BIOETHICS: EXAM QUESTIONS
INTRODUCTION TO BIOETHICS
OUR APPROACH TO BIOETHICS
WHAT IS MEANT BY AN 'ETHICO-ONTO-EPISTEMOLOGY'?
An ‘ethico-onto-epistemology’ refers to an approach in bioethics where ontology, epistemology, and ethics are understood as
deeply interconnected rather than separate domains. In the bioethical framework used in this course, these three dimensions are
considered fundamentally entangled when reflecting on scientific and biomedical questions.
To understand this concept, it is important to break down the three components. First, ontology concerns how the world is. It asks
questions about the nature of reality and how we conceive of phenomena. In bioethics, ontological questions concern how we
understand concepts such as disease, health, disability, life, or personhood. For example, one may ask: what exactly is a disease? Is
disease merely a biological dysfunction, a deviation from normal functioning, or also socially determined? The way we define such
concepts influences how we approach biomedical problems.
Second, epistemology concerns how we know things, particularly scientific knowledge. It raises questions about what counts as
scientific evidence, when something is scientifically proven, and how science progresses. Bioethics therefore does not only evaluate
scientific outcomes but also critically examines scientific practice itself. For example, values may influence scientific decision-
making, such as balancing false positives and false negatives in drug trials, where caution must be weighed against efficacy.
Scientists may also be influenced by biases, making it important to consider different perspectives or standpoints in the production
of objective knowledge.
Third, ethics concerns what we should do. Ethics reflects on norms, values, and moral principles, asking what is good or bad, or
what constitutes the “good life.” In bioethics, ethical reflection goes beyond merely following regulations or performing a risk-
benefit analysis. Instead, it involves critically considering questions such as: what does unnecessary harm mean?, how should human
and non-human interests be weighed?, and who benefits from scientific research?
An important aspect of an ethico-onto-epistemological approach is that these three elements cannot be separated. The way we
understand reality (ontology) influences what we consider valid knowledge (epistemology), and both affect what we believe ought
to be done (ethics). For example, in animal experimentation, ethical decisions depend not only on regulations but also on how
animals are understood, what scientific evidence is considered sufficient, and what goals research should serve. Thus, bioethics
becomes more than a top-down application of ethical rules: it becomes a process of thinking with scientists while also asking
deeper philosophical questions.
In conclusion, an ethico-onto-epistemology is an approach in which questions about reality, knowledge, and morality are
inseparable. In bioethics, understanding what exists, how we know it, and what we should do are all intertwined, making ethical
reflection an essential part of scientific and biomedical practice.
1
,WHAT DO THOMAS HOBBES AND FRANS DE WAAL SAY ABOUT THE ORIGINS OF MORALITY?
The question of the origins of morality has been approached differently by philosophers and scientists. In the context of bioethics,
two important perspectives are those of Thomas Hobbes and Frans de Waal, who offer contrasting explanations for why humans
are sensitive to morality. While Hobbes emphasizes self-interest and social contracts, De Waal argues for a biological and
evolutionary basis of morality.
According to Thomas Hobbes (1588–1679), morality originates from egoistic prudence and the need for social order. Hobbes
believed that in a natural state, human beings are primarily self-interested and compete for scarce resources. Without rules or
authority, this would lead to a constant struggle for survival, often described as a “war of all against all.” To avoid chaos and
insecurity, individuals collectively agree to follow certain moral rules and laws. This agreement forms the social contract, in which
people accept restrictions on their behavior because doing so is ultimately in their own best interest. Morality, from this
perspective, is not naturally present but emerges as a practical solution to ensure peaceful coexistence in society.
In contrast, Frans de Waal (°1948) argues that morality has a biological and evolutionary basis. Through observations of primates
and other animals, De Waal demonstrated that behaviors such as fairness, altruism, empathy, and cooperation are not unique to
humans. Non-human animals also display forms of helping behavior, social bonding, and reactions to unfair treatment. According to
De Waal, morality did not suddenly appear in humans but developed gradually through evolution from pre-existing social behaviors
that promoted group survival. Therefore, morality is rooted in biology rather than solely in rational agreements or contracts.
The major difference between Hobbes and De Waal lies in how they explain moral sensitivity. Hobbes sees morality as socially
constructed and based on self-interest, whereas De Waal considers morality to be partly innate and biologically grounded.
Hobbes focuses on competition and the necessity of rules to avoid conflict, while De Waal highlights cooperation and altruism as
natural tendencies already present in animals.
In conclusion, both thinkers attempt to explain why humans are moral beings, but they provide different answers. Thomas Hobbes
explains morality through egoistic prudence and the social contract, while Frans de Waal sees morality as emerging from
evolutionary and biological processes involving fairness and altruism. Together, these theories illustrate how morality can be
understood as either socially constructed or naturally evolved.
2
, MORAL THEORIES
EXPLAIN UTILITARIANISM. WHAT ARE ITS STRONG AND WEAK POINTS? EXPLAIN UTILITARIANISM. WHAT
ARE ITS STRENGTHS AND WEAKNESSES?
Utilitarianism is a moral theory rooted in consequentialism that evaluates actions based on their consequences.
Its core principle, famously articulated by Jeremy Bentham, states that an action is considered good if it delivers
"the greatest good for the greatest number of people." This principle implies conducting a cost-benefit analysis
in which the positive outcomes, such as pleasure or happiness, outweigh the negative consequences, such as
pain or suffering.
Bentham introduced a hedonistic calculus to measure the intensity, duration, certainty, and other factors of
pleasure or pain resulting from actions. However, critics such as Robert Nozick questioned the hedonistic
approach, arguing that mere experiences of pleasure do not necessarily equate to real satisfaction that comes
from actual experiences.
John Stuart Mill expanded utilitarianism by emphasizing qualitative differences in pleasure, suggesting that
intellectual pursuits may have greater value than mere physical gratification. In addition, preferred utilitarianism
took into account preferences rather than hedonistic experiences, recognizing that individuals can prioritize
different sources of satisfaction.
Utilitarianism evolved further with a distinction between deed- and rule-utilitarianism. While actutilitarianism
evaluates each action individually, ruleutilitarianism evaluates actions based on general rules aimed at
maximizing happiness in the long run.
Despite its strengths, such as its ethical inclusivity (anyone who can experience happiness is considered) and
practical usefulness in policymaking, utilitarianism faces significant criticism. One challenge lies in measuring and
comparing the suffering of different individuals or groups. In addition, utilitarian calculations inherently involve
speculation about future consequences, leading to ethical dilemmas and potential harm to minorities or
individuals who are sacrificed for the greater good.
In addition, utilitarianism can lead to conclusions that are considered superfluous/super-erogatory and demand
actions beyond what is morally obligatory, causing individuals to experience moral discomfort. For example,
Peter Singer's example of sacrificing personal luxuries to save a child's life illustrates the demanding nature of
utilitarian ethics.
3
, In summary, utilitarianism provides a rational framework for ethical decision-making, based on the pursuit of the
greatest overall happiness. However, its application raises complex questions about measuring happiness, taking
into account various interests and balancing individual rights with the common good.
Good points Bad points
How do we measure suffering? – It is difficult to
Progressive (animals, women) – Utilitarianism was determine who suffers the most and how much weight
ethically progressive for its time, as it considers we should give to the suffering of animals, fetuses or
anyone who can experience happiness or suffering, the biosphere.
including women and children, to be morally relevant.
Bentham/Peter Singer: Speciesism – Jeremy Bentham Sacrifice of minorities – Utilitarianism can be harmful
argued that moral consideration should not be based to minorities if an action that benefits the majority
on rationality or language, but on the ability to suffer. disadvantages the minority. Examples: killing one
Peter Singer expands on this and argues that making person to save five others, or justifying slavery as
moral distinctions based on species advantageous
comparable to racism or sexism. is for many.
Based on common sense – Utilitarianism fits well with Speculative – The consequences of certain actions are
our intuitive way of moral thinking. uncertain. For example: nuclear energy can help
climate change
but a disaster can wipe out all the benefits.
Interesting for policy – It provides a rational basis for Don't look back: promises – Utilitarianism focuses
policymaking, for example in the allocation of limited mainly on future consequences and has difficulty with
resources in health care: money should go to life- the moral value of promises and obligations from the
saving cancer research rather than cosmetic past.
treatments such as
Botox.
Importance of personal relationships – Utilitarianism
takes little account of the moral value of personal
connections and feelings.
Super-erogatory conclusions – Utilitarianism can be
extremely demanding. For example, Peter Singer
argues that luxury spending is immoral because that
money could save a person's life. This can be seen as
morally right,
but at the same time asking too much of people.
4
INTRODUCTION TO BIOETHICS
OUR APPROACH TO BIOETHICS
WHAT IS MEANT BY AN 'ETHICO-ONTO-EPISTEMOLOGY'?
An ‘ethico-onto-epistemology’ refers to an approach in bioethics where ontology, epistemology, and ethics are understood as
deeply interconnected rather than separate domains. In the bioethical framework used in this course, these three dimensions are
considered fundamentally entangled when reflecting on scientific and biomedical questions.
To understand this concept, it is important to break down the three components. First, ontology concerns how the world is. It asks
questions about the nature of reality and how we conceive of phenomena. In bioethics, ontological questions concern how we
understand concepts such as disease, health, disability, life, or personhood. For example, one may ask: what exactly is a disease? Is
disease merely a biological dysfunction, a deviation from normal functioning, or also socially determined? The way we define such
concepts influences how we approach biomedical problems.
Second, epistemology concerns how we know things, particularly scientific knowledge. It raises questions about what counts as
scientific evidence, when something is scientifically proven, and how science progresses. Bioethics therefore does not only evaluate
scientific outcomes but also critically examines scientific practice itself. For example, values may influence scientific decision-
making, such as balancing false positives and false negatives in drug trials, where caution must be weighed against efficacy.
Scientists may also be influenced by biases, making it important to consider different perspectives or standpoints in the production
of objective knowledge.
Third, ethics concerns what we should do. Ethics reflects on norms, values, and moral principles, asking what is good or bad, or
what constitutes the “good life.” In bioethics, ethical reflection goes beyond merely following regulations or performing a risk-
benefit analysis. Instead, it involves critically considering questions such as: what does unnecessary harm mean?, how should human
and non-human interests be weighed?, and who benefits from scientific research?
An important aspect of an ethico-onto-epistemological approach is that these three elements cannot be separated. The way we
understand reality (ontology) influences what we consider valid knowledge (epistemology), and both affect what we believe ought
to be done (ethics). For example, in animal experimentation, ethical decisions depend not only on regulations but also on how
animals are understood, what scientific evidence is considered sufficient, and what goals research should serve. Thus, bioethics
becomes more than a top-down application of ethical rules: it becomes a process of thinking with scientists while also asking
deeper philosophical questions.
In conclusion, an ethico-onto-epistemology is an approach in which questions about reality, knowledge, and morality are
inseparable. In bioethics, understanding what exists, how we know it, and what we should do are all intertwined, making ethical
reflection an essential part of scientific and biomedical practice.
1
,WHAT DO THOMAS HOBBES AND FRANS DE WAAL SAY ABOUT THE ORIGINS OF MORALITY?
The question of the origins of morality has been approached differently by philosophers and scientists. In the context of bioethics,
two important perspectives are those of Thomas Hobbes and Frans de Waal, who offer contrasting explanations for why humans
are sensitive to morality. While Hobbes emphasizes self-interest and social contracts, De Waal argues for a biological and
evolutionary basis of morality.
According to Thomas Hobbes (1588–1679), morality originates from egoistic prudence and the need for social order. Hobbes
believed that in a natural state, human beings are primarily self-interested and compete for scarce resources. Without rules or
authority, this would lead to a constant struggle for survival, often described as a “war of all against all.” To avoid chaos and
insecurity, individuals collectively agree to follow certain moral rules and laws. This agreement forms the social contract, in which
people accept restrictions on their behavior because doing so is ultimately in their own best interest. Morality, from this
perspective, is not naturally present but emerges as a practical solution to ensure peaceful coexistence in society.
In contrast, Frans de Waal (°1948) argues that morality has a biological and evolutionary basis. Through observations of primates
and other animals, De Waal demonstrated that behaviors such as fairness, altruism, empathy, and cooperation are not unique to
humans. Non-human animals also display forms of helping behavior, social bonding, and reactions to unfair treatment. According to
De Waal, morality did not suddenly appear in humans but developed gradually through evolution from pre-existing social behaviors
that promoted group survival. Therefore, morality is rooted in biology rather than solely in rational agreements or contracts.
The major difference between Hobbes and De Waal lies in how they explain moral sensitivity. Hobbes sees morality as socially
constructed and based on self-interest, whereas De Waal considers morality to be partly innate and biologically grounded.
Hobbes focuses on competition and the necessity of rules to avoid conflict, while De Waal highlights cooperation and altruism as
natural tendencies already present in animals.
In conclusion, both thinkers attempt to explain why humans are moral beings, but they provide different answers. Thomas Hobbes
explains morality through egoistic prudence and the social contract, while Frans de Waal sees morality as emerging from
evolutionary and biological processes involving fairness and altruism. Together, these theories illustrate how morality can be
understood as either socially constructed or naturally evolved.
2
, MORAL THEORIES
EXPLAIN UTILITARIANISM. WHAT ARE ITS STRONG AND WEAK POINTS? EXPLAIN UTILITARIANISM. WHAT
ARE ITS STRENGTHS AND WEAKNESSES?
Utilitarianism is a moral theory rooted in consequentialism that evaluates actions based on their consequences.
Its core principle, famously articulated by Jeremy Bentham, states that an action is considered good if it delivers
"the greatest good for the greatest number of people." This principle implies conducting a cost-benefit analysis
in which the positive outcomes, such as pleasure or happiness, outweigh the negative consequences, such as
pain or suffering.
Bentham introduced a hedonistic calculus to measure the intensity, duration, certainty, and other factors of
pleasure or pain resulting from actions. However, critics such as Robert Nozick questioned the hedonistic
approach, arguing that mere experiences of pleasure do not necessarily equate to real satisfaction that comes
from actual experiences.
John Stuart Mill expanded utilitarianism by emphasizing qualitative differences in pleasure, suggesting that
intellectual pursuits may have greater value than mere physical gratification. In addition, preferred utilitarianism
took into account preferences rather than hedonistic experiences, recognizing that individuals can prioritize
different sources of satisfaction.
Utilitarianism evolved further with a distinction between deed- and rule-utilitarianism. While actutilitarianism
evaluates each action individually, ruleutilitarianism evaluates actions based on general rules aimed at
maximizing happiness in the long run.
Despite its strengths, such as its ethical inclusivity (anyone who can experience happiness is considered) and
practical usefulness in policymaking, utilitarianism faces significant criticism. One challenge lies in measuring and
comparing the suffering of different individuals or groups. In addition, utilitarian calculations inherently involve
speculation about future consequences, leading to ethical dilemmas and potential harm to minorities or
individuals who are sacrificed for the greater good.
In addition, utilitarianism can lead to conclusions that are considered superfluous/super-erogatory and demand
actions beyond what is morally obligatory, causing individuals to experience moral discomfort. For example,
Peter Singer's example of sacrificing personal luxuries to save a child's life illustrates the demanding nature of
utilitarian ethics.
3
, In summary, utilitarianism provides a rational framework for ethical decision-making, based on the pursuit of the
greatest overall happiness. However, its application raises complex questions about measuring happiness, taking
into account various interests and balancing individual rights with the common good.
Good points Bad points
How do we measure suffering? – It is difficult to
Progressive (animals, women) – Utilitarianism was determine who suffers the most and how much weight
ethically progressive for its time, as it considers we should give to the suffering of animals, fetuses or
anyone who can experience happiness or suffering, the biosphere.
including women and children, to be morally relevant.
Bentham/Peter Singer: Speciesism – Jeremy Bentham Sacrifice of minorities – Utilitarianism can be harmful
argued that moral consideration should not be based to minorities if an action that benefits the majority
on rationality or language, but on the ability to suffer. disadvantages the minority. Examples: killing one
Peter Singer expands on this and argues that making person to save five others, or justifying slavery as
moral distinctions based on species advantageous
comparable to racism or sexism. is for many.
Based on common sense – Utilitarianism fits well with Speculative – The consequences of certain actions are
our intuitive way of moral thinking. uncertain. For example: nuclear energy can help
climate change
but a disaster can wipe out all the benefits.
Interesting for policy – It provides a rational basis for Don't look back: promises – Utilitarianism focuses
policymaking, for example in the allocation of limited mainly on future consequences and has difficulty with
resources in health care: money should go to life- the moral value of promises and obligations from the
saving cancer research rather than cosmetic past.
treatments such as
Botox.
Importance of personal relationships – Utilitarianism
takes little account of the moral value of personal
connections and feelings.
Super-erogatory conclusions – Utilitarianism can be
extremely demanding. For example, Peter Singer
argues that luxury spending is immoral because that
money could save a person's life. This can be seen as
morally right,
but at the same time asking too much of people.
4
