly by the scientific method.
An example is Jared Diamond's hypothesis expressed in his book, Guns, Germs, and Steel. In that book, Diamond poses the following questions: o Why was it Europeans who produced steel, built ocean-going ships, developed guns, and traveled to the Americas and conquered the indigenous peoples? o Why didn't it happen the other way around: Why didn't indigenous Americans invent steel, build ocean-going ships, develop guns, and travel to Europe and conquer the Europeans? o In other words, why didn't sophisticated technology develop anyplace else? Not in North America, Central America, South America, or Africa? An intuitive solution historically has been that somehow Europeans were intrinsically superior; however, Diamond offers an alternative explanation based on geography: o First, Europe should not be considered a continent. It is part of a massive and continuous landmass: Eurasia. o Eurasia is a horizontally-oriented continent stretching approximately 8,000 miles. In contrast, North America, South America, and Africa are all vertically oriented continents and far narrower in an east-west direction. In the case of the Americas, less than 100 miles at the narrowest. o This is important because technology spreads very rapidly horizontally but not vertically. What may take a hundred years to spread in an east-west dimension may take a thousand years to spread in a northsouth direction. o This is because Eurasia's 8,000 east-west miles are all at the same latitude, which means the same number of hours of light
What is the goal of all three approaches deontology, consequentialism, virtue ethics ?
The goal of all three approaches is the same: acting virtuously. All are valuable and we will refer to all three in this course.
Three different approaches to the teaching of ethics include:
Deontology, Consequentialism, and Virtue Ethics.
The trolley problem has occupied the thinking of some of the finest philosophers and thinkers of our time, including
Elizabeth Anscombe of Oxford and Cambridge, Philippa Foot of UCLA, and Thomas Nagel of NYU.
What is Ethics?
Ethics is not directly related to the state or to the law. Rather, ethics refers to certain behavioral standards of right and wrong that are well founded, prescriptive and purposeful.
The domains of law, ethics, and morality overlap but are not entirely congruent. And the degree of overlap has changed over time
For instance, the degree of overlap was much greater in 1950 than it is today. ❃A simple example proves the point: In 1950 stores closed on Sundays because that day was considered the Sabbath by most people at that time in the United States. ❃This was not only a moral dictum ("Keeping the Lord's day holy") it was also inscribed into law that stores had to close. ❃ These are known as Blue Laws and still exist in a few places today.
What is the formal and informal title of this course ?
Formal title:"Professionalism and Ethics in Health Care." Informal: "LEAP"
Both ways of reasoning are useful, but can lead to different kinds of understanding.
In class we will use Jan van Eyck's painting of the wedding portrait of Giovanni di Nicolao Arnolfini and Giovanna Cenami painted in 1434 in an original approach to differentiating analysis vs. synthesis (deductive vs. inductive reasoning). Studying the painting from the perspective of analysis vs. synthesis will lead, potentially, to very different interpretations of what the painting is trying to say—and both interpretations will be simultaneously true. The point will be to argue that analysis tells us how things work; synthesis tells us what things mean. Both systems of reasoning are needed, though both can go wrong when taken to an extreme. In the extreme of deductive analysis, nothing can be definitively shown to mean anything. Without meaning, all kinds of depravity can emerge. Correspondingly, inductive reasoning, taken to the extreme, can lead to accepting prejudice and bias as acceptable norms.
It is important to differentiate law, ethics, and morality from each other in order to what?
It is important to differentiate law, ethics, and morality from each other in order to understand the primary focus of this course: professional ethics.
How is Consent in life in general defined (as opposed to strict medical-legal circumstances)
It is the voluntary agreement by a person who possesses sufficient mental capacity to make an intelligent choice to allow something proposed by another to be performed on himself or herself."
What is the negative effects of " Lack of public trust in institutions—governmental, academic, professional, corporate, ecclesiastic, and philanthropic—and an accompanying decline in ethical norms " on Institutions?
It prevents social institutions from regulating themselves.
Why it i important to develop a personal "brand" as a dental practitioner? What should the brain project?
It should project competence and a high ethical standard—this goes beyond behavior in the dental office (or dental school) alone, inasmuch as others will draw conclusions about your practice and about you in both formal and informal settings and in the way you are depicted in social media.
What is the usual way to teach professional ethics ?
The deontologic approach. This assumes a common set of normative values that the individual is expected to follow. The assumption is that everybody already accepts these normative values and so the only goal is to inform people of what those values are. The obvious problem, in practice, is that everyone does not always accept the stated values. This is true for any set of normative values as embodied in codes of ethics, rule books, honor codes, or sets of commandments.
In contrast, the Ethics Handbook for Dentists of the American College of Dentists—which is not generally relied upon legally—speaks to a far more inspirational and moral understanding of dental practice.
The handbook can be found at: https://www.acd.org/ethics/publications/ethicshandbook/. The American College of Dentists does not interpret the relationship between the practitioner and the public in strictly contractual terms. Instead, it has a distinctly moral tone. The American College of Dentists begins its document on ethics with an appeal written by William J. Gies on July 11, 1937. Gies was a professor at Columbia University (also founder of two key organizations, the American Association of Dental Schools, now renamed the American Dental Education Association and the American Association for Dental Research). Though not a dentist, his understanding of the key elements of professional education in dentistry is still valid today and remains the framework for today's curricula in dental schools. The Appeal reads as follows: "Follow impulses and leaderships that represent ideals; that point the way to your professional destiny; that express integrity, fidelity, service, and lofty purposes—the finest that is in you individually and professionally! The American College of Dentists document then goes on to say: A professional respects patients for their unique needs and values. A professional places patients' interests first and foremost, with only rare, legitimate exceptions. A professional always considers patients' values and relevant personal preferences. A professional has integrity. A professional is honest. A professional is competent. A professional strives to improve personally and to effect improvement in the profession. A professional actively supports professional organizations. A professional is concerned about conduct and perceptions of conduct. A professional is ethical." [The underlined words are italicized are in the original.]"
"Why our ethics curricula don't work." abstract
The impact our ethics curricula have on students seems marginal at best. Students take the ethics courses we offer and pass the tests we give, but no one's behavior changes as a result. We fundamentally see ourselves teaching about ethics, which is slightly different than teaching ethics— and expecting behavior to change as a result of what is taught. The premise of this article is that our ethics courses are inadequate in content and form to the extent that they do not cultivate an introspective orientation to professional life. In some cases they amount to little more than a study of various state dental practice acts or the Code of Ethics of the American Dental Association. Three specific weaknesses are identified in a typical ethics curriculum: 1) failure to recognize that more education is not the answer to everything; 2) ethics is boring; and 3) course content is qualitatively inadequate because it does not foster an introspective basis for true behavioral change. A fourth element, an innovation, is directed to this third weakness and entails implementing a precurriculum very early in the dental educational experience to address the disconnect between knowledge and action.
An effort to produce such a simulation will be attempted in class with the three men on the mountain scenario (Figure).An effort to produce such a simulation will be attempted in class with the three men on the mountain scenario (Figure).
The simulation is intended to achieve the following lessons: 1. Experiencing the feeling of an insight—the percussive "Wow" factor. 2. Learning to listen to the silence—recognizing when you are not being told something important. 3. Recognizing that the person with the most information may not be the person with the most knowledge. 4. Understanding that knowledge may be more important than information and that it requires processing, assimilation, ownership, responsibility, and, most importantly, synthesis 5. Differentiating the objective from the subjective. Great emphasis is placed on the objective and the measurable in modern life; however, a deep experience of truly understanding something often comes from the domain of the subjective.
Laws come from -------- --------
The state
Is the state the same thing as the government. ?
The state is not exactly the same thing as the government. -The government may run the state for a period in the same way that a driver runs a car; but the driver is not the car. Governments can change without losing the authority and autonomy of the state—this is especially true with the peaceful transitions of governments. The British monarchy has achieved a high level of differentiation between the government (Parliament) and the embodiment of the state (the monarch, i.e., the Queen).
12. The outcome of the social revolution of the 1960s was: a. Uniformly positive b. Uniformly negative c. A mix of positive and negative d. None of the above
The third was the social revolution of the 1960s that caused a loss of faith in traditional mores, placing individual preferences, self-indulgence, and personal expression above social responsibility so, I think the answer is: b. Uniformly negative
28. According to Haden and Jenkins, which of the following is true? a. Balance is a pursuit, not a destination b. Balance is a destination, not a pursuit c. Balance is both a pursuit and a destination d. Balance is neither a pursuit nor a destination
a. Balance is a pursuit, not a destination
22. According to Haden and Jenkins, which of the following statements is true? (Choose all that apply). a) "Confidence lies in knowing that if you do the right things and always give your best effort, then you have an excellent chance of achieving the desired result." b) "Arrogance involves believing that you'll get what you want just because of how wonderful you are." c) "Arrogance lies in knowing that if you do the right things and always give your best effort, then you have an excellent chance of achieving the desired result." d) "Confidence involves believing that you'll get what you want just because of how wonderful you are."
a) "Confidence lies in knowing that if you do the right things and always give your best effort, then you have an excellent chance of achieving the desired result." b) "Arrogance involves believing that you'll get what you want just because of how wonderful you are."
16. According to Haden and Jenkins which of the following is true regarding "vision" as a leadership quality? (Choose the one best answer). a) Being innovative b) Being transformational c) Pushing the envelope taking an organization where it has never been before d) It is an outer manifestation of a deeper virtue
a) Being innovative b) Being transformational c) Pushing the envelope taking an organization where it has never been before d) It is an outer manifestation of a deeper virtue
11. A law that exempts from legal liability a person who attempts to give reasonable aid to another person who is injured, ill, or otherwise impaired is termed a: a) Good Samaritan law b) Friendly Neighbor law c) Friend in Need Act d) Title IX, also known as HIPAA
a) Good Samaritan law
1. Most malpractice claims are based on the accusation of negligence. Ordinary negligence is a civil offense that may involve a financial settlement; whereas, criminal negligence may involve incarceration (jail). They differ primarily on the basis of: a) Intent b) Intellect c) Freedom d) Ethnicity
a) Intent
5. The doctrine advanced by British philosopher Jeremy Bentham (1748-1832) aimed at providing the greatest good for the greatest number of people is known as: a) Utilitarianism b) The Categorical Imperative c) Existentialism d) Law of Comparative Advantage
a) Utilitarianism
6. How does Aristotle's concept of wisdom differ from that of Plato's according to the authors of The 9 Virtues of Exceptional Leaders: Unlocking your leadership potential? (Indicate all that apply, there may be more than one correct response) a. Aristotle's concept of wisdom advances "practical reasoning." b. Aristotle moves wisdom from being a mere attribute into a call for action. c. Wisdom is not about simply "doing" but "knowing." d. Wisdom is about making (and implementing) good decisions based on sound moral reasoning.
a,b, and d a-Aristotle's concept of wisdom advances "practical reasoning." b- Aristotle moves wisdom from being a mere attribute into a call for action. - Wisdom is about making (and implementing) good decisions based on sound moral reasoning. C is wrong. It should On the contrarily: Aristotle believed: Wisdom is not about simply "knowing." but "doing"
31. When the self-interest or greed of individuals becomes the norm, and is amplified at the societal level, it ends up contributing to an overall decline of ethical norms and... a. An increase in external regulation b. A decrease in external regulation c. An increase in internal regulation d. No change in regulation
a. An increase in external regulation
5. The Ancient Greek philosopher who wrote the Nicomachean Ethics was: a. Aristotle b. Socrates c. Euripides d. Sophocles
a. Aristotle
9. The right of the individual to make his or her own decisions refers to an ethical principle known as: a. Autonomy b. Beneficence c. Paternalism d. Nonmaleficence e. Justice
a. Autonomy
9. When ethical norms are strong, institutions: a. Can regulate themselves b. Require stronger regulation by the state c. Need a compensatory increase in laws d. Lose the confidence of the public
a. Can regulate themselves
5. By the term analysis, we are referring to... a. Deductive reasoning b. Inductive reasoning c. Hypothesis formation d. None of the above
a. Deductive reasoning
17. In class a paper was discussed by Gino, Norton and Ariely's entitled "The counterfeit self: the deceptive costs of faking it" published in Psychological Science 21(5) 712-720, 2010. In it, a psychological study was devised that examined the effect of wearing counterfeit or genuine ChloéTM sunglasses. What was the purpose of the study? a. Establishing whether wearing counterfeits influenced other aspects of behavior in a negative way b. Testing whether discerning women could differentiate authentic ChloéTM sunglasses from counterfeit ones c. Promoting the sale of authentic ChloéTM sunglasses and Gucci handbags d. All of the above
a. Establishing whether wearing counterfeits influenced other aspects of behavior in a negative way
3. What is the difference between ethics, values, and virtue? a. Ethics is a theory about what you should do, values arise from beliefs that you have, but virtue is something that you are b. Ethics is a theory about who you are, values arise from what you do, but virtue is something that you have c. Ethics is about what you are, values arise from beliefs you do, but virtue is something that you have d. Ethics is a theory about what you should have, values arise from the state, but virtue is something that you are
a. Ethics is a theory about what you should do, values arise from beliefs that you have, but virtue is something that you are
27. Jared Diamond advances the hypothesis in his book, Guns, Germs, and Steel that the sophisticated technologies of settled agriculture and domestication of animals occurred in Europe because: a. Europe is really part of a larger continent—Eurasia—that extends 8,000 miles in a horizontal orientation. Horizontally oriented continents have an advantage over vertically oriented continents (North America, South America, Africa) in terms of the development and spread of technology. b. Technology spreads very rapidly vertically but not horizontally. What may take a hundred years to spread in an north-south direction may take a thousand years to spread in an east-west direction. c. Eurasia's 8,000 north-south miles are all at the same latitude, which means the same number of hours of light and dark, roughly the same climate (apart from intervening geological features like mountain ranges), the capacity to grow the same crops and to raise the same animals across the entire north-south expanse of an enormous land mass. d. All of the above
a. Europe is really part of a larger continent—Eurasia—that extends 8,000 miles in a horizontal orientation. Horizontally oriented continents have an advantage over vertically oriented continents (North America, South America, Africa) in terms of the development and spread of technology.
13. Which of the following statements is true according to Haden and Jenkins? a. Humility is a source of strength, a reservoir of great power b. The reason most leaders do not listen empathetically to others is because of humility c. Power generally derives from being the loudest or most emphatic d. As our island of knowledge grows, the shores of our ignorance decrease
a. Humility is a source of strength, a reservoir of great power
4. A form of reasoning that moves from observations, to generalization, to formation of a hypothesis or theory is known as... a. Inductive reasoning b. Deductive reasoning c. Analysis d. Morality
a. Inductive reasoning
21. Courage refers to: a. Integrity in the moment of choice b. The desire to be in charge c. Stepping aside when the bullets are flying d. The desire to tell others what to do
a. Integrity in the moment of choice
2. How is law defined? a. Law is whatever the state says it is b. Law is determined by religious moral codes c. Law is established by professional organizations d. All of the above
a. Law is whatever the state says it is
23. If being generous is the opposite of being stingy, then generosity of spirit means that you are not stingy with (choose all that apply): a. Praise b. Encouragement c. Credit d. Narcissism
a. Praise b. Encouragement c. Credit
5. What did Plato mean by wisdom? a. Recognizing the greater good b. Self-restraint c. Promoting what is right even when afraid d. Courage
a. Recognizing the greater good
29. Which of the following sequences in the history of technological development is true according to Jared Diamond's hypothesis expressed in his book Guns, Germs, and Steel? a. Settled agriculture and domestication of animals permits surplus food that promotes increases in population, which lead to the development of cities, which allows for a division of labor, that leads to advanced technological development. b. Intrinsic biologic superiority among those people who developed technology explains why Europeans developed ocean going ships, guns, and steel. c. Surplus food in Eurasia benefited the population by preventing the development of deadly diseases. d. The hypothesis of technological development proposed byJared Diamond perfectly fulfills the requirements of the scientific method, including: asking a question, conducting background research, constructing a hypothesis, and conducting an experiment with both an experimental (test) group and a control group.
a. Settled agriculture and domestication of animals permits surplus food that promotes increases in population, which lead to the development of cities, which allows for a division of labor, that leads to advanced technological development.
7. In Profit with Honor: The new stage of market capitalism, Daniel Yankelovich establishes an ethical hierarchy. Which of the following constitutes the lowest and easiest level to achieve? a. Staying within the law b. Passing the smell test c. Higher ethical standards d. All of the above
a. Staying within the law
34. In Jim Collins's book Good to Great the author makes which of the following points: a. The difference between good and great embodies an exponential relationship, meaning that just a small amount of additional effort can transform being good at something to being great at it. b. The difference between being good and great is substantial and reflects a logarithmic relationship; that is, achieving greatness always demands far greater effort than that required to be good at something. c. All of the above d. Neither of the above
a. The difference between good and great embodies an exponential relationship, meaning that just a small amount of additional effort can transform being good at something to being great at it.
13. True or False: "Consent" and "assent" are two closely related ideas. Consent carries the idea of granting permission to someone else (often someone in a position of greater power or authority) whereas assent refers to internal agreement with the proposed course of action. a. True b. False
a. True
22. True or False: Prominent Cell Biologist Frederick Grinnell observes that scientific research is very neat, definitive, and without the influence of human judgment, opinion, or bias. a. True b. False
a. True
23. True or False: At the edge of knowledge, method and logic are insufficient. Intuition and creative insight become just as important. a. True b. False
a. True
24. Practicing charity is based not on feelings but on actions, it is developed through practice just like any other virtue. a. True b. False
a. True
24. True or False: While the scientific method may be the gold standard for investigating the natural world, it is extremely difficult to actually define what the scientific method is. a. True b.false
a. True
True or False: There are people who would not push the large man off the bridge physically, but who would be willing to push a lever opening a trap door depositing the man on the trolley tracks. a. True b. False
a. True
7. Which of the following statements is true? a. Virtue has to do with what a person is and with what he or she does b. Virtue is a list of rules for living c. Actions seldom shape character d. The virtuous person will act in a morally praiseworthy way because of knowing a lot about theories of ethics
a. Virtue has to do with what a person is and with what he or she does
3. The Columbia University professor who was the founder of the American Dental Education Association (ADEA) and the American Association for Dental Research (AADR) was: a. William Gies b. G. V. Black c. Willoughby Dayton Miller d. Pierre Fauchard
a. William Gies
What do people Intuitively recognize that law, ethics, and morality?
all frameworks for evaluating rightness and wrongness—but taken from different perspectives.
But we might be asked on a licensure examination questions about the traditional definitions of the usual key principles of professional ethics.
autonomy, beneficence, non-paternalism, nonmaleficence, and justice.
15. Leaders need to show faith in their followers... (Choose all that apply.) a) Only when they merit it b) Even when they do not merit it c) Only when reciprocated d) As a powerful motivating factor
b) Even when they do not merit it d) As a powerful motivating factor
8. True or False: People seldom follow the instructions of an authority figure, seeing their options as much greater than the few presented by the authority figure. a) True b) False
b) False
19. Which of the following statements is true for the knowledge a virtuous leader requires? (Choose all that apply). a. Knowledge by itself is sufficient for virtuous leadership b. Knowledge by itself is not sufficient for virtuous leadership c. Knowledge can exist without wisdom d. Wisdom can exist without knowledge
b. Knowledge by itself is not sufficient for virtuous leadership c. Knowledge can exist without wisdom
27. How do Haden and Jenkins define the virtue of "balance?" a. Devoting more time to one's family than to one's work b. Devoting more time to one's work than to one's family c. Being fully aware of the present d. A tensionless state
c. Being fully aware of the present
31. Using the following categories: (A) urgent and important, (B) urgent but not important, (C) not urgent, but important, (D) not urgent and not important, we should aim to spend most of our time in which category? a. A b. B c. C d. D
c. C (C) not urgent, but important
3. The most distinguishing feature of the state is that a. It is defined to be small, having only several hundred distinct occupations b. The law-making powers of the state are never delegated to smaller jurisdictions c. It has an absolute monopoly on legal violence d. The state exists only in democracies
c. It has an absolute monopoly on legal violence
8. In healthcare, the concept that the care-provider makes the decisions for the patients is known as: a. Autonomy b. Beneficence c. Paternalism d. Nonmaleficence e. Justice
c. Paternalism
10. In The Collapse of Complex Societies, Joseph Tainter defines the state as: a. A smaller province within a larger country b. City government c. That entity within society which has an absolute monopoly on legal violence d. The combination of all freely elected public officials in a democracy or representative government
c. That entity within society which has an absolute monopoly on legal violence
8. The virtuous leader is someone who has actively incorporated the virtues into his or her life. This leader's actions are determined by: a. Calculation of the ethics of a particular situation b. Virtuous habits of thought and behavior acquired during early childhood c. Virtuous habits of thought and behavior acquired over a lifetime d. Seldom following the example of someone else
c. Virtuous habits of thought and behavior acquired over a lifetime
6. In comparing the "Spur" vs. the "Fat Man" scenario, the vast majority would not push the man off the bridge to achieve the identical result of saving 5 people at the expense of 1. How is this explained? a) We differentiate direct physical interaction from the more antiseptic technological approach of pushing a lever b) A possible explanation for this outcome is 200,000 years of human evolution which favors self-protection while avoiding violence c) Human beings have learned to avoid the risk of harm that direct contact (violence) entails. d) All of the above
d) All of the above
7. In the "Double Push" scenario, 28% pushed the lever only once, thus pointlessly diverting the trolley but still killing the 5. Whereas, 72% went to the trouble of pushing the lever twice just to make sure that the trolley had enough speed to kill the man and save the 5. How can this outcome be explained? a) The person pushing the lever did intend to kill the man. The reason why they wanted to do so is a separate question—they wanted to save the 5; but to do so they had to kill one; therefore, they intended to kill him b) The person pushing the lever did not intend to kill the man; such an outcome is just a collateral consequence of achieving a greater good: saving 5 people rather than just 1 c) It is explained by the doctrine of "Double Effect" which says that undesired consequences may accompany a greater good d) All of the above
d) All of the above
9. The Trolley Problem offers the following interpretations: a) Strong inclination to Utilitarianism b) Strong opposition to personal physical involvement c) Technology seems to make things more "antiseptic," that is we're willing to execute harmful actions provided we have a technological interface separating ourselves from the direct action d) All of the above
d) All of the above
15. Which of the following are fundamental assertions of Natural Law philosophy? a. Human choice and action are directed toward intelligible purposes b. There exist basic human goods that are intrinsic aspects of human well-being and fulfillment c. That there are reasons for human actions whose intelligibility as reasons does not depend on more fundamental (sub-rational) motives d. All of the above
d. All of the above
8. Informed consent is based on which of the following ethical principles? a. Non-maleficence b. Beneficence c. Paternalism d. Autonomy
d. Autonomy
7. A moment of sudden revelation; a poignant, sudden, profound understanding of something is known as... a. ESP b. Preconception c. Foreseeing d. Epiphany
d. Epiphany
18. Which of the 9 virtues is considered the most elusive? a. Courage b. Justice c. Balance d. Humility
d. Humility
36. Seeing the inner nature of things refers to: a. ESP b. Preconception c. Foreseeing d. Insight
d. Insight
13. The ethical principle that requires caregivers to avoid causing patients harm is known as: a. Autonomy b. Beneficence c. Paternalism d. Nonmaleficence e. Justice
d. Nonmaleficence
25. At the center of the scientific method is the notion of testing a hypothesis with an experimental procedure—doing so usually involves an experimental (or test) group and a control group. The earliest reference to an experimental design that uses an experimental and a control group dates to: a. The Enlightenment of the 17th Century b. The Renaissance c. The Middle Ages d. The 2nd century BC
d. The 2nd century BC
2. When an individual engages in an argument but does not address the specific points being made but rather resorts to name-calling, this is known as a. The cum hoc ergo propter hoc fallacy b. The appeal to anonymous authority fallacy c. The appeal to authority fallacy d. The ad hominem fallacy
d. The ad hominem fallacy
28. Grain(s) native to Eurasia is (are): a. Wheat b. Rice c. Corn d. a and b above
d. a and b above
Implied consent
is "determined by some act of silence, which raises a presumption that consent has been authorized." ❇Implied consent generally relies on a given set of circumstances that would lead a reasonable person to conclude that consent has been granted despite not being direct, express, or explicit. o Implied consent is inevitably open to interpretation after the fact and thus is usually reserved for emergency situations in which an individual is simply unable to express consent. o "Good Samaritan laws" have come into existence precisely because of the difficulty of interpreting what implied consent really means.
"Informed" consent
is a legal concept referring to a patient's right to know the risks, benefits and alternatives to a medical intervention. As we will see subsequently, use of the term "informed" in reference to consent is actually redundant because, from a moral standpoint, consent is simply not possible without a person being informed ❂that is, having the knowledge requisite to making an informed decision. Nevertheless, the term "informed consent" is now such an intrinsic part of the medical-legal lexicon, we will continue using it in this course.
What is central to the consequentialist approach
is the making of an argument—that is, making a rational intellectual case in favor ethical behavior.
What is the importance of Rational emotional control?
it is central to ethical behavior without which it becomes hard to think straight.
Adequacy and validity of consent can be complex from a legal standpoint and we will not go into more detail on medical-legal consent. However, interested students can refer to: Pozgar, G. D. Legal and Ethical Issues for Health Professionals for more detailed discussions on matters such as:
o Statutory consent o Capacity to consent o Adequacy of consent o Spousal consent o Parental consent o Consent by minors o Incompetent patients o Guardianship o Refusal of treatment o Refusal based on religious beliefs
Dental practitioners cannot afford to think of their rights alone. They must also think about their -------------
obligations — specifically to society as a whole. In fact, rather than thinking about "Rights" and "Obligations" it might be better for professionals to think about "Privileges" and "Obligations" as a reminder that the authority to practice comes from the public.
Examples of intermediary institutions might include what?
the family, church and other religious institutions, schools and colleges, mutual aid societies, the media, the Boy Scouts, the Girl Scouts, the YMCA, the YWCA, the American Dental Association, the Metropolitan Museum of Art, the Metropolitan Opera, and the New York Academy of Medicine—even the dental office. ✲ The power and authority of such institutions may extend only to formal members of that organization (or to people willing to subject themselves to the rules of the organization voluntarily) but, in the aggregate, such organizations' world view of rightness and wrongness is recognized as contributing to the overall set of ethical norms understood as accepted by society as a whole unless formally rejected.
To say that some insights can be transformational is not an exaggeration.
⁎ In fact, business consultants use such insights as a way of promoting the efficient operation of a business, whether a major corporation or a dental practice, because they make you see things differently.
Daniel Yankelovich attributes a decline in ethical norms to three successive waves of mistrust permeating Western society over the last 90 years. What are these waves of mistrust?
✦ The first was the Great Depression of the 1930s which caused a temporary loss of faith in the economy (capitalism) ✦ The second was the Vietnam War and Watergate, which caused a temporary loss of faith in government (democratic, representative government) ✦ The third was the social revolution of the 1960s that caused a loss of faith in traditional mores, placing individual preferences, self-indulgence, and personal expression above social responsibility. -As each surge of mistrust crested and began to subside, another materialized, making not only itself felt but sparking recrudescence (recurrence) of antecedent (previous) waves, doing so not only additively but synergistically.
Leap refers to
✦Leadership, Ethics, Accountability, and Professionalism. All four topics are closely related.
In this class we will confine ourselves to Natural Law, unless there is a special interest among some students in metaphysical deliberation and/or making a case for Divine Revelation (I have lectures prepared in support of both approaches in addition to Natural Law).
✧ An entirely moral life can be based on Natural Law considerations alone; thus, if asked whether an atheist can live a moral life, the answer would be absolutely. ✧Natural Law arguments take nothing away from either Metaphysics or Divine Revelation and, in fact, the three moral systems do support and reinforce each other
When do we use the consequentialist approach ?
✬when making truth claims that together comprise an intellectual argument in favor of ethical behavior and whose intent is to persuade a person to make a positive change in behavior.
Whatever decisions you arrive at regarding the trolley problem, there are two different and respected ways of interpreting the problem. What are they?
✭ In most cases, people do tend to be willing to push the lever to divert the train away from five people and allow one person to be killed. This is an example of Utilitarianism, an approach associated with the 18th Century English economist, Jeremy Bentham. ✭In summary, this way of thinking aims to achieve the greatest good for the greatest number of people. Killing one to save five would be an example of utilitarianism. ✭An alternative view is embodied in the writings of the German philosopher, Immanuel Kant, particularly in the doctrine of the Categorical Imperative. This view makes no exceptions and is always aimed at what is right not necessarily at what is good.
Dentists often exhibit culpable ignorance in the case of the dental management of pregnant women.
✭ Practitioners can sometimes use technical jargon subliminally to distance themselves from patients. Consider the name of the book, Would You Kill the Fat Man? The author gave a lot of thought to the use of the word "fat." This could be interpreted as an insult or, at the very least, hurtful. Would it be better if we called the book, "Would You Kill the Obese Man?" Would it be better still if we medicalized the title by saying "Morbidly Obese" or even better, "the Man with the Body Mass Index (BMI) of 180" so no one would know what we were talking about?
The consequentialist approach to professional ethics is important but also has pitfalls. What is some of its pitfalls?
✮ A consequentialist holds the view that that the moral quality of a given act is based on the possible consequences it produces. ✮Allied with consequentialism is the proportionalist, that is, an act is good if its consequences bring about a relatively better outcome in a particular situation.
The profession is the sum total of what? Give an example.
✰The profession - good or bad—is the sum total of all the practitioners within it. ✰ Another example might be the way a mineral at the macroscopic level reflects the architecture of each individual crystal composing it at the microscopic level. This effect has been greatly intensified and individuated through the influence of social media. ✰ A single dental practice that comes to negative attention can attract a huge audience and can color the public's impression of the profession as a whole.
The problem in real life is that we don't know with absolute certainty any of the conditions that we do know in the trolley case; but it doesn't matter because?
✰we tend to make moral decisions based on what we believe not on what we know. ✰ There's no other choice because making decisions on what we do not believe to be true seems immoral and making no decision at all ("dithering" or "analysis paralysis") may also lead to great harm. In most decision-making there's usually never enough time or information. ✰ Thus, two nations go to war because one is believed to have and is expected to use weapons of mass destruction. The nation has a history of doing so and various intelligence sources indicate that it will do so again. After the war has been fought and lives have been lost, it is discovered that there were no weapons of mass destruction. Oops.
Collins's work was aimed at discovering the real difference between companies that enjoy enduring success during bad economic times as well as in good times—the corporate superstars that succeed in comparison to similar companies that are less successful. Collins asks, what's the difference between successful and the unsuccessful companies? Collins underscores the importance of a corporate vision that makes sense to everybody in the organization and that has a strong aspirational character.
✱ People care about more than just market share and share price. The same idea was expressed in the Ultimatum Bargaining Game in which it was shown that people care about self-interest, but they also care about fairness. ✱ Part of generating an inspirational vision has to do with understanding a few transformational insights. ✱ The transformational insights that have the most impact have nothing to do with a charismatic CEO, the specific nature of the business, splashy marketing campaigns, or the ups and downs of the economic cycle. Rather, success has a lot to do with capturing the imagination of the employees who are actually doing the work.
What is Natural Law?
✲ Natural Law involves self-evident truths that virtually every human person is likely to understand from direct personal experience in earliest childhood. ✲ According to Daniel Goleman in Emotional Intelligence, some of these personal experiences occur while the infant is still in the crib and unable to speak. Such experiences may be strongly felt, but never able to be put into words (even when an adult) if the experience was had during the child's pre-verbal stage of development. ✲Consider two very young children are playing in a sandbox—when it's time to leave, the first child wants a toy belonging to the other. When the first child's parent sees the minor dispute, the parent takes the toy and gives it to her own child promising to return it to the second child's (owner's) parent later. The second child now has a lifelong lesson in unfairness and injustice and will remember what unfairness is. ✲The American Declaration of Independence is based on Natural Law philosophy as embodied in the language of self-evident truths: "We hold these truths to be self-evident: that all men are created equal; that they are endowed by their Creator with certain unalienable rights; that among these are life, liberty, and the pursuit of happiness."
✮In fact, things are more complicated—the moral quality of an action depends on assessing what?
✲ The object, end, and circumstances of the act. ✲ Each must be good in order for the act as a whole to be good.
-A key element in assigning culpability (legally, morally, or ethically) is what a person intended by a given action.
✳ In law, intent is a critical factor in assigning blame and punishment. Thus, the killing of someone admits various degrees of intentionality—which is why there are different degrees of culpability ranging from negligence through involuntary manslaughter, voluntary m anslaughter (third degree murder), second degree murder, and first degree murder. ✳ When a dentist is accused of malpractice, what he or she is usually being accused of is negligence and, as a result, these cases are usually resolved through civil litigation as opposed to criminal proceedings and generally end up with a financial settlement as opposed to incarceration or capital punishment. ✳ Even in cases where a dental patient dies in a dental office as a result of dental treatment (such cases do occur periodically), the dentist is seldom accused of intending this outcome. That the dentist intended to help the patient mitigates against criminal punishment but does not excuse his/her negligence (civil punishment— usually a financial payment).
The "Double Push" scenario comes closer to the question of intentionality. If the lever is pushed only once, the trolley is diverted onto the loop but lacks the speed to kill the man. In that case, it glides harmlessly over him and circles back onto the loop to kill the 5 tied to the main line. Whereas, if the lever is pushed twice, the trolley is both diverted onto the spur and is given enough speed to definitely kill the man, but save the 5. Twenty-eight per cent pushed the lever only once, thus pointlessly diverting the trolley but still killing the 5. Whereas, 72% went to the trouble of pushing the lever twice just to make sure that the trolley had enough speed to kill the man and save the 5. Can we say that in this case those that pushed the lever twice had the intent of killing the man?
✳ There are at least three way of looking at this: (1) they did intend to kill the man. The reason why they wanted to kill the man is a separate question—they wanted to save the 5; but, to do so, they had to kill one; therefore, they intended to kill him. (2) They did not intend to kill the man; such an outcome is simply a collateral—but entirely foreseeable—consequence of achieving a greater good: saving 5 people rather than just 1. This explanation would fall under the doctrine of "Double Effect" which says that undesired consequences may accompany a greater good. Thus, by this argument, the intent was entirely the saving of 5 people. The loss of the 1 man was simply a necessary and unavoidable collateral outcome. (3) The third way of looking at this is to see that the set up for "Double Push" is completely different from "Spur" because in "Spur" there were only 2 possible options available (push the lever or don't push the lever, diverting the trolley or not); but, in "Double Push" there are actually three options: (a) push the lever once, (b) push the lever twice, or (c) don't push the lever at all (that is, don't vote in the in-class survey). While I can't prove this with absolute certainty, it doesn't appear that anyone opted not to vote because more people voted in "Double Push" (169) than in "Spur" (164). In other words, there was a hidden third option; but, people followed the instructions of the authority figure (me in this situation) and confined their options to those the authority figure presented.
An extreme example of the difference between the two world views would be What?
✳ the case of the acceptability of torture (or the threat of torture). If it was known that a nuclear weapon had been hidden within a major metropolitan area, and, if the person who had hidden the weapon was apprehended, would torture (or the threat of torture) be morally acceptable in order to extract the information concerning the location of the weapon from the man in order to save millions of people? ✳ The utilitarian perspective might say "yes" in order to achieve the greatest good for the greatest number of people. (If you thought it was okay to kill an innocent man to save just five, you've already disclosed your utilitarian mindset). On the other hand, the categorical imperative says that torture is always wrong no matter what. ✳ The categorical imperative seems to align more closely with some religious traditions' qualification for moral acts. Such qualification asserts that it is an error to "judge the morality of human acts by considering only the intention that inspires them or the circumstances (environment, social pressure, duress or emergency, etc.) which supply their context. There are acts which, in and of themselves, independently of circumstances and intentions, are always gravely illicit by reason of their object; such as blasphemy and perjury, murder and adultery. One may not do evil so that good may result from it." ✳ Immanuel Kant (categorical imperative) would probably agree. Jeremy Bentham (utilitarianism) would not (see figure above right).
Robert C. Solomon in his book, Ethics: A short introduction, makes the point that "The importance of choice in ethics is often confused with the notion that we choose our values or that values are merely subjective."
✴ "This assumption is misleading. Most of ethics involves decisions between already-established possibilities and already-established reasons." ✴ Thus, if a student is confronting a decision about whether to join the Navy or attend law school, the student does indeed have a decision to make; but, that decision is between already existing alternatives. ✴ To even have such a choice, "there must already be a military to join or a role for lawyers in society. ✴ One does not create the alternatives, one chooses among the alternatives. Once the choice is made, one is suddenly situated in a world of 'objective' values—the ironclad rules of the military, or the stringent rules of the legal profession." ✴ Therefore, the values we adopt are almost never our own—in the sense that they are not original with us. Instead we buy into the prefabricated values of the organization or society we wish to join.
Part of the goal of this course to help students be vigilant in recognizing the possibility of insights and transformational change when the opportunities arise.
✴Interestingly, you have to be in the mood to perceive an insight—and it might arise from something you've read many times before without impact; or from hearing something you've heard before without dramatic effect. ✴Insight is contextdriven and varies from time-to-time and place-toplace. What strikes you as an insight capable of changing your life might strike somebody else as nothing more than a cliché. ✴Insights cannot be delivered on demand, but they can sometimes be simulated.
In Why Smart People Can Be So Stupid, what does psychologist Robert J. Sternberg point out?
✵ High intelligence is no guarantee of wisdom or of ethical behavior. ✵ New studies have determined that the upper social classes are more likely to behave unethically than others and that unethical behavior is tied to attitudes toward greed.
What happens when ethical norms are strong?
✵ institutions can regulate themselves. ✵ Historically, the dental profession has enjoyed the trust of the public and, as a result, has been allowed to regulate itself to a large degree.
The contractual nature of the ADA Code of Ethics is understandable:
✵Not everybody subscribes to the same moral codes. Honest and sincere disagreements inevitably arise over what is moral or immoral, ethical or unethical. ✵ Moreover, while the ADA is not a governmental agency, it is relied upon by governmental agencies in establishing the parameters of dental practice. ✵Thus, the Commission on Dental Accreditation; the National Board of Dental Examiners; and other entities linked directly or indirectly to the ADA have great influence in determining both legislation and regulatory practices related to the practice of dentistry. ✵ Though the ADA is a private organization, state governments generally require that dental schools be accredited by the Commission on Dental Accreditation in order for the schools' graduates to be licensable in any jurisdiction, accepting the determination of this ADA-related Commission in lieu of states devising their own accreditation schemes. ✵The same relationship holds for the acceptance by the state of the results of licensing examinations even though the examining bodies are private entities.
What happens when when ethical norms erode?
✵societies resort to punitive regulation. ✵As ethical norms decline, a compensatory increase in regulation occurs to accomplish through legal means (that is, force) what individual people are not willing to do based on their own ethical commitments.
Explain what is the ethical hierarchy hypnosis by Daniel Yankelovich
✶ Daniel claims that the lowest and easiest to attain ethical standard is simply "staying within the law." ✶ He points out that staying within the law is not much of an accomplishment and does not qualify as achieving a high level of ethical behavior. ✶ To say "It's the LAW" or more pretentiously "It's the law of the land" is not saying much from an ethical perspective; but such statements are sometimes interpreted, erroneously, as the highest standard of ethical behavior. ✶ In fact, they represent the lowest standard. Above the baseline of what is legal, is what Yankelovich calls "Passing the smell test." ✶This refers to an intuitive sense that a given action may not be right ethically— such intuition is related to the concept of "Natural Law" ✶ Higher in the hierarchy of ethical behaviors, above the smell test, there is a break or a disjunction before attaining "Higher ethical standards" which are embodied in stewardship ethics. ✶ Stewardship ethics can include a credo (that is, a creed or a fundamental statement of belief or commitment), and Corporate Social Responsibility (CSR).
What Daniel Yankelovich work focuses on? What is the difference between laws and Norms, what are Norms?
✶Yankelovich's work focuses primarily on the corporate world and on attaining ethical standards that have sometimes, in the past, run counter to prevailing corporate philosophies. Nevertheless, his ideas of CSR apply equally well to dental practice. ✶ Yankelovich differentiates "laws" and "norms:" Norms are social values—unwritten rules that dictate what sorts of behavior are acceptable or unacceptable. A coherent set of norms constitutes an ethic: a generalized way of understanding one's relation to others. ✶Because the law is such a minimal standard, well-functioning societies require strong ethical norms; which is to say that some things "just aren't done" even if they are not formally written into the law.
"Why our ethics curricula don't work." The points made by Dr. Bertolami
✷ By way of explanation, what I am criticizing in this paper is the exclusive use of the deontologic approach to teaching ethics in professional practice when the diversity of students and backgrounds no longer assures that everyone buys into any one code of behavior. ✷ It becomes necessary to look into the underpinnings of the rules in greater depth than simply presenting a rule and saying that everyone has to follow it. ✷ Thus, this course uses an approach known as "Virtue Ethics" based on the premise that information about ethical principles is not enough; rather, the goal is cultivating certain habits through practice that incorporate specific behaviors as an integral part of one's life. ✷ It's not about what one knows; it's about who one is. Professional education is all about submitting to formation, not about absorbing information , though acquiring knowledge and skills is certainly an important outcome of such formation.
Why people may appeal to a moral argument?
✷ it is understood to be superior to (more persuasive than) either a strictly legal or a strictly ethical argument. The latter two are generally, if implicitly, derived from the former (moral argument) and morality, in turn, is derived from either a Natural Law argument, a metaphysical argument, or from divine revelation (or any combination of the three) ✷In this class, to the extent that we consider morality as a basis for ethics, we will rely only on Natural Law arguments which almost everyone can relate to.
What is a State as defined by Joseph Tainter in The Collapse of Complex Societies,
✷ that entity within society that has an absolute monopoly on legal violence. ✷ Hence, regulation by the state can be inherently heavy handed when a profession's own ethical standards decline. ✷ It is in a profession's own interest to prevent this from happening by being worthy of the public's continuing trust and confidence.
All three approaches approach the same objective—which is?
✷ virtuous behavior in professional life -doing so from three different but mutually reinforcing and inseparable angles.
What is the problem with appeal to morality?
✷The problem is that the appeal to morality can quickly degenerate to name-calling through ad hominem attacks. ✷The accusation of immorality can be immensely gratifying to the accuser, which is why 17th Century English economist Adam Smith is cited as saying, "Virtue is more to be feared than vice for its excesses are not subject to the regulation of conscience." ✷This may also be why some professional ethicists intentionally blend the concepts of ethics and morality in order to give their own opinions more weight.
Would You Kill the Fat Man. He was troubled over the word "fat" because it seems pejorative and could hurt the feelings of people who self-identify as overweight. Finally, he decided to use the word.
✸ In other words, would the title of the book have gained respectability if we replaced "Fat" with the more intellectualized, "Obese," or with the medicalized "Morbidly Obese," or with technical medical jargon "BMI 180?" ✸ In other words, we are sometimes willing to give up effective communication and comprehension by using technical terms even though others won't understand us. We do this because it allows us to preserve the illusion that we tried to communicate. The hope is that this will exonerate us from failing to communicate effectively. Physicians and dentists typically and habitually resort to technical jargon at the risk of the patient understanding what is really meant.
The 9 Virtues of Exceptional Leaders book by N. Karl Haden and Rob Jenkins asks"Can ethics be taught?"
✺ The answer offered by the authors is "Probably not." ✺ If this is true, then why are we all wasting our time talking about ethics? ✺ They offer the following explanation: Though ethics cannot be taught, it can be learned. ✺ What is required is a teacher, a role model, a coach, or a mentor who can point the way. This is much like learning to play a sport or a musical instrument. ✺You can receive pointers and guidance, but anything worth learning you ultimately have to teach yourself. ✺Doing so depends on your state of mind—that is to say a way of thinking that is open to guidance and coaching. ✺ One of the great benefits to openness in thinking is the opportunity for insight. Insight also underpins later discussion of moral intuition and the effort to reduce intuition to moral principle.
But, who is to say what is well founded, prescriptive and purposeful?
✽ Ordinarily intermediary organizations and institutions like professional societies having specialized expertise in particular areas make that determination. ✽ The individual person then voluntarily decides to join or follow the proscriptions of that organization/society or not. The state may accept the pronouncements of such intermediary institutions as a surrogate for itself, holding such determinations as binding.
Given that membership in the ADA is voluntary, why bother joining, paying a relatively high membership fee every year, and binding oneself to the code of ethics of this private, external, nongovernmental organization?
❀ Clearly, the benefits of being a member of the ADA far exceed the costs and potential restrictions on one's freedoms. ❀ In addition to certain financial and material benefits, ADA membership is one way of confirming to the public that you do, in fact, adhere to its code of ethics and are voluntarily binding yourself to a high standard of practice as part of your social contract with the public by which you commit yourself to ethical practice. ❀ In turn, the public (through the state) grants you the right to practice
Consider the virtue of courage: Author Kevin discusses The Wizard of Oz by L. Frank Baum: 1. "The tin woodman, the scarecrow, and the cowardly lion found their dreams—a heart, a brain, courage—in the very act of envisaging them as needs.
❁ The act of envisaging needs is the beginning of transformation. It is a project for a lifetime. ❁ Haden and Jenkins elaborate on this notion of cultivating courage by citing Steven Covey: "We need great courage to live our lives by correct principles and to have integrity in the moment of choice." ❁ They then go on to point out that "...acting as if you are...courageous...is not the same as actually being [courageous]; but if you continue to behave that way over time, what is the practical difference? If you consistently show courage...in what way are you not courageous?" ❁ Some would describe this as a "fake it 'til you make it!" philosophy. Is "faking" it okay? Is it honest? For me the term "fake" is filled with negative connotation; yet, anybody in professional school is trying, by definition, to move from lay person to professional person and many of the stages in that transformation may feel contrived and artificial (fake), until one becomes habituated to a new identity.
Both personally and professionally, the matter of the intent behind one's actions is crucial. Why?
❁It differentiates negligence (a civil offense which encompasses most malpractice claims, i.e., exoneration or a financial settlement) from criminal negligence (possible incarceration). ❁Correspondingly, the question of intent underlies differentiating manslaughter (3rd degree murder) from 2 nd degree murder, and 1 st degree murder. But even in everyday life, personal culpability for our actions is largely a matter of intent. ❁Hurting someone by accident (without intending to do so) is one thing, but hurting someone on purpose is altogether different.
Why was the inscription "Know Thyself" (γνῶθι σεαυτόν) inscribed at the Oracle of Delphi in ancient Greece?
❂ Because Knowledge of oneself is essential for personal growth. ❂ Simply recognizing a deficiency in oneself goes a long way to correcting it. ❂The peer assessment process we use at the school is another way in which we try to encourage introspection
Consent
❂ has distinctive legal, ethical, and moral dimensions. Up until now, we've emphasized that morality, legality, and ethics represent different domains and have features distinguishable from each other. ❂However, one area where there is significant overlap between the legal and the ethical is in "medical-legal ethics" as suggested by this term itself. As clinicians have found it necessary to practice, so-called, "defensive medicine," the overlap between ethics and law has become even greater in the minds of many practitioners.
What is Central to success in dental practice, regardless of the circumstances?
❂ is a maxim known as "The 3-A's:" Availability, Amiability, Ability. ❂ These qualities require both transactional and relational competence.
By definition, "consent changes an act of touching that otherwise would be nonconsensual to touching that is consensual." Absent consent, depending on the circumstances and the presence of actual harm, such touching may qualify as battery.
❃ Thus a dentist who administers a local anesthetic, performs an extraction, or restores a tooth, absent consent of the patient, may be liable to an accusation not only of malpractice (a civil offense), but also of battery (a criminal offense) if harm is sustained. ❃ For anything dental—particularly when dealing with the legal, ethical, and moral aspects of practice, it is common to turn first to the codes of ethics of the American Dental Association (ADA) or the American College of Dentists. ❃ Students should briefly scan the Principles of Ethics & Code of Professional Conduct of the American Dental Association
Why is this kind of "interior life" state-of-mind matter of any importance for dentists?
❃ it is significant because so much of the routine care a dentist provides to patients is entirely hidden, even to the patient. -Much of the dentist's work is not evident to the patient or to anybody else (except, possibly, to another dentist examining the same patient.) -In other words, the necessity and quality of a dentist's treatment while giving care is just not knowable by anybody else. Was the amalgam really condensed well and correctly? - Were the contacts adequate? Were the overhangs from posterior composite restorations removed if they existed? In the preparation of a tooth, was an interproximal surface of an adjacent tooth inadvertently damaged? Will such damage simply appear like new caries in a radiograph months later? Was a pulpal exposure truly unavoidable? In short, how the dentist thinks about these things when nobody else is watching—when nobody else can watch—becomes vitally important.
When ethical norms erode
❃ societies resort to compensatory punitive regulation. This up-regulation of law is done to compensate for declining ethical norms. ❃Unfortunately, no amount of legalistic regulation can ever completely compensate for each individual person opting to do the right thing.
.❃ The key is the need to move from the abstract to the concrete. This is accomplished how?
❃This is accomplished first by selfawareness—that is recognizing a lack in oneself that one wants to address and remedy, not because anybody else says so, but rather, as a matter of personal desire, motivated and energized by a conception of one's higher self. ❃ Once recognized, consciousness of this new reality invites an opportunity to practice the chosen virtue in real life as appropriate circumstances arise. Eventually, the virtue becomes a habit and incorporated into personality and character. ❃ When one has this internal mindset, previously missed opportunities for improvement abound, become recognized, and offer a basis for immediate action
When ethical norms are strong
❃institutions can regulate themselves. ❃ Think of this as the firm bedrock of law. Law is essential, but the layer of laws is relatively thin. ❃In contrast, in a healthy society there is a very thick layer of ethical norms—that is to say norms are just the way people go about doing things and treating each other in a civil society and are not based on written rules or threats of punishment. ❃The internal conscience of each individual is what ultimately dictates how things will be done.
The Appeal to anonymous authority fallacy
❅ "authorities" are cited but not named. ❅ This is easily recognized in news stories that begin, "Sources report..." Such anonymous authority undermines credibility.
The Appeal to authority fallacy
❅ even though an authority is cited, the authority is not credible. ❅ This is a common tactic in dental marketing (e.g., "Four out of five dentists recommend...")
The Cum hoc ergo propter hoc fallacy
❅because two events occurred at the same time, one is presumed to have caused the other when, in fact, the two events may be completely unrelated.
Ten trolley problem scenarios are aimed at understanding what?
❇ not only our sense of rightness and wrongness, but also at understanding the nature of intentionality as well as the inconsistencies in our own thinking and actions. ❇ In the past, in-class results for the various scenarios mirrored almost exactly the results for the public at large in the United States as well as in many other countries, suggesting that the sense of morality that underlies the interpretation of rightness and wrongness transcends countries and cultures. ❇ This is the basis of Natural Law as discussed on pages 52-54. The percentages shown in the figure correspond to the results for the Class of 2021. ❇These results are described below and will be explained in class.
Good Samaritan law examples:
❈ In New York, Pennsylvania, New Jersey, and Connecticut, "any person with CPR training acting in good faith and with reasonable care who voluntarily and without expectation of monetary compensation renders emergency treatment at the scene of an accident shall not be liable for damages, injuries, or death alleged to have occurred as a result of such emergency treatment. The immunity does not apply to gross, willful, or wanton negligence" nor does it necessarily apply to paid rescuers who are usually held accountable for their mistakes since they are expected to do their jobs correctly. ❈ In some states "medical personnel, such as doctors, nurses, and medical responders, are also protected as long as they follow normal procedures and are providing free emergency medical assistance outside their normal employment or practice."
Example of "Experimental Philosophy." ❈ Scenario 1: "The vice president of a corporation rushes into the CEO and says 'I have an idea that will make us oodles of money. The problem is that it will harm the environment." The CEO responds 'I don't care at all about that, all I care about is making as much money as possible. Go ahead with the idea.' They proceed with the project, they do make a lot of money and the environment is harmed." Here's the question: Should the CEO be blamed for harming the environment? ❈ Now consider Scenario 2: Scenario 2: "The vice president of a corporation rushes into the CEO and says 'I have an idea that will make us oodles of money. It will also benefit the environment." The CEO responds 'I don't care at all about that, all I care about is making as much money as possible. Go ahead with the idea.' They proceed with the project, they do make a lot of money and the environment is improved." Should the CEO be credited for helping the environment? ❈ Whatever your answers, can you explain them?
❈ When these scenarios are given to the members of the general public, people in general are willing to blame the CEO for a bad outcome but not credit him for a good outcome. What was his intention and does the intention influence credit or blame? ❈ When this question was posed the Dentistry class of 2022, it agreed with the general public in some cases but not all. The results are revealing in terms of how future dentists think about the problem. This will be discussed in class.
What results when self-interest or greed of individuals becomes the norm—especially when amplified at the level of intermediary institutions
❈ it ends up contributing to the overall decline of ethical norms in society as a whole and causes an inevitable increase in external regulation by the state. ❈ This is especially dangerous when the state itself becomes corrupt. ❈ Dependency on the state and the eventual transformation of the elite into the state are nothing new. ❈They are both features of empires in decline. ex: The ottoman Empire collapse.
What is a Good Samaritan law ?
❉ A Good Samaritan law is a law that "exempts from legal liability a person who attempts to give reasonable aid to another person who is injured, ill, or otherwise impaired." ❉ Thus, if someone administering CPR to a victim on the street in a state of cardiac arrest saves the victim's life but, in the process, fractures 2 ribs, would the person administering CPR be liable legally for injuring the victim? ❉ At a time of increasing litigation, "Good Samaritan" laws have been passed in some states to formalize the value and importance of intention.
What is MORALITY?
❉ Morality may be the most difficult and controversial term to define and. ❉ yet, it is the appeal to morality that law and ethics make to justify the legitimacy of law and ethics. ❉ Morality is seen as the highest and final authority. ❉Morality may be based on ancient moral codes that often, but not necessarily, having a religious character. ❉ Ultimately, morality can be understood by reference to the foundations upon which it is based.
Why we are learning about fallacies?
❉ Understanding arguments requires some understanding of fallacies, so I would like to introduce the notion of fallacious reasoning—a useful way of recognizing that an argument as false. ❉ The ability to recognize fallacies when you encounter them can be extremely useful in deciding whether a given argument is valid and persuasive.
What is Rationalization ?
❊ the process of justifying and exculpating ourselves in order to achieve what we want at the expense of what is right ("right" being defined according to Natural Law Philosophy and Virtue Ethics) ❉ While rationalization often serves to soothe our own consciences or to justify a wrongful act, sometimes good intent despite a bad outcome really does justify a given action. An example of a situation where intent overrides outcome applies to so-called "Good Samaritan" laws.