Preparation Werkgroep 1 - Introduction to Ethics
Part 1
Just a case…
Suppose you are the CEO in charge of a hospital which provides specialist medical care. Your hospital
is financed by several health care insurance companies, the largest of which is responsible for more
than 70% of the hospital’s income. That insurance company is willing to invest in a new clinic for hip
and knee replacement therapy. Even more, it is willing to ptovide extra funding. You and the other
members of the Board are delighted to hear that the funding will enable the clinic’s surgeons to offer
their services during the weekends. The insurance company does, hoewever, have one condition:
during the weekends the clinic is opened exclusively for patients having insurance policies with that
company. Theother Board members agree to this condition. After all, the additional financing enables
the clinic to help more patients. You, on the other hand, have reservations. Although most clinicians
welcome the proposed deal, some have informed you that the proposed deal is unfair. They feel that
patients who are insured with other companies are being discriminated against. They argue that the
deal is at odds with medical ethics. The hospital’s Patients’ Council is also not in favor. It is opposed to
what they call ‘preferential treatment’. You are faced with a moral problem, a dilemma. What are you
to do?
What is Ethics?
The province of ethics
• ‘Morality’ refers to views held in society on right and wrong behavior -> qualifying behavior in
what is right or wrong.
• Yet, morality differs from religion, politics, law and etiquette.
• There is some overlap in this (lawyers can also describe what is right and wrong in human
behavior), however they are distanced from these subjects.
• ‘Morality’ does not refer to standards of prudence (sensible behavior). Moral behavior ≠
Prudent behavior.
• ‘Morality’ refers to a more or less durable social institution: standards of human behavior
which is transferred from generation to generation, the existence of which precedes their
acceptance by individual human beings. (These standards were set long before we were born
and will still exist long after we are gone).
• ‘Morality’ refers to behavior with implications for others -> it occurs when people live
together
• Moral judgements are not merely subjective. -> If I say what you did is wrong, these are more
than merely subjective. Morality is what is studies by ethics, they are not synonyms
Ethics is often used as the synonym for morality, but strictly seen its not. Ethics is the name of the
subject and morality is a subject within this bigger subject. So they are not synonyms.
Morality is a way of thinking that people ought to behave or we think that they ought behave,
nevertheless it seem to review of how the society thinks about what is right and what is wrong in
human behavior.
What is Ethics?
The province of ethics
• Mortality
• Mortality vs. religion, politics, law and etiquette
• Moral behaviour ≠ prudent behaviour.
What is Ethics?
The concept of a Moral Position (R. Dworkin)
• What must I do to convince you that my position is a moral position? I must produce reasons
for it, but not every reason will do. A moral position cannot be based on:
o Prejudices
o Emotional reaction
, o False propositions of fact
o The beliefs of others
• I must genuinely endorse the principles my reasons presuppose.
• The moral arguments I make not only presuppose principles, but also more abstract views on
moral reasoning.
The object of morality (G.J.Warnock):
If morality is a social institution, what function does it have?
• The purpose of morality is to overcome human shortcomings.
-> we as individuals are far from perfect -> we cannot feel how people are feeling. We are
lacking in sympathy. We also lack rationality, we cannotnot always for see all the
consequences of our behavior. We need a more or less durable social institution which
counterferes those shortcomings.
• The general object of morality is to contribute to betterment - or non-deteriation - of the
human predicament, primarily and essentially by seeking to countervail ‘limited rationality
and limited sympathies’ and their potentially most damaging effects.
-> Human predicament (hachelijk situatie), we are not rational enough. We have limited sympathies.
Approaches to the study of morality; ethics can be done in 2 ways:
1. Nonnormative approaches
a. Descriptive ethics: factual investigation of moral beliefs and conduct. It uses scientific
techniques to study how people reason and act (observer’s perspective, description
and theory of prevailing morality.). What do people think about the wright and wrong
in a certain society.
-> Not concerned with questions, what can I do
b. Meta-ethics; reflection on (true philosophy)
Really looking through true philosophy, What makes us say that this kind of behavior
is immoral and that kind of behavior is morally correct? What is it about human
behavior that warns those kinds of qualifications? For example, is it because of the
outcomes? Inefficiency? Well-being?
i. The meaning of moral use of language
ii. The differences with nonmoral use of language
iii. The nature of moral judgement (de aard van moreel oordeel)
iv. Morality and relativism, morality and pluralism, etc. etc..
-> What kind of aspect of human behavior makes it wrong or right? When you want to find out the
meaning of wrong and right, you need to use meta-ethics.
-> Descriptive ethics and metaethics are nonnormative because their objective is to establish what
factually or conceptually is the case, not what ethically ought to be the case or what is ethically
valuable
2. Normative approaches
a. No longer an observer, but a participant. Reflect on the morality as it occours around
you. You are part of a community that has it’s thought about human behaviour and
you want to try to explain it: why do we in a community think about it in this way? Or
as umanity as a whole?
b. General normative ethics: which general moral norms for the guidance and
evaluation of conduct should we accept, and why?
• Participant’s perspective
• Systematic-philosophical reflection on prevailing morality, i.a.
→ Utilitarianism (Bentham, Mill), Deontologie (Kant, Rawls), Virtue ethics (Aristotle,
Awuinas, Macintyre)
, c. Applied/ practical ethics: employs general concepts and norms to address particular
problems.
d. Medical ethics, bioethics, etc. and healthcare ethics?
Part 2
Relativism and Pluralism
Morality and relativism (R. Brandt); types of relativism:
• Cultural relativism: what? -> Idea that people can hold different views on the same moral
issues
o Criticism
o Relativism with regard to moral judgements -> these can differ
o Relativism with regard to underlying moral standards
• Normative relativism: what? -> feel that you ought to accept. Chinese feel very differently, we
feel that it is not okay. We accept the differences, normative relativism:
o Criticism: fundamental cultural relativists, but with a more rational view. They believe
that you cannot criticize another culture, because they have a different view due to
the circumstances.
Morality and pluralism (A. Macintyre); moral disagreement:
• What? -> Different people have different answers, facts of life. But there is always one correct
answer. What should you do to arrive at a shared opinion?
One thing about morality is that people have disagreements, we can have two
options/courses of actions. One can choose the one and the other the other thing and
produce reasons for that. With moral issues it is typical that people disagree. What are you to
do then? If people disagree on a moral issue, there are a few things that make sense:
o Objective factual information, is correct. (when you choose one way, you have to
have facts that are correct)
o Unambiguous terminology
(every word you use in moral argument has only one meaning)
o Acceptance of common framework of moral norms.
o Use of (counter) examples
o Analysis of arguments (logic)
Justification
Assuming that it will not do to simply claim that something is right because we believe it to be right,
would it – then – be possible to justify moral judgements? In other words, how can we show that
something is morally right?
• Is it possible to refer to an independent standard? Internal justification and External
justification
• Can we justify that we ought to be good human beings? Can we justify that we ought to live
moral lives? In other words, why be moral?
o Is living a moral life a reasoned choice? Is morality in the end a mattor of reasons and
reasonableness or rationality?
o If living a moral life is not a reasoned choice, is morality – then – a matter of desire
and belifs, of feeling?
o If living a moral life is a reasoned choice, could we- then – speak of moral knowledge
and Moral thruth?
Knowledge as truth in Morality:
• Cognitivism -> proof moral claims with empirical sciences; demonstrate the truth of moral
claims. Now really rare, people don’t think that you can prove the truth of a moral claim in
, the same way as you prove the truth of a claim made by for example an astronomer.
(When you claim it is raining, you can let them see that it is)
o Naturalism
o Intuitionism
• Non cognitivism -> making moral claims is just showing emotions.
o Emotivism, prescriptivism
• Reflective equilibrium -> the best possible fit with our overall understanding of morality. That
idea of the best fit is very common in science as well. The most convincing explanation.
Part 3
The ethical perspective
1. A moral problem is a normative problem - how you should behave
2. No appeal is made to authority or dogma to come to a moral judgement - we do it by proper
thinking of our own
3. Moral judgements should be based on good arguments exclusively
4. The point of view of all concerned are taken into account
Moral norms
Common morality = universal morality
• People committed to morality, grasp the fundamental norms of morality, although there may
be differences of opinion regarding their precise meaning, scope, weight, etc.
• Fundamental norms apply to all human beings in all circumstances
• Common morality is the product of human experience and history, shared by all.
• Common morality is present in all cultures of all ages - No place for relativism and pluralism
on the level of the fundamental norms
• Common morality enconpasses (overtreft) moral convictions (overtuigingen), not the
standards preceding those convictions.
• Theories of common morality are historical products.
Particular morality ≠ universal
• Many norms do not apply to all human beings in all circumstances. These norms are not
vague and abstract but specific and rich in content
• Particular moralities share fundamental norms with other particular moralities but not their
specific norms.
• Particular moralities provide for responsibilities, professional standards, etc.
• Types of particular morality: professional moralities, medical professional morality.
Moral Norms
A common framework of moral norms;
Principles:
• Respect for autonomy
• Non-maleficence
• Beneficence
• Justice; principlism in biomedical ethics
Rules:
• Substantive norms
• Authority norms
• Procedural norms
Virtues, emotions, etc.
Dilemmas frequently occur because of the difference in moral norms.
• Conflicting moral norms:
Part 1
Just a case…
Suppose you are the CEO in charge of a hospital which provides specialist medical care. Your hospital
is financed by several health care insurance companies, the largest of which is responsible for more
than 70% of the hospital’s income. That insurance company is willing to invest in a new clinic for hip
and knee replacement therapy. Even more, it is willing to ptovide extra funding. You and the other
members of the Board are delighted to hear that the funding will enable the clinic’s surgeons to offer
their services during the weekends. The insurance company does, hoewever, have one condition:
during the weekends the clinic is opened exclusively for patients having insurance policies with that
company. Theother Board members agree to this condition. After all, the additional financing enables
the clinic to help more patients. You, on the other hand, have reservations. Although most clinicians
welcome the proposed deal, some have informed you that the proposed deal is unfair. They feel that
patients who are insured with other companies are being discriminated against. They argue that the
deal is at odds with medical ethics. The hospital’s Patients’ Council is also not in favor. It is opposed to
what they call ‘preferential treatment’. You are faced with a moral problem, a dilemma. What are you
to do?
What is Ethics?
The province of ethics
• ‘Morality’ refers to views held in society on right and wrong behavior -> qualifying behavior in
what is right or wrong.
• Yet, morality differs from religion, politics, law and etiquette.
• There is some overlap in this (lawyers can also describe what is right and wrong in human
behavior), however they are distanced from these subjects.
• ‘Morality’ does not refer to standards of prudence (sensible behavior). Moral behavior ≠
Prudent behavior.
• ‘Morality’ refers to a more or less durable social institution: standards of human behavior
which is transferred from generation to generation, the existence of which precedes their
acceptance by individual human beings. (These standards were set long before we were born
and will still exist long after we are gone).
• ‘Morality’ refers to behavior with implications for others -> it occurs when people live
together
• Moral judgements are not merely subjective. -> If I say what you did is wrong, these are more
than merely subjective. Morality is what is studies by ethics, they are not synonyms
Ethics is often used as the synonym for morality, but strictly seen its not. Ethics is the name of the
subject and morality is a subject within this bigger subject. So they are not synonyms.
Morality is a way of thinking that people ought to behave or we think that they ought behave,
nevertheless it seem to review of how the society thinks about what is right and what is wrong in
human behavior.
What is Ethics?
The province of ethics
• Mortality
• Mortality vs. religion, politics, law and etiquette
• Moral behaviour ≠ prudent behaviour.
What is Ethics?
The concept of a Moral Position (R. Dworkin)
• What must I do to convince you that my position is a moral position? I must produce reasons
for it, but not every reason will do. A moral position cannot be based on:
o Prejudices
o Emotional reaction
, o False propositions of fact
o The beliefs of others
• I must genuinely endorse the principles my reasons presuppose.
• The moral arguments I make not only presuppose principles, but also more abstract views on
moral reasoning.
The object of morality (G.J.Warnock):
If morality is a social institution, what function does it have?
• The purpose of morality is to overcome human shortcomings.
-> we as individuals are far from perfect -> we cannot feel how people are feeling. We are
lacking in sympathy. We also lack rationality, we cannotnot always for see all the
consequences of our behavior. We need a more or less durable social institution which
counterferes those shortcomings.
• The general object of morality is to contribute to betterment - or non-deteriation - of the
human predicament, primarily and essentially by seeking to countervail ‘limited rationality
and limited sympathies’ and their potentially most damaging effects.
-> Human predicament (hachelijk situatie), we are not rational enough. We have limited sympathies.
Approaches to the study of morality; ethics can be done in 2 ways:
1. Nonnormative approaches
a. Descriptive ethics: factual investigation of moral beliefs and conduct. It uses scientific
techniques to study how people reason and act (observer’s perspective, description
and theory of prevailing morality.). What do people think about the wright and wrong
in a certain society.
-> Not concerned with questions, what can I do
b. Meta-ethics; reflection on (true philosophy)
Really looking through true philosophy, What makes us say that this kind of behavior
is immoral and that kind of behavior is morally correct? What is it about human
behavior that warns those kinds of qualifications? For example, is it because of the
outcomes? Inefficiency? Well-being?
i. The meaning of moral use of language
ii. The differences with nonmoral use of language
iii. The nature of moral judgement (de aard van moreel oordeel)
iv. Morality and relativism, morality and pluralism, etc. etc..
-> What kind of aspect of human behavior makes it wrong or right? When you want to find out the
meaning of wrong and right, you need to use meta-ethics.
-> Descriptive ethics and metaethics are nonnormative because their objective is to establish what
factually or conceptually is the case, not what ethically ought to be the case or what is ethically
valuable
2. Normative approaches
a. No longer an observer, but a participant. Reflect on the morality as it occours around
you. You are part of a community that has it’s thought about human behaviour and
you want to try to explain it: why do we in a community think about it in this way? Or
as umanity as a whole?
b. General normative ethics: which general moral norms for the guidance and
evaluation of conduct should we accept, and why?
• Participant’s perspective
• Systematic-philosophical reflection on prevailing morality, i.a.
→ Utilitarianism (Bentham, Mill), Deontologie (Kant, Rawls), Virtue ethics (Aristotle,
Awuinas, Macintyre)
, c. Applied/ practical ethics: employs general concepts and norms to address particular
problems.
d. Medical ethics, bioethics, etc. and healthcare ethics?
Part 2
Relativism and Pluralism
Morality and relativism (R. Brandt); types of relativism:
• Cultural relativism: what? -> Idea that people can hold different views on the same moral
issues
o Criticism
o Relativism with regard to moral judgements -> these can differ
o Relativism with regard to underlying moral standards
• Normative relativism: what? -> feel that you ought to accept. Chinese feel very differently, we
feel that it is not okay. We accept the differences, normative relativism:
o Criticism: fundamental cultural relativists, but with a more rational view. They believe
that you cannot criticize another culture, because they have a different view due to
the circumstances.
Morality and pluralism (A. Macintyre); moral disagreement:
• What? -> Different people have different answers, facts of life. But there is always one correct
answer. What should you do to arrive at a shared opinion?
One thing about morality is that people have disagreements, we can have two
options/courses of actions. One can choose the one and the other the other thing and
produce reasons for that. With moral issues it is typical that people disagree. What are you to
do then? If people disagree on a moral issue, there are a few things that make sense:
o Objective factual information, is correct. (when you choose one way, you have to
have facts that are correct)
o Unambiguous terminology
(every word you use in moral argument has only one meaning)
o Acceptance of common framework of moral norms.
o Use of (counter) examples
o Analysis of arguments (logic)
Justification
Assuming that it will not do to simply claim that something is right because we believe it to be right,
would it – then – be possible to justify moral judgements? In other words, how can we show that
something is morally right?
• Is it possible to refer to an independent standard? Internal justification and External
justification
• Can we justify that we ought to be good human beings? Can we justify that we ought to live
moral lives? In other words, why be moral?
o Is living a moral life a reasoned choice? Is morality in the end a mattor of reasons and
reasonableness or rationality?
o If living a moral life is not a reasoned choice, is morality – then – a matter of desire
and belifs, of feeling?
o If living a moral life is a reasoned choice, could we- then – speak of moral knowledge
and Moral thruth?
Knowledge as truth in Morality:
• Cognitivism -> proof moral claims with empirical sciences; demonstrate the truth of moral
claims. Now really rare, people don’t think that you can prove the truth of a moral claim in
, the same way as you prove the truth of a claim made by for example an astronomer.
(When you claim it is raining, you can let them see that it is)
o Naturalism
o Intuitionism
• Non cognitivism -> making moral claims is just showing emotions.
o Emotivism, prescriptivism
• Reflective equilibrium -> the best possible fit with our overall understanding of morality. That
idea of the best fit is very common in science as well. The most convincing explanation.
Part 3
The ethical perspective
1. A moral problem is a normative problem - how you should behave
2. No appeal is made to authority or dogma to come to a moral judgement - we do it by proper
thinking of our own
3. Moral judgements should be based on good arguments exclusively
4. The point of view of all concerned are taken into account
Moral norms
Common morality = universal morality
• People committed to morality, grasp the fundamental norms of morality, although there may
be differences of opinion regarding their precise meaning, scope, weight, etc.
• Fundamental norms apply to all human beings in all circumstances
• Common morality is the product of human experience and history, shared by all.
• Common morality is present in all cultures of all ages - No place for relativism and pluralism
on the level of the fundamental norms
• Common morality enconpasses (overtreft) moral convictions (overtuigingen), not the
standards preceding those convictions.
• Theories of common morality are historical products.
Particular morality ≠ universal
• Many norms do not apply to all human beings in all circumstances. These norms are not
vague and abstract but specific and rich in content
• Particular moralities share fundamental norms with other particular moralities but not their
specific norms.
• Particular moralities provide for responsibilities, professional standards, etc.
• Types of particular morality: professional moralities, medical professional morality.
Moral Norms
A common framework of moral norms;
Principles:
• Respect for autonomy
• Non-maleficence
• Beneficence
• Justice; principlism in biomedical ethics
Rules:
• Substantive norms
• Authority norms
• Procedural norms
Virtues, emotions, etc.
Dilemmas frequently occur because of the difference in moral norms.
• Conflicting moral norms:
