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Questions and Answers
What is the primary purpose of moral theories?
What is the primary purpose of moral theories?
Which of the following falls under applied ethics?
Which of the following falls under applied ethics?
What is an example of a mid-level ethical principle?
What is an example of a mid-level ethical principle?
How do specific moral rules differ from moral theories?
How do specific moral rules differ from moral theories?
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What is an example of a specific considered judgment in ethics?
What is an example of a specific considered judgment in ethics?
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What principle overrides respect for autonomy in the case of the two patient groups?
What principle overrides respect for autonomy in the case of the two patient groups?
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What does the term 'moral residue' refer to in ethical decision-making?
What does the term 'moral residue' refer to in ethical decision-making?
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What does the principle of reflective equilibrium emphasize in ethical decision-making?
What does the principle of reflective equilibrium emphasize in ethical decision-making?
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Which situation exemplifies the balancing of ethical principles as discussed?
Which situation exemplifies the balancing of ethical principles as discussed?
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What is implied by aiming for coherence in ethical decision-making?
What is implied by aiming for coherence in ethical decision-making?
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What does ethics study in its philosophical context?
What does ethics study in its philosophical context?
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Which of the following describes normative ethics?
Which of the following describes normative ethics?
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What is the primary investigation focus of ethics?
What is the primary investigation focus of ethics?
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Which of the following is NOT a focus of ethics?
Which of the following is NOT a focus of ethics?
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What characterizes the study of ethics in its descriptive sense?
What characterizes the study of ethics in its descriptive sense?
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How does philosophy contribute to the understanding of ethics?
How does philosophy contribute to the understanding of ethics?
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What aspect of morality does ethics primarily seek to explore?
What aspect of morality does ethics primarily seek to explore?
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Which of the following best describes the term 'moral philosophy'?
Which of the following best describes the term 'moral philosophy'?
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What is a key strength of principlism in bioethics?
What is a key strength of principlism in bioethics?
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Which of the following is NOT mentioned as a limitation of principlism?
Which of the following is NOT mentioned as a limitation of principlism?
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Which aspect does the coherence model of ethics aim to enhance?
Which aspect does the coherence model of ethics aim to enhance?
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What does principlism attempt to mitigate in moral reasoning?
What does principlism attempt to mitigate in moral reasoning?
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How does principlism aim to unify moral judgments?
How does principlism aim to unify moral judgments?
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What is the main justification for infringing on individual liberties according to the principles outlined?
What is the main justification for infringing on individual liberties according to the principles outlined?
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Which of the following is NOT one of the conditions required to justify the infringement of a moral norm?
Which of the following is NOT one of the conditions required to justify the infringement of a moral norm?
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What is implied by the 'moral residue' concept?
What is implied by the 'moral residue' concept?
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Which outcome is required for the moral objective to justify infringement?
Which outcome is required for the moral objective to justify infringement?
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In the context of the vaccine pass, which of the following options illustrates the lowest level of infringement?
In the context of the vaccine pass, which of the following options illustrates the lowest level of infringement?
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According to the theory of utilitarian justice, the goal should be to maximize what?
According to the theory of utilitarian justice, the goal should be to maximize what?
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What is an example of a morally preferable alternative action mentioned?
What is an example of a morally preferable alternative action mentioned?
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Which key factor involves the minimization of negative effects during infringement?
Which key factor involves the minimization of negative effects during infringement?
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What is indicated by the presence of moral residues in the context of principlism?
What is indicated by the presence of moral residues in the context of principlism?
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Which limitation is associated with the coherence model in principlism?
Which limitation is associated with the coherence model in principlism?
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In what situation might one question the aim for coherence in bioethics?
In what situation might one question the aim for coherence in bioethics?
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Which principle is associated with the justification for implementing a Vaccine Pass according to the coherence model?
Which principle is associated with the justification for implementing a Vaccine Pass according to the coherence model?
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Which of the following is NOT a risk identified with emphasizing rationalism in principlism?
Which of the following is NOT a risk identified with emphasizing rationalism in principlism?
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Why might moral commitments remain despite their irreconcilability?
Why might moral commitments remain despite their irreconcilability?
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What is a primary characteristic of the four principles of biomedical ethics in healthcare?
What is a primary characteristic of the four principles of biomedical ethics in healthcare?
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Which aspect may be overlooked if one focuses solely on rationalism in moral reflection?
Which aspect may be overlooked if one focuses solely on rationalism in moral reflection?
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Study Notes
Course Information
- Course title: Public Health and Healthcare Ethics
- Course code: MEDF1021
- Instructor: Roger Chung
- Department: JC School of Public Health & Primary Care, The Chinese University of Hong Kong
- Date: September 25, 2024
Lecture Objectives
- Describe the relevance of ethics to public health and healthcare
- Describe bioethics and public health ethics
- Describe basic bioethical approaches, including theories and principles
- Describe the fundamentals of how bioethical principles work
- Describe general principles in biomedical ethics
What is Ethics?
- A set of principles, rules, values, and ideals of a particular group of people (descriptive sense)
- What is right or wrong?
- The systematic study of moral concepts and theories (a philosophy discipline), also known as moral philosophy
What is Philosophy?
- Philosophy is not about coming up with answers to fundamental questions
- It is about the process of trying to find those answers through reasoning, rather than accepting conventional views or authority.
What is Ethics? (Continued)
- Studies and considers what is good and bad conduct, right and wrong values (good/evil)
- Dichotomous or continuous?
- Primary investigations: How to live a good life? Identify standards of morality
- First-order ethics leads to normative ethics (is it right/wrong to do something? What is morally right/wrong?)
- Second-order ethics leads to meta-ethics (what is the principle behind the decision of doing right/wrong? What makes the action right/wrong?)
What is Bioethics?
- A complex word cloud of related terms relating to bioethics, including ethical issues in various subfields.
Bioethics as Applied Ethics
- Concerned with the analysis of particular moral issues in private or public life
- Bioethics is a cross-disciplinary study not confined to the medical perspective
- Three core areas: Medical/clinical ethics, Research ethics, and Public health ethics
Applied Ethics of Biomedical Sciences
- Medical/clinical ethics focuses on the practice of medicine (doctor-patient relationships, clinical decision making, consent, abortion, reproductive ethics, etc.).
- Research ethics focuses on clinical trials, big data, consent, misconduct, authorship, and research subjects.
- Public health ethics seeks to understand factors influencing people's health and improve health as a population (public health regulations, laws, policies, global health, health equity, social determinants of health.
Moral Dilemma
- A situation involving ethical conflict.
Trolleyology Scenarios
- Series of hypothetical scenarios involving moral dilemmas, specifically about healthcare decisions.
2 Major Types of Moral Theories
- Consequentialism (results-oriented): Right/wrong based on the outcomes of actions (e.g., utilitarianism).
- Kantian Deontology (duty-based): Based on reasoned duties that are categorically correct.
What are Moral Theories?
- Moral theory seeks systematic answers to questions about what to do and how to be.
Moral Theories and Their Purpose
- Establish in systematic fashion, at the general abstract level, what makes some actions ethically right/wrong.
- As opposed to the ethical evaluation of specific practices (e.g., abortion, assisted dying, death penalty, eating meat), which is covered by applied ethics
Level of Abstraction in Ethics
- Describes levels from Moral theories to principles, rules, and judgments (more abstract to more specific)
Aims of Moral Theory
- Practical aim: Create a decision procedure for correct moral verdicts.
- Theoretical aim: Discover underlying morally salient features that make actions right/wrong/good/bad.
Moral Principles
- The theoretical and practical aims of moral theory are fulfilled by specifying features that make things moral and guiding moral deliberation and choice.
Major Moral Theories
- Pre-theory includes religion and traditions.
- Traditional Western monistic theories are based on one principle alone. Examples include:
- Consequentialism (Utilitarianism): Outcome-oriented, concerned with maximizing good outcomes and minimizing bad ones.
- Categorical deontology: Action-oriented, concerned with whether actions can be universally applied.
- Virtue ethics: Agent-centered, concerned with actions of virtuous persons.
- Sentimentalism: Emotion-driven, not strictly reasoning based.
Recent Critiques of Traditional Theories and Developments
- Care ethics: Influenced by virtue ethics, agent-centered (What would a caring person do?), gave rise to feminist ethics.
- Principlism: Pluralistic (4 main principles: respect for autonomy, non-maleficence, beneficence, and justice), balance principles.
- Narrative ethics: People's stories influencing decisions.
- Non-Western/Non-mainstream ethics: Incorporates diverse cultural perspectives.
- Feminist ethics: A perspective not a theory, a pluralistic approach.
Limitations of Monistic Theories
- Most controversial moral conflicts cannot be resolved by a single principle. There are multiple perspectives in a pluralistic society.
Major Moral Theories (Continued)
- Focus on principles that are the most important for health and healthcare (Specific guidelines for evaluating concrete situations).
- Narrative ethics- perspective, understanding factors that shape people's health and ways to improve it (including people's stories).
- Non-western/non-mainstream ethics to incorporate perspectives from other cultures and traditions
- Feminist ethics : a perspective approach that incorporates the multiple perspectives of various moral theories
Perspectives Matter
- No single theory can represent all perspectives
A Feminist Ethics Approach
- List of different types of ethical approaches.
Not Stacking All Lenses
- A reminder that applying multiple lenses at once, not just checkboxes
Major Moral Theories (Summary and Development)
- Pre-theory: Religion and traditions.
- Traditional Western monistic theories (e.g., theories based on one principle alone) (e.g., consequentialism, categorical deontology, etc.)
- Recent critiques of the traditional theories and developments (e.g., care ethics, Principlism, narrative ethics, non-western ethics, feminist ethics)
Principlism- Core Concept
- Describes Principlism's framework using 4 main principles that serve as general guidelines.
- Prima facie concepts as a foundational characteristic.
Principlism- Core Elements (Continued)
- The four principles are derived from common morality.
- Emphasizes reasoning, similar to utilitarianism and deontology but with additional aspects
Principle 1- Respect for Autonomy
- Respecting and supporting autonomous choices.
- Important conditions for autonomy include intentionality, understanding, and absence of coercion.
Principle 2- Non-maleficence
- A moral obligation to avoid causing harm.
- Requires justification for any potentially harmful actions.
Principle 3- Beneficence
- Moral norms for providing benefits and balancing benefits against risks (including promoting good as well as avoiding harm)
Principle 4- Justice
- Moral norms for fairly distributing benefits and burdens
The Formal Principle of Justice
- Equally treat equals, unequally treat unequals.
Principlism- Conception of Right Action
- Principles guide moral decisions and resolve conflicts resulting form different considerations.
Principlism - Methods/Analysis: 4-Step Process
- Identify relevant moral norms.
- Specify the norms in the context being evaluated.
- Make balanced judgments between the principle in place.
- Aim for coherence by linking the results of the case study to other cases or principles.
Specifications
- Describes the process of specifying abstract principles in particular contexts.
- Offers various details about how to specify principles.
Balancing (Principles)
- Balancing judgments from ethical considerations
- Principles must meet conditions for thorough reasoning to avoid intuition
Example of Balancing (Principles)
- Balancing examples of how differing principle considerations could override one another
Aim for Coherence
- Integrate case learning to inform decision-making.
- Ethical decisions are not isolated from surrounding considerations and must be interconnected with other judgments.
- Moral residues to be addressed in decisions
Moral Residue
- Acknowledging that an obligation does not silence other moral considerations.
- Addresses ways to deal with these moral residues, such as notification, apologies, and compensations, to further avoid similar conflicts in the future.
Case Study 1- Vaccine Pass (Public Health)
- Describes the case study surrounding vaccine passes, COVID-19 prevalence
- Relevant facts and context
- Details of cases, efficacy of vaccine, and implementation of vaccine passes.
Moral Norms Identification (& Specifications)
- Identifies the relevant moral norms associated with vaccine passes by examining different considerations and conflicts in this specific case
Balancing (Case Study)
- Specific criteria detailing how decisions have to be made, and criteria when conflicts between different principles happen.
Am for Coherence (Case Study)
- Specific steps in dealing with the case study, utilizing a broader context.
Moral Residue (Case Study)
- Addresses how to deal with the moral implications of a case
Principlism – Strengths
- Powerful, encompassing (complex issues)
- Role for principled justification.
- Unifying/systematic approach for ethical decision-making.
- Enables a deductive approach for resolving issues with different considerations.
Principlism – Limitations
- Leaves out important features of morality.
- Insoluble conflicts between principles could still exist
- Relies too much on intuition about the balance to be made.
- Risk of neglecting other perspectives
Principlism– Relevance to Bioethics
- Widely used framework.
- Valuable approach for addressing moral dilemmas in healthcare.
- Recognizes moral pluralism (different values/perspectives).
Is the Selection of Moral Theories Only a Matter of Taste?
- The selection of moral theories shouldn't be based solely on individual preferences.
- Theories should reflect shared human experiences and knowledge
- Use different perspectives (e.g., feminist ethics) to analyze the issue
Why Do Moral Theories Matter?
- Questioning the role of theoretical models when considering ethical situations
Straightforward Application Model
- A straightforward interpretation of applying an ethical theory
Car Mechanic/ Physics Model
- Explains how ethical cases can be handled based on a straightforward approach similar to how a mechanic might go about fix a car
Biology-Medicine Model
- Ethical problems handled on their own, not influenced by underlying theories
Key Messages - Reflection on Principles and Theories
- The three models.
- Important takeaways surrounding the application/lack of direct applicability of moral principles & theories.
- We need both theoretical models and practical application
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Description
Test your knowledge on the primary concepts of moral theories and applied ethics. This quiz covers various ethical principles, decision-making processes, and examples of moral judgments. Perfect for students studying philosophy or ethics.
