Ethics and Morals
strong paternalism
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Schwatz-THREE TYPES of limitations
1.patients may not require they be treated by nonmedical means eg. herbal remedies 2. patients may not request futile treatments 3. patients may not require they be treated in ways inconsisten with ends/purpose of medicine
Socrate's Question (DCT)
Are actions morally right because God commands them, or does God command them because they are morally right?
Mill (Utilitarianism)
Believes there are lower and higher pleasures Higher pleasures-emotions, intellect, love, spiritual Lower pleasures-food, lust, physical satisfaction -need training for higher values
Betham thinks (utilitarianism)
Bentham thinks that happiness is one-dimensional. It is pleasure, pure and simple, something that varies only in the amount that an agent can experience. Hedionism-right actions produce the greatest amount of PLEASURE for the greatest amount of sentient beings. Ex. Drop the bomb in Hiroshima, suffering going to happen either way which involves the most amount of people.
example of hedon vs. mill
Building a fast food restraunt or a museum for auburn Hedon: measure pain and pleasure Mill: depends on what kind of pleasure
Natural Law Theory
Comes from the Virtue Theory-the view that right actions are those that conform to moral standards discerned in nature through human reason (God put it in our nature)
Kant's CHALLENGE to Utilitarianism
Consequences alone do not determine the morality of an action. YOU GET TO USE/HARM SOMEONE
Example of cool helments, Delberation and Consistent view
Consistent view-believes its cool, safe enough, looks like itd be rational Good deliberation-not logical, experts says its safer because of statistics so thus it is not rational
Diminished autonomy
Dax when he was in shock
Dworkin's challenge to Mill
Dworkin is a utilitarianist, but doesnt believe in whatever maximizes the good of society, more about the own person's choice
True or False Dworkin takes Mills strategy on Paternalism
FALSE
CHALLENGE to the CHALLENGE of God is arbitrary
God would never command something evil because God is all good.
Virtue Theory
Have a nature, and from your nature, we can determine how to make you better/worse. Ex. courage is a virture, try to find mean between cowardice and recklessness.
Dworkin-how does he get from parental paternalism to RW model?
He likes the kind of model or reasoning that parents use-there are dangers that await if that were to happen, if you were fully autonomist you would agree.
Inductive Reasoning
If my evidence is true then it is very likely that my argument is true. Law enforcement in the city is a complete failure. Incidents of serious crime have doubled
CHALLENGE to DVT-God is all-good
It would be meaningless and the traditional religious idea of the goodness of God would become an empty notion. The moral term "good" would be "commanded by God" which tells us nothing about the goodness of God. It would translate "God's commands are God's commands"
Ethical Relativism
Moral standards are not objective but are relative to what individuals or cultures believe. There simply are no objective moral truths, only relative ones. In this way, moral norms are not discovered but made; the individual or culture makes right and wrong
Kant's system
Morality is best captured by looking at RESPECT for RATIONAL/PRUDENT beings. What makes an act right is that it follows the categorical imperative form.treat someone(sentient beings) as the ends(intrinsic value) rather than the means(treat its worth is extrinsic). Its humanity/rational beings. RESPECT-that's like a test for all the other rules. Ex cheating on a test-it will get me a good grade, the categorical imperative is like a test..are you about to treat someone like a mere means.Always act of those rules that can be universal(could everyone follow it?) -against lying, treating people as a mere means. -hates utilitarians
Moral life's 4 key factors
Normative dominance, universality, impartiality, and reasonableness
Weak Paternalism
Not fully autonomist (five year old)
Dworkin's example of Paternalism
Odyssey-please limit my liberties (because of the Siren). kind of model for actual consent. Rational people would consent.
Principle of autonomy restriction
Paternalism
Strong Paternalism
Patient ex. law wearing your seatbelt
Ackerman's CHALLENGE TO Peligrino
Peligrino-non interference model-whatever the patient says, the doctor gets the patient back to an autonomist position (remove physical and cognitive contraints from patient) and then respect for autonomy is just letting the patient make the decision
CHALLENGE TO Virtue Theory
Problem with finding a nature (same with natural law)
According to Aristotle, how are humans different in nature from animals
Rational-Theoritically (moral rules) and Practically(acts, love)
Dworkin's model
Real Will Model
Divine Command Theory
Right actions are those commanded by God, and wrong actions are those forbidden by God. God is the author of the moral law, making right and wrong by his will.
One challenge that Dworkin's model would allow to visit
Ultra-hazardous activities-things that are part of who I am, or identify then that case RW model will not restrict it
intrinsic
a value in it of itself (love, knowledge, emotions)
Universality
apply is all relevantly similar situations. If it is wrong to tell a lie in a particular circumstance then it is wrong for everyone is that particular circumstance to tell a lie.
nonmaleficence
above all, do no harm. Is the bedrock precept of countless codes of professional conduct, instituational regulations
Impure Paternalism
advertize Joe Camel, should we prevent marketers to show it because minors loved it too much. Limiting the marketers for the benefit of minors.
What should have the health care providers asked in Wanglie's case
argued that medical practice simply did not include providing a ventilator...under circumstances of this case and that no surrogate decision maker..should be able to choose this option
FOUR moral PRINCIPLES
autonomy, benefiecence, utility, and justice
Rule-Utilitarianism
avoids judging rightness by specific acts and focuses instead on the rules governing categories of acts. It says a right action is one that conforms to a rule that, if followed consistently, would create for everyone involved the most beneficial balance of good over bad.
Morality
concerns beliefs regarding morally right and wrong actions and morally good and bad persons or character.
weak paternalism
ex. seriously depressed people are restrained from killing themselves
Legal Norms
enforced by the state to protect or promote the public good. Prevent chaos, do not always correlate with moral norms
Impartiality
the idea that everyone should be considered equal, that everyone's interests should count the same.
moral theory
explains not why one event causes another but why an action is right or wrong or why a person is good or bad. Tells us what it is about about an action that makes it right
Pure Paternalism
go straight after the group, they are the ones that are going to be benefitted
PERSONS are morally
good or bad
extrinsic
has value because of something else (money, objects, college)
CHALLENGE to DVT that God is arbitrary
if actions are morally right just because God commands them to be so, then it is possible that any actions whatsoever could be morally right. God could will murder if he wanted to and it would be morally right.
Deductive Reasoning
if my evidence is true then you have to accept my argument. Its wrong to take the life of an innocent person Abortion takes the life of an innocent person Therefore, abortion is wrong.
moral argument
is an argument whose conclusion is a moral statement, an assertion that an action is right or wrong or that a person or motive is good or bad.
empirical claim
is one that can be confirmed by sense experience-that is by observation or scientific investigation
Consistenly Rational Choice
measured by consistency with persons actual beliefs ex. cult-kill themselves because they say so
Deliberatily Rational Choice
measured by good deliberation (by person or borrowed from experts)
Normative Dominance
moral norms are presumed to dominate other kinds of norms, to take precedence over them. (overridingness-because moral considerations so often seem to override other factors. Ex. stealing without getting caught is overrided by a moral prohibition against stealing
How do moral theories fit into our everyday moral reasoning?
moral theories can figure directly in our moral arguements. 2. theories can have an indirect impact on moral arguments because principles appealed to are often supported in turn by a moral theory.
Consequentialists
moral theories insist that the rightness of actions depends solely on their consequences or results. (Utilitarianism)
If moral standards are not grounded in the divine will, logically independent of religion, then
morality is a legitimate concern for the religious and nonreligious alike, and everyone has equal access to moral reflection and the moral life.
only ACTIONS are morally
morally right or wrong
Ackerman's view of Paternalism
more to it involves more than non interference returning control to the patient-MD removing physical, cognitive, psycological, and social contraints.
Paternalism
overridiing of an autonomist being for THAT PERSON'S own good
Paternalism
overriding of a person's actions or decision-making for her own good.
Physical, cognitive, psychological, and social contraints
physical-stablize cognitive-fully inform him psychological-worry about fear, anxiety, depression, social-society puts pressure on you (this is who i am)
prima facie
principle applies in all cases unless an exception is warranted
Autonomy
refers to a person's rational capacity for self-governance or self-determination-to ability to direct one's own life and choose for oneself
Rawl's Contractarianism
refers to moral theories based on the idea of a social contract or agreement, among individuals for mutual advantage. What principles should a just society structure itself to ensure a fair distribution of rights, duties, and advantages of social cooperation?-Answer: Required principles-essentially principles of justice-are those that people would agree to under hyporthetical conditions that ensure fair and unbiased choices
Justice
refers to people getting what is fair or what is their due
Ackerman's argument to Peligrino
serious contraints are intrinsic-then noninterference is not the best.
One exception to Mill's view on Paternalism
slavery
Ethics
study of morality using the tools and methods of philosophy.
Premises
supporting statements.
Subjective Relativism
that right actions are those sanctioned by a PERSON. Morality is essentially a matter of personal taste, which is an extremely easy thing to establish. "That may be your truth, but its not my truth"-has a way of stopping conversations and putting an end to reasoned arguments. CHALLENGE- person may be content with the moral issue of gambling however a genocide in africa-is wrong period.. Doctrine implies that each person is morally infalliable. No one is mistaken. Ex. Hussein approved of slaughtering thousands, by the light of subjective relativism he is correct in his view. Also implies the illusion of moral disagreement. -NO disagreement, just what you believe is right or wrong.
Descriptive Ethics
the actual beliefs, lab work
Moral Absolutism
the belief that objective moral principles allow no exceptions or must be applied the same way in all cases and cultures
Moral Objectivism
the idea that at least some moral standards are objective.
Act-Utilitarianism
the idea that the rightness of actions depends solely on the relative good produced by individual actions. An act is right if in a particular situation it produces a greater balance of good over bad than any alternative acts.
Conclusion
the supported statement
Cultural Relativism
the view that right actions are those sanctioned by ONES CULTURE.CHALLENGES: moral infallibility- cultures make moral rightness, so they cannot be mistaken about it. 2. We cannot legitimately criticize other cultures, because they approve of their actions-so therefore it is right. 3. No such thing as moral progress-can never change because what was right in the beginning has to be right the whole time. 4. Social reformers(Martin Luther, Susan B Anthony) could never be morally right. 5. People belong to multiple social groups-hard to follow jsut one.
Utilitarianism
the view that right actions are those that result in the most beneficial balance of good over bad consequences for everyone involved. What makes an act right is that it produces the greatest happiness/good/value for greatest number of sentient beings.
Real-Will Model
there are actions that rational beings would agree to have others prevent them from doing (or make them do) and those are places where we are justified in being paternalistic.
Reasonableness
to engage in the essential, unavoidable practices or the moral life-is to do moral reasoning. Use both logic and commonsense. Cant just have no reason for believing in physician-suicide
Nonmoral norms
value judgements about art, norms or etiquette, grammar, legal norms
Beneficence
we should do good to others and avoid doing harm to others
Utility
we should produce the most favorable balance of good over bad (or benefit over harm) for all concerned. We should do what yields the best overall outcome-the maximum good and minimum evil
Schwarts- are there limits to the demands that "respect for patient autonomy" places on a physician
yes, it is not disrespecting the patient's autonomy to refuse a choice if it not among the "resonable medical alternatives"
Categorical Imperative
you ought to do this whether you want to or not. Use as a test, should it be a universal law