Ethical theories

Deontologism

"Is the purpose of healthcare : to prevent death....or to alleviate suffering? To prevent death: then providers would be correct to keep this person alive To relieve suffering, then practioners who use "heroic measures" keeping the patient alive may be providing cruelty to the patient and/or to the family. >>Would be better to alleviate suffering and medically induce death so as the patient doesn't suffer during or after the procedure.

Case study

A patient with a long standing smoking history is hospitalized with advanced COPD and lung cancer with bone metastasis.

Ethical theories

CONSEQUENTIALISM Most common being Utilitarianism DEONTOLOGISM Kantianism NATURAL LAW VIRTUE ETHICS

Consequentialism

Consequentialism refers to those moral theories which hold that the consequences of a particular action form the basis for any valid moral judgment about that action. From the standpoint of a consequentialist, a morally right action is one that produces a good outcome, or consequence.

Comparisons of consequentialism and denotlogy

Consequentialism: The consequences of an action form morality. John Stuart Mill Examples: Contraception The good would be determined by the end- pleasure-> good choice a child-->> bad choice Denotology The act itself determines the right or wrong. Immanuel Kant Example: Contraception Violation of another's respect-> bad choice In marriage-> good choice

Denotology

Deontological ethics is an approach to ethics that determines goodness or rightness from examining acts, (not the consequences of those acts). Deontologists look at rules and duties. The act might be considered as good, but the results might be considered as bad. Powerfully expressed in the work of Immanuel Kant. >>Often called Kantian Deontologism

Another example: lying and morality

How is lying approached as a moral dilemma? The consequentialist-> lying is wrong because it produces negative consequences. - But, may be ok if the consequences are acceptable. The deontologist- lying is always wrong regardless of any potential good. The Virtue ethicist-> what will the lie say about one's character, not on any particular instance. Natural Law would rely on the common law in place, based on individual worth, moral duty, and universal brotherhood.

Consequentialism

If trying to do heroic measures and treatment to preserve the patients life and the end results: Is death anyway - then that action is bad. If the patient lives another day, week or month = then that action is good.

Natural Law

Natural Law is a theory that posits the existence of a law whose content is set by nature and therefore has validity everywhere. The universe is governed by reason, rational principle; humans will know and obey its law. Humans exercise 'free will', therefore they may not necessarily obey the law, if they act in accordance with reason, they will be "following nature". Natural law is identified with the law of God and the ethics of action.

Utilitarian ethical analysis of contraception

Prevention of pregnancy after sexual intercourse Utilitarian will look at contraception from the perspective of the concerns of the individual or society. Individual may want the pleasures of sexual activity without any commitments to raising a child. Pleasure is understood as an appropriate end, and thus contraception, as a means of preventing conception, is good to be chosen. Society may view or perceive pregnancy or population growth as a burden. On the other hand. The individual desires a child, or society wants to encourage population growth, contraception would be a bad choice. Contraception itself is neither good nor bad; rather, it acquires its value because of the larger end that is pursued.

Autonomy and informed consent

The respect for the dignity of individuals involves allowing them to make their own choices and to develop their own life plans. To provide the patient with autonomy: informed consent, the following conditions must be met: 1. The patient (or surrogate) must be competent or have decision-making capacity. 2. The patient must be free of coercion to make a voluntary decision for his/her care. 3. The patient must be informed by the provider, of his/her condition.

Utilitarianism

Utilitarianism - is one form of and is the most common form of consequentialism - emphasizing the consequences of one's action, looks at the standard of right vs. wrong as being governed by pleasure vs. pain. Happiness on this account is defined as the maximization of pleasure and the minimization of pain. John Stuart Mill: brought about 'the greatest amount of good for the greatest number'. Utilitarianism is also distinguished by impartiality and agent-neutrality. Everyone's happiness counts the same. No one is more important than anybody else.

Comparisons of virtue ethics and natural law ethics

Virtue ethics: Emphasis is on the character of the moral agent. Plato & Aristotle Example: Contraception Neither good nor bad Consider the attitudes of the individuals and society Natural law ethics: The existence of a law is determined by the law of nature. Thomas Aquinas Example: Contraception Natural order - is species reproduction-> good The pleasure w/o the reproduction-> bad choice

Virtue Ethics

Virtue theory is an approach to ethics which emphasizes the character of the moral agent as the key element of ethical thinking- not the rules, not the consequences. What does a particular action say about one's character and moral behavior? The emphasis in virtue ethics is on being rather than doing. Morality stems from the identity and character of the individual, rather than being a reflection of the actions (or consequences) of the individual.

Purpose of healthcare

We asked the question, "Is the purpose of healthcare : to prevent death....or to alleviate suffering? If it is to prevent death, then providers would be correct to keep people alive in a vegetative state. If it is to relieve suffering, then physicians who use "heroic measures" may be providing cruelty to the patient or the family. the prevention of disease and the maintenance of the health of the whole population."

Virtue ethics

What does a particular action say about one's character and moral behavior Morality stems from the identity and character of the individual >>Identity and character: a person who is in and out of jail, a known felon and suspected of murder - he is toast >>Identity and character: a person who is married, supports his family, hard worker and always looks out for others - save him at all cost

Natural law

Would rely on the common law in place, based on individual worth, moral duty, and universal brotherhood. >>Taking it one step further = if the law stated that no one will be kept alive that will not reenter society and not be a burden and will continue the groups beliefs? >>>Individual worth - homeless person seen as worthless or what if he was the founder of Apple Inc.