BIO ETHICSlecture oneppt

BIO ETHICSlecture oneppt - BIO ETHICS BIO ETHICS BIOETHICS...

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Unformatted text preview: BIO ETHICS BIO ETHICS BIOETHICS BIOETHICS Why are you here? What do you expect to learn? What we are gonna do What we are gonna do here….. Everyone has a perspective. I am not going to tell you how to think You may not agree but you have to allow that person to have that perspective You will be asked to discuss and occasionally advocate perspectives with which you do not agree….. My job is to put problems before you Discuss the pros and cons Delineate the problems Not necessarily find a solution but help you find a way to think and evaluate these problems I have to teach some science to explain some of the problems associated with the situations we will discuss. If you are not fully educated with all the data, then the decisions and lessons that you may draw from each problem will be, by definition, flawed. (Dr Crawley’s Axiom) Some of the questions we Some of the questions we have…… DNA End of Life Informed Consent Hierarchy of Basic Needs and Goods and Rights to those Needs or Goods Logic vs Compassion Few vs Many Spock vs Capt Kirk You will write a lot You will write a lot Essays that I will post on the schedule about the topics we are discussing in class. You write your essays and submit them to me by email. DO NOT BORROW OTHER PEOPLES STUFF!!! No copying of other stuff will be tolerated …..if you do, Ill start making you write it down on PAPER!!! First thoughts First thoughts Where do you get your values? Are there any rules for values? What do you base your values on? Are values relative or absolute? Dogma Dogma Everyone has some What is yours? Where did you get it? Is it still valid based on your life experience or have you changed it and why? What are the theories or Dogma about ethics? First Essay First Essay Write an essay about something that occurred in or around your life that profoundly affected your moral/ ethical beliefs. It should be around 2 pages typed double spaced. You can submit it by email or hand it to me in class. Any Questions discussion Any Questions discussion etc??? stuff…. If not….we are gonna move on to Problem solving Problem solving Define the Problem Define the Problem Make sure the problem is understood by all concerned. Is it poor communication, failure to appreciate cultural differences,genuine differences in religious or values and principles Is there more than one problem Sometimes just clarifying the problem is all that needs to be addressed Solving a Moral Problem Solving a Moral Problem Collect as much data as you can BEFORE thinkng about a solution. Accurate. Comprehensive. Witnesses to an auto accident see things differently…frame the conflict accurately Solving a Moral Problem Solving a Moral Problem Identify the important values and principles For all parties involved Identify Religious and other tightly held beliefs Identify all BELIEF systems that are at play Solving a Moral Problem Solving a Moral Problem Reflect on personal perspective and intentions Discern Motives and possible outcomes and intentions by others to obtain these outcomes…ie incentives Individual character of parties involved…. Solving a Moral Problem Solving a Moral Problem Prioritize conflicting values Decide what is most important first NOT making a decision is sometimes making a decision that also has consequences Plan for dissecting these Plan for dissecting these issues. We need to Examine both sides of the issue. Consider the opinions of experts on the issue because they are intimately involved in the decisions made Read and write down your thoughts and decisions Plan for dissecting these Plan for dissecting these issues II If you do not fully understand your opponents viewpoint you cannot understand yours Analyzing sources of information and biases Plan for dissecting these issues Plan for dissecting these issues III Pitfalls we all need to avoid in these discussions and exercises…………. 1 Regarding your opinion as common sense and the most rational viewpoint and any other viewpoint could not possibly be entertained by anybody with any sense!!! 2 Closing your mind to what the other person is saying….you gotta listen!!! Plan for dissecting these issues Plan for dissecting these issues IV 3 Don’t make it personal. Leave that at CRITICAL THINKING ISSUES the door!!! 1 Evaluate sources of information for truth 2 Separate FACT from OPINION 3 Identify Stereotypes (oversimplified, exaggerated descriptions based on race or religion or national group as an example) Plan for dissecting these Plan for dissecting these issues V 4 Recognize Ethnocentrism the feeling that your race or religion or subgroup is inherently superior OR JUDGING ANOTHER GROUP IN TERMS OF YOUR VALUES!! Basic Moral Basic Moral Orientations Overview 02/05/11 (c) Lawrence M. Hinman 2002 23 On what basis do we make moral decisions? On what basis do we make moral decisions? “Do what the Bible tells you”­­Divine Command Theories “Follow your conscience”­­The Ethics of Conscience “Watch out for #1”­­Ethical Egoism “Do the right thing”­­The Ethics of Duty “Don't dis' me”­­The Ethics of Respect “...all Men are created ...with certain unalienable Rights”­­The Ethics of Rights “Make the world a better place”­­Utilitarianism “Daddy, that’s not fair”­­The Ethics of Justice “Be a good person”­­Virtue Ethics 02/05/11 (c) Lawrence M. Hinman 2002 24 "Do what the Bible tells you” "Do what the Bible tells you” Divine Command Theories Being good is equivalent to doing whatever the Bible­­or the Qur’an or some other sacred text or source of revelation­­tells you to do. “What is right” equals “What God tells me to do.” 25 02/05/11 (c) Lawrence M. Hinman 2002 “Follow your conscience” The Ethics of Our Inner Voice Conscience tells us what is right or wrong Often has a religious source May be founded in a notion of human nature Is often negative in character, telling us what is not right 02/05/11 (c) Lawrence M. Hinman 2002 26 "Watch out for #1” "Watch out for #1” Ethical Egoism Says the only person to look out for is yourself Ayn Rand, The Ethics of Selfishness Well known for her novel, especially Atlas Shrugged 02/05/11 (c) Lawrence M. Hinman 2002 27 "Do the right thing" "Do the right thing" The Ethics of Duty Begins with the conviction that ethics is about doing what is right, about doing your duty. Duty may be determined by: ◦ Reason ◦ Professional role ◦ Social role Kant: Do what any rational agent should do A physician’s duty to care for the sick A parent’s duty to care for his or her children 02/05/11 (c) Lawrence M. Hinman 2002 28 "Don't dis' me" "Don't dis' me" The Ethics of Respect Human interactions should be governed by rules of respect What counts as respect can vary from one culture to another ◦ Examples: spitting in the sand showing the soles of one’s shoes­­Richardson What is it that merits respect? 02/05/11 (c) Lawrence M. Hinman 2002 29 “...all Men are created ...with certain unalienable Rights” The Ethics of Rights The most influential moral notion of the past two centuries Established minimal conditions of human decency 02/05/11 (c) Lawrence M. Hinman 2002 30 “Make the world a better place” Utilitarianism Seeks to reduce suffering and increase pleasure or happiness Demands a high degree of self­sacrifice—we must consider the consequencs for everyone. Utilitarians claim the purpose of morality is to make the world a better place. 02/05/11 (c) Lawrence M. Hinman 2002 31 “Daddy, that’s not fair” The Ethics of Justice Begins early in the family with fairness to all family members What is fair for one should be fair for all. Treating people equally may not mean treating them the same. 02/05/11 (c) Lawrence M. Hinman 2002 32 "Be a good person” "Be a good person” Virtue Ethics Seeks to develop individual character Assumes good persons will make good decisions Developed by Plato and Aristotle Integral to the Jesuit tradition ◦ The Spiritual Exercises Provides a way of integrating all the theories 02/05/11 (c) Lawrence M. Hinman 2002 33 First Essay First Essay Write an essay about something that occurred in or around your life that profoundly affected your moral/ ethical beliefs. It should be around 2 pages typed double spaced. You can submit it by email or hand it to me in class. Dictionary: bi∙o∙eth∙ics (bī'ō­ Dictionary: ĕth'ĭks) The study of the ethical and moral implications of new biological discoveries and biomedical advances, as in the fields of genetic engineering and drug research. The branch of ethics that investigates problems specifically arising from medical and biological practice. These include problems of the nature and distribution of treatment; the sphere of authority of the patient, the physician, and others; the scope and limits of confidentiality; the limits of acceptable intervention and experimentation and the propriety of genetic research and its applications. Early codes of conduct Early codes of conduct Hippocrates 4th century BC Limited abilities to change course of disease Easy to uphold a oath that really doesn’t describe really difficult situations Beginning of the problem Beginning of the problem 1950s newer medical technologies Costs were going up How should the medical profession act toward others in this complex environment Who should pay for it…..follow the money!!!!!! What are our pathways we can pursue Ethics Ethics Ethics (also known as moral philosophy) is a branch of philosophy which seeks to address questions about morality; that is, about concepts like good and bad, right and wrong, justice, virtue, etc. Ethics vs Morals Ethics vs Morals "[Ethics is] is the philosophical study of morality. The word is also commonly used interchangeably with 'morality' to mean the subject matter of this study; and sometimes it is used more narrowly to mean the moral principles of a particular tradition, group, or individual. Christian ethics and Albert Schweitzer's ethics are examples." Ethics vs Morality Ethics vs Morality Morality is defined as society’s standards of conduct and of the character traits that denote “good and Bad” Scientific approach ­descriptive ethics Philosophical approach­ ­reasoning behind (metaethics) ­what they ought to be (normative ethics) Ethics vs Morals Ethics vs Morals Ethics (also known as moral philosophy) is a branch of philosophy which seeks to address questions about morality; that is, about concepts such as good and bad, the noble and the ignoble, right and wrong, justice, and virtue. Major branches of ethics include: meta­ethics, about the theoretical meaning and reference of moral propositions and how their truth­values (if any) may be determined; normative ethics, about the practical means of determining a moral course of action; applied ethics, about how moral outcomes can be achieved in specific situations; moral psychology, about how moral capacity or moral agency develops and what its nature is; and descriptive ethics, about what moral values people actually abide by. A great example……. A great example……. When considering the difference between ethics and morals, it may be helpful to consider a criminal defense lawyer. Though the lawyer’s personal moral code likely finds murder immoral and reprehensible, ethics demand the accused client be defended as vigorously as possible, even when the lawyer knows the party is guilty and that a freed defendant would potentially lead to more crime. Legal ethics must override personal morals for the greater good of upholding a justice system in which the accused are given a fair trial and the prosecution must prove guilt beyond a reasonable doubt. Metaethics­Normative Ethics Metaethics­Normative Ethics M­Meanings of moral terms and logic N­kinds of actions and principles that will promote moral behavior Normative ethics Normative ethics Some acts and character traits are more MORAL than others (even IMMORAL) There are standards by which all is judged….ie there is no ethic relativity True, certain cultures behave differently however…….. THERE ARE CERTAIN MORAL JUDGEMENTS THAT ARE UNIVERSAL Moral relativism Moral relativism Feels good….is good Emotion has a big component in decisions We must have some standards Ethical Relativism, Ethical Relativism, Absolutism, and Pluralism 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 46 Ethical Relativism Ethical Relativism Ethical relativism has several important insights: The need for tolerance and understanding The fact of moral diversity We should not pass judgment on practices in other cultures when we don’t understand them Sometimes reasonable people may differ on what’s morally acceptable 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 47 Two Types of Relativism Two Types of Relativism Descriptive ethical relativism Normative ethical relativism ◦ Claims as a matter of fact that different cultures have different moral values ◦ Claims that each culture is right unto itself 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 48 What part of morality is relative? •Behavior •Peripheral values •Fundamental values Three Questions about the Meaning of Three Questions about the Meaning of Relativism Morality is relative. Relative to what? •Individuals •Cultures •Nations •Groups ©Lawrence M. Hinman http://ethics.acusd.edu/values/ How much of morality is relative? •All •Most •Some 02/05/11 49 Relative to what? Relative to what? Descriptive ethical relativists say that moral values are relative, but to what: ◦ Culture ◦ Nation ◦ Group ◦ Individual—subjectivism How do we individuate cultures? 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 50 What is relative? What is relative? Behavior Peripheral values Core values ◦ Different behaviors may exemplify the same value ◦ The same behavior may exemplify different values in different culture ◦ Obviously some culturally­specific values ◦ Are there central values found in all cultures? 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 51 Ethical Relativism: Limitations Ethical Relativism: Limitations Presupposes an epistemological solipsism Solipsism is an epistemological or ontological position that knowledge of anything outside one's own specific mind is unjustified. Is unhelpful in dealing with overlaps of cultures­­precisely where we need help. ◦ Commerce and trade ◦ Media ◦ World Wide Web Is self­defensive: if we can’t judge others, neither can they judge us 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 52 Ethical Relativism: Ethical Relativism: Solipsism Sometimes we say that we can’t judge other cultures because we can’t fully understand them. Do we need full understanding to judge something? Do we even have full understanding of ourselves? Would this eliminate anthropology as a discipline? Does it deny a main goal of multiculturalism? 53 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ Ethical Relativism: Ethical Relativism: Overlapping Cultures, 1 Ethical relativism suggests that we let each culture live as it sees fit This is only feasible when cultures don’t have to interact with one another. 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 54 The challenge of the Ethical Relativism: Ethical Relativism: Overlapping Cultures, 2 coming century is precisely overlapping cultures: ◦ Multinational corporations ◦ International media­­BBC, MTV, CNN ◦ International sports­­ Olympics ◦ World Wide Web 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 55 Ethical Relativism: Ethical Relativism: Overlapping Cultures, 3 The actual situation in today’s world is much closer to the diagram at the right. 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 56 Ethical Relativism: Ethical Relativism: A Self­Defensive Position Ethical relativism maintains that we cannot make moral judgments about other cultures The corollary of this is that we are protected in principle against the judgments made by other cultures Shares this characteristic with absolutism 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 57 Ethical Absolutism Ethical Absolutism Absolutism comes in many versions­­including the divine right of kings Absolutism is less about what we believe and more about how we believe it Common elements: ◦ There is a single Truth ◦ Their position embodies that truth 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 58 Ethical Absolutism Ethical Absolutism Ethical absolutism gets some things right But it gets some things wrong, ◦ We need to make judgments (at least sometimes) ◦ Certain things are intolerable including: ◦ Our truth is the truth ◦ We can’t learn from others 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 59 Ethical Pluralism Ethical Pluralism Combines insights of both relativism and absolutism: ◦ The central challenge: how to live together with differing and conflicting values ◦ Fallibilism: recognizes that we might be mistaken ◦ Sees disagreement as a possible strength: checks and balances government analogy 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 60 Ethical Pluralism, 2 Ethical Pluralism, 2 Ethical pluralism offers three categories to describe actions: Prohibited: those actions which are not seen as permissible at all Tolerated: those actions and values in which ◦ Absolutism sees the importance of this legitimate differences are possible would be like Ideal: a moral vision of what the ideal society ◦ Relativism sees the importance of this 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 61 Ethical Pluralism, 3 Ethical Pluralism, 3 For each action or policy, we can place it in one of three regions: ◦ Ideal­­Center ◦ Permitted­­Middle Respected Tolerated ◦ Prohibited­­Outside 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 62 Five Questions Five Questions What is the present state? What is the ideal state? What is the minimally acceptable state? How do we get from the present to the minimally acceptable state? How do we get from the minimum to the ideal state? ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 02/05/11 63 Developing a Moral Stance Developing a Moral Stance Here’s a way of visualizing these issues: Flash Animation 02/05/11 ©Lawrence M. Hinman http://ethics.acusd.edu/values/ 64 BIOETHICS defined.. BIOETHICS defined.. A branch of normative ethics applied to medicine or science. “applied or professional” ethics Belief is that: some solutions to dilemmas are more MORAL than others and that conclusion can be obtained by moral reasoning and reflection……. Ethics has been Ethics has been described…… a society with a common set of ethical underpinnings, rules of behavior that do not depend on religious training or perspective, a framework that will not dissipate in the face of changing belief systems. What are our sources of right What are our sources of right and wrong? If we DON’T rely on cultural norms and customs……. Religion is replete with rules and regs OUTSIDE of religion we find­­­ ­Teleological theories ­Deontological theories ­Natural Law theories ­“Virtue” Teleological Theories Teleological Theories The end (outcome) of the action determines the rightness or wrongness of the action. Utilitarianism­greatest good for the greatest number Hedonism­ pain bad, pleasure good Mill­ pleasure translates to “happiness” (life liberty and the pursuit of ….) Utilitarianism Utilitarianism End justifies the means (not so good) Case by case risk benefit ratio clinical decision making pathway Utilitarian Decision is performed from a perspective of LOVE then it is ok (Fletcher,1950s) Deontological Theory Deontological Theory Duty Rightness based on whether it conforms to a rule or duty and not what the outcome is (KANT) Performance of actions to conform to law is its own reward because we can and should Categorical Imperative ­ actions should be so good such that they could become law Kant Kant Moral rule must: ­ serve as a guide for everyones conduct ­ permits people to treat each other as ends in themselves not as a means to another end ­ can be imposed on oneself by their own will (not other entity) No rule can be moral unless it can be applied to all other humans by all Other Duty Philosophers Other Duty Philosophers Distribution of resources (Veatch) Equalization of society’s resources is prime importanceto benefit those less well off SOCIAL JUSTICE Reapportionment to benefit those less well off is main goal Natural Law Theory Natural Law Theory St Thomas Aquinas Actions are morally right if they are in accord with our NATURE as human beings ­ie. Reason and exercise intelligence Natural law comes from GOD but can be known by the efforts of humans Catholic Church Theory of Virtue Theory of Virtue We must ACT morally such that we produc or “are” virtuous Temperance, compassion, professional competence, justice, honesty, courageous, and practicality are listed as desirable Emulate your mentors …..if they were virtuous so will you be….. NONE OF THESE THEORIES NONE OF THESE THEORIES WORK ALL THE TIME OR IN ISOLATION!! In the 1970s a comission was created to help with all of these difficult problems BELMONT REPORT 1978 ­Respect for persons ­Beneficence ­ Justice These three are basic to almost all ethical dilemmas. Respect for Persons Respect for Persons Autonomous agents ­those that are not are entitled to protection People can have rational thought and therefore should have their decisions respected (Unless their choices are detrimental to others) Respect for persons Respect for persons Informed consent Truth Telling ­information,comprehension,voluntary ­ must always tell the truth because any lie told always will do injury to others. Beneficence Beneficence Hippocratic oath big on this!!! Primum non nocere ­prevent harm ­remove harm ­inflict no harm most important ­promote good least important Justice Justice What is “fair” or “deserved” Equals should be treated equally ­ equal treatment is not always fair… unequal treatment may be more fair? Claim to individual “Rights” (not yet agreed upon in our society) “Life, liberty, and pursuit of happiness……” is all we got so far….. Conflict of these principles Conflict of these principles Respect for persons Beneficence Justice Interpretation Government involvement vs Private sector Costs This has given rise to other theories……. Ethics of Caring Ethics of Caring Women Based Relationships vs Autonomy Nurturing vs Dominance Reconciliation vs VICTORY Casuistry Casuistry Get concensus by starting with simple problems….then work up to harder ones. Our job Our job Evaluate and discuss these problems that we come across and discuss different ways to look at each problem using different perspectives…. Examples of clashes of Ethics Examples of clashes of Ethics and Morality Abortion is legal and therefore medically ethical, while many people find it personally immoral. In the case of homosexuality, many believe it is morally wrong, yet some of the same people also believe it is unethical to discriminate legally against a group of people by disallowing them the same rights afforded heterosexuals What do you think about these What do you think about these topics? Monogenetic diseases Polygenetic diseases Cloning Cloning of Organs Selecting “better” people Reproductive Genetics Counselling services Who owns the embryo Who owns the sperm Who owns the eggs Wrongful life? What is a quality life? Patient Autonomy vs Society vs Beneficence Take it off and save a life Jehovah's Witnesses Christian Scientists Whose responsibility is it?? ...
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