Day_6_101316_PHI+015+Presentation

Day_6_101316_PHI+015+Presentation - Dr Rulli PHI 015...

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October 13, 2016 Dr. Rulli PHI 015: Introduction to Bioethics 1
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Today’s Agenda Methods in Bioethics Previously: Principlism Today: Casuistry: the case-based approach Start: Human Subjects Research (through Oct 18 and 20 th ) Important ethical documents Reminder: Essay 1 due October 20th 2
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Recap Slide—What We’ve Done So Far 3 Looked at historical influences in development of bioethics Discussed the major ethical theories in philosophy Utilitarianism (a kind of consequentialism) Deontology (of which Kantianism is a kind) Explored the first major, practical framework for applying ethical theory to bioethics—Principlism Respect for Autonomy Beneficence Nonmaleficence Justice Focused on the importance of informed consent to treatment/research
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Methods and Approaches 4 1. Principlism 2. Casuistry
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Case-Based Approach: Casuistry Principlism is a top-down approach Casuistry is bottom-up Start from real, concrete cases From there we can derive norms Much like Common Law tradition 5
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Case-Based Approach: Casuistry Method: 1. Describe a case in rich detail and categorize the case E.g. “termination of life case” 2. Fit it into a taxonomy of other cases: “a structured reservoir of responses to similar cases that contains various paradigm cases of conduct judged to be manifestly right or wrong” When we have moral certainty, it comes from cases, not in the abstract 3. Locate the present case on the spectrum, from unacceptable to acceptable conduct 4. Draw a conclusion 6
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Casuistry vs. Principlism Is casuistry an alternative to principlism? Much disagreement about their relationship Several bioethicists think that the two approaches compliment each other We still need ethical theory and principles in cases But casuistry helps us determine how to balance principles in cases of conflict 7
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Advantages of Casuistry Fits well with practical reasoning and medicine: doctors are familiar with case- based reasoning No need for deep theory Well-suited for consensus in a pluralistic society; the aim is to reach overlapping consensus Deciding cases at case-level doesn’t threaten people’s deeply held higher level principles 8
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Criticisms of Casuistry It is insufficiently critical; it starts with the judgments we already have and analogizes from them But what if those judgments were wrong to begin with? In this way, it is a fundamentally “conservative” approach 9
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John Arras’s Assessment Still a very valuable tool, a method, a heuristic for decision-making Can be supplemented with appeal to higher ethical theory How aspirational or conservative it is depends on who is using it and what their values are 10
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Application: Case Study Imagine you are a psychiatrist. Your patient is a Supreme Court Judge, Justice Gibson.
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