Ethical theories

2011 Marek Vácha Ethical theories

HedonismWhat should I do to live a succesfullife?(hedoné = pleasure, bliss) • ultimate goal of all our actions is pleasure • among human values pleasure is the highest and pain the lowest • actions which increase the sum of pleasure areright, and what increases pain is wrong. • optimization of calculus of pleasure and displeasure Aristippus of Cyrene (435 – 355?)

An action is good when it maximises the amount of pleasure, leading to the minimum amount of pain.

Utilitarianism • Jeremy Bentham (1748 – 1832) • John Stuart Mill (1806 – 1873)

Utilitarianism • Combination of four principles • principle of consequences • principle of hedonism • principle of tolerance • social principle

Utilitarianism • A utilitarian believes in ‘the greatest happiness for the greatest number.’ • The more people who benefit from a particular action, the greater its good.

Utilitarianism „Nature has placed mankind under the governance of two sovereign masters, pain and pleasure.“ (Jeremy Bentham) (1748 – 1832)

JeremyBentham • „The blackness of the skin is no reason why human being should be abandoned without redress to the caprice of a tormentor. It may come to be recognized, that the number of the legs, the villosity of the skin, or the termination of the os sacrum are reasons equally insufficient for abandoning a sensitive being to the same fate.“ • (Bentham, J., (1948) An Introduction to the Principles of Morals and Legislation, Laurence J.LaFleur, ed. New York, 311)

JeremyBentham • The question is not • Can they reason? nor • Can they talk? but • Can they suffer? • (Bentham, J., (1948) An Introduction to the Principles of Morals and Legislation, LaurenceJ.LaFleur, ed. New York, 311) • The cruelty to people, whosenervoussystem is the most refined, is worse than cruelty to lowerforms of life, but this is a quantitativedifference only. • The time will come, when humanity will extend its mantle over every thing which breathes.“

Utilitarianism • it is theconsequences of human actions that count • The principle of utilitydefines the meaning of moral obligation by reference to thegreatesthappiness of the greatestnumberof people • Utilitarianism is a Consequentialisttheory of ethics. Consequentialist theories judge the rightness (or wrongness) of an action, by what occurs as a result of doing something.

Utilitarianism • " . . . actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure, and the absence of pain; by unhappiness, pain, and the privation of pleasure.„ (John Stuart Mill) (1806-1873)

Utilitarianism • principle of consequences • „The end justifies the means“ • principle of hedonism • greatest happiness of the greatest number of people

What is happiness? • when highlymotivated research scientist work to the point of exhaustion in search of new knowledge, they do not appear to be seeking a professionalhappiness • J.S.Mill: such persons are motivated by success, recognition, or money ( which all promisehappiness) • Recentutilitarianphilosophers: there are also diverse set of values other than happiness: knowledge, health, understanding, deeppersonalrelationshipetc.

Critique of Utilitarianism

Critique of Utilitarianism • the question is, whether human actions are to be judged right or wrong solely according to their consequences.

Critique of Utilitarianism • If a surgeon, for example, could save two innocent lives by killing a prisoner on death row to retrieve his heart and liver for transplantation, this outcome would have the highest net utility (in the circumstances), but the surgeon´s action would be morally indefensible. • (Beauchamp, T.L., Childress, J.F., (2009) Principles of Biomedical Ethics. 6th ed. Oxford University Press, New York, Oxford, p. 150)

Case Report • A five-year-old girl has a progressiverenal failure and is not responding well on chronicrenaldialysis. The medicalstaff is considering a renaltransplant, but its effectiveness is „questionable“ in her case. Nevertheless, a clearpossibilityexists that the transplanted kidney will not be affected by the disease process. The parentconcur with the plan to try a transplant, but an additionalobstacleemerges. The tissuetypingindicates that it would be difficult to find a match for the girl. The staffexcludes her two siblings, ages two and four, as too young to provide a kidney. The mother is not histocompatible, but the father is compatible and has „anatomicallyfavorablecirculation for transplantation.“

Case Report • Meeting alone with the father, the nephrologistgives him the results and indicates that the prognosis for his daughter is „quiteuncertain“. After reflection, the father decides that he will not donate a kidney to his daughter. His severalreasonsincludes the fear of the surgery, the uncertainprognosis for his daughter even with a transplant, the slightprospect of a cadaver kidney etc. The father then requests that the physician „tell everyoneelse in the family that he is not histocompatible“. He is afraid that if familymembers know the truth, they will accuse him of failing to save his daughter when he could have. He meintains that truth-telling would have effect of „wrecking the family.“ • The physician is uncomfortable with the request, but after furtherdiscussion he agrees to tell the man´s wife that the father should not donate a kidney „for medicalreasons“.

UtilitarianApproach • probableconsequences • the potentialeffectiveness is questionable and the prognosisuncertain • there is a slightpossibility that a cadaver kidney could be obtained • the girl probably die without a transplant, but the transplantoffers a small chance for survival • the risk of death to the father from anesthesia is 1: 10 000 or 1: 15 000 • nevertheless, because the chance of success is likelygreater than the probability that the father will be harmed, many utilitarians would hold that the father is obligated to undertake what others would consider a heroicact that surpasseobligation.

The Problem of Truthtelling • „Even under the guise of benevolentdeception, the idea of not telling the truth to patients is rather suspect. The suggestion is that the individual is not strongenough to tolerate the truth, or more time is needed to prepare the patient for an unpleasantfact. Unfortunately, this lack of truthtellingleads to a slipperyslope, for while it givescomfort to the one individual, it teaches all othersinvolved – for examplefamilymembers, friends, housekeepingstaff, and hospitalvolunteers – that health care practitionerslie to their patients. When these others become sickthemselves, they remember the previousdeception and feel they cannot rely on the word of the professionals.“ • (Edge, R.S., Groves, J.R., (2007) Ethics of Health Care. 3rd ed. Thomson Delmar Learning, NY, p.62)

Immanuel Kant(1724 – 1804)"Act only according to that maxim whereby you can at the same time will that it should become a universal law." • Deontological ethics • Categorical Imperative • maxim • Critique of Pure Reason

Immanuel Kant(1724 – 1804) • Kant's moral theory is deontological: actions are morally right in virtue of their motives, which must derive more from duty than from inclination. • The clearest examples of morally right action are precisely those in which an individual agent's determination to act in accordance with duty overcomes her evident self-interest and obvious desire to do otherwise.

Immanuel Kant(1724 – 1804) • Of course, human agents also have subjective impulses—desires and inclinations that may contradict the dictates of reason. • So we experience the claim of reason as an obligation, a command that we act in a particular way, or an imperative.

Immanuel Kant(1724 – 1804) • Kant held that morality is derived from rationality, not from experience, and that obligation is grounded not in the nature of man or in the circumstances of the world but in pure reason • These universaltruthapplied to all people, for all times, in all situations • Human minds works the same way, regardless of who you are, where you are, or when you are. • categorical imperative • categorical = without anyexception

Immanuel Kant(1724 – 1804) • categorical imperative • universal application (i.e., binding on every individual) • unconditionality • demanding an action • we must always treat others as ends and not as means only

Immanuel Kant(1724 – 1804) • Categorical Imperative: • Act only according to that maxim whereby you can at the same time will that it should become a universal law. • we must be willing for the rules we set for ourseleves to become a „law of nature“ • we must be willing to have such rules apply universally

Immanuel Kant(1724 – 1804) • The essence of immorality, is to make an exception of myself by acting on maxims that I cannot willfully universalize. • It is always wrong to act in one way while wishing that everyone else would act otherwise. (The perfect world for a thief would be one in which everyone else always respected private property.)

Immanuel Kant(1724 – 1804) • "formula of the end in itself" as: "Act in such a way that you treat humanity, whether in your own person or in the person of another, always at the same time as an end and never simply as a means."

Criticism of Kant • The exceptionlesscharacter of Kant´s moral philosophymakes it too rigid for real life. Real-life situations are so varied that it is impossible to createrules that can guide us in all circumstances • it is often the spirit of law, rather than the letter, that provides the arena for rationaldecisions • even thoughanimalsfeel pain and pleasure, they have not any independent moral standing since they are not rationalbeings.

utilitarianism • the end justifies the means • hodnota jednání závisí výlučně na následcích jednání • deontology • an act in itself would be either right or wrong; it could not be both • hodnota jednání závisí výlučně na způsobu jednání

Not long ago the media told of a family who could not find an acceptable bone marrow transplant donor for their daughter, who suffered from a rare form of cancer. In order to gain acceptabel bone marow, they decided to have an additional child, hoping that the child would provide the match. Kantian theorists would find this action unacceptable, inasmuch as the baby was being used as a means rather than as an end of its own.

Patients with sensorydisorders • The Universal Declaration of Human Rights • Article 7 • All are equal before the law and are entitled without any discrimination to equal protection of the law. All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.

Common Morality • is a product of human experience and history and is a universaly shared product • is found in all cultures • is not realtive to cultures and individuals, because it transcends both • (Beauchamp, T.L., Childress, J.F., (2009) Principles of Biomedical Ethics. 6th ed. Oxford University Press, New York, Oxford, p. 4)

VirtueEthics • Aristotle: • not „What ought I do?“ • but What should I be?“ • An American medical Association code in effect from 1957 to 1980 urged the physician to be • „pure in character and … diligent and conscientious in caring for the sick.“

Virtue Ethics • aretaic ethics (arete = excellence; virtue) • it is not only important to do right thing but equally to have right disposition, motivation, and traits for being good and doing right. • personalcharacter and moral habit are more important than a particularaction • without the foundation of individualcharacter to motivateaction, the action-basedsystemsseemed more mentalgymnastics than basis for morality

Virtue Ethics • Aristotle: „The moral virtues, then, are produced in us neither by nature nor against nature. Nature, indeed prepares in us the ground for their reception, but their complete formation is the product of habit.“

Virtue Ethics • people become morally virtuous similar to the way in which people acquire other excellences and skills, such as driving car or playing golf, tha is, through practice • good drivers are not born, but instead daevelop the skills and instincts necessary to act intuitively while on the road • an honest person tells the truth automatically • a generous person is inclined to share things with others

Virtue Ethics • the virtue of courage has two opposites - cowardice and foolhardiness • it is possible to have too much fear or too little

Virtue Ethics • virtue = mean between two extremes • not every passion has a mean: there is no mean of murder

Virtue Ethics • An American medical Association code in effect from 1957 to 1980 urged the physician to be • „pure in character and … diligent and conscientious in caring for the sick.“

Critique of the Virtue Ethics • virtue ethics provides little, if any, guidance for actions • even kind, honorable, compassionate beings often do not know the right thing to do

Aristotle virtue ethics Kant deontology Bentham, Mill utilitarianism man behavior consequences

Many Thanks Marek Vácha

Ethical theories