Bioethics Midterm 2 Ethical Frameworks Questions With Complete Solutions

Major Ethical Frameworks correct answer: egoism, authority-based ethics, virtue ethics, natural law, deontology, consequentialism (teleological/utilitarianism), liberal individualism/rights, communitarianism, ethics of care/feminist ethics, casuistry Mappes' 2 criteria for evaluating ethical theories correct answer: 1. implications of theory must be largely reconcilable with experience of moral life 2. must provide effective guidance where most needed, in situations where substantial moral considerations can be advanced on both sides Criteria for Theory construction correct answer: clarity (theory is as clear as possible), coherence (no contradictions), completeness (covers ethical terrain), simplicity (not more complicated than necessary), explanatory power (addresses broadly the concerns of moral life), justificatory power (user-friendly for defending presuppositions and beliefs), output power (bears new fruits), practicability (methods are applicable by the average person of good will) 3 main types of ethical theories correct answer: 1. teleological theories - consequences 2. deontological theories - rules & duties 3. virtue ethics - character formation egoism correct answer: one's self interest is basis of one's ethics decisions -not helpful in health care ethics bc professionals are taught to set aside self-interest -interest of patient comes first authority-based ethics correct answer: decisions based on central authority (think theology or ideology) -health care: may be difficult deciding which authority is correct -knowing this view helps with understanding patients & health policy decisions Virtue/Character ethics correct answer: balancing obligations & using practical wisdom; emphasizes the character of agents who perform actions, make choices, & moral ideals; help to define character & assist with actions -founded in writings of Aristotle -everything moves from potentiality to actuality -character development allows you to actualize your highest good -Eudaimonia sought as highest good virtue correct answer: praiseworthy traits of human character -moral virtue: trait that is morally valued; dispositional trait of character that is moral valuable & reliably present -Aristotle: acquired states of mind which lead to human flourishing *eudaimonia* ---seek to build your character & increase virtue; ppl who work towards it become persons of practical wisdom return to virtues by Richard White correct answer: a good human being is one who lives & acts in accordance with virtue , in accordance with nature as rational, social beings -cardinal virtues: temperance, courage, justice, wisdom, compassion -Aristotle: real reason to study ethics is to learn how to become a better person Aristotle: Happiness as Chief Good correct answer: "happiness, above all else, is held to be; for this we choose always for self and never for the sake of something else" Fr Benedict Ashley correct answer: "a virtue is a quality or skill that enables us consistently to keep moving toward the goal, no matter what obstacles arise before us" -fruit of the Spirit is love, joy, peace, patience, kindness, generosity, faithfulness, gentleness, self-control -Spiritual virtues come through baptism; natural virtues come from practice Cardinal Virtues: -temperance: moderation in lifestyle so we can pursue greater goods -courage: fortitude, patience, & endurance -justice: virtue that puts the human will to the service of God and neighbor (righteousness); respect for the common good -wisdom: prudence learned from listening to God in the Bible & tradition Pellegrino's 3-tiered system of moral obligations correct answer: 1. observance of laws of the land -licensure, Good Samaritan laws, protections of human subjects 2. Observance of rights & fulfillments of duties -promise keeping, truth telling, confidentiality 3. practice of virtue Pellegrino's defense of hippocratic oath correct answer: almost all med schools use the oath, 95% Americans believe in God, strong requirement for confidentiality and non-exploitation, demands accountability to peers/patients -can be seen through discretion, prudence, generosity, reverence Pellegrino's Philosophical Basis for Patient-Physician Interaction correct answer: physician must get to know patient/their value to they can work together for action (conscientiousness) -sick patient is vulnerable than they would be -patients must be truthful to physician & not violate conscience Beauchamp's Prime Virtues correct answer: 1. Compassion: "detached" in order to have clear judgement & avoid burnout 2. Discernment: Aristotle's 'phronesis' - a creative response in meeting responsibilites 3. Trustworthinedd: being lost now with the depersonalization of professions & scandals 4. Integrity (fidelity): tempered with humility & respect for others' points of view (vs hypocrisy) 5. Conscientiousness: doing all one can to do the right thing Virtues & Principles correct answer: Virtues need principles and rules to regulate and supplement them. Principles guide us to actions -character & training allow us to assess situations and formulate appropriate responses Strengths of Character Ethics correct answer: more complete when virtues are included; to look at acts w/o looking at moral appropriateness and desirability of feelings, attitudes, sympathy, etc. is to miss a large part of the moral pictyre Weaknesses of Character ethics correct answer: risk of arrogance, whose list of virtues, how can virtues be ranked or chosen among particular situation magis correct answer: latin for 'more' or 'better' -being all that we can be -Magis (high quality pedagogy and learning processes) -Attention (recognition of uniqueness of each student - cure personalis) -Gifts: faculty are encouraged to promote reflection, discernment, and solidarity with the poor as gifts of educational heritage -Integrity (early Jesuits integrate liberal arts with professional skills) -Service (high impact learning is achieved thru service and community engagement) Pope Francis on Virtue of Humility correct answer: humility is our shield against temptations of the devil -devil tempts us to play he peacock & forget our dependence on God Citizen Ben's 7 Great Virtues correct answer: 1. Aversion to Tyranny 2. Free Press 3. Humor 4. Humility 5. Idealism in Foreign Policy 6. Compromise 7. Tolerence St Thomas Aquinas correct answer: Natural law ethics -do good & avoid evil -do what is reasonable natural law theory correct answer: Aquinas: assumes nature is rational and orderly, humans are part of natural world & given ability to be rational, natural reason allows us to distinguish right from wrong -reason: actions humans choose to do good or evil -Principle of Double Effect used to decide which action is good -good defined as helps to maximize potential (preserving life, gaining wisdom, knowing God Four Basic Human Needs correct answer: 1. health of body (self-preservation) 2. good social relations with others 3. wisdom about oneself, world, and its creator 4. generatively (children or other creative productivity) Abraham Maslow's Hierarchy of Needs correct answer: St Thomas on Ultimate Felicity correct answer: felicity = happiness -what every intellectual substance desires as an ultimate end -ultimate felicity of intellectual is to know God Conscience as syllogism correct answer: Albert the great & acquinas -major premise came from conscience (syneresis) & minor demise from fallible moral reasoning -3 lines *notes* Strengths of natural law theory correct answer: higher law to evaluate national or cultural law, supported by variety of sources, doesn't require religious affiliation weaknesses of natural law theory correct answer: still often culturally conditions (feminist, non-western critique) -requires specification of what is good or reasonable Kantianism (Deontology) correct answer: Immanuel kant -moral judgements: based on reasons generalized for others similarly situated -therefore we must act not only in accordance with but for the sake of obligation -the two categorical imperatives deontology theory correct answer: 'deon' meaning duty so aka duty-based ethics -world exists directly (phenomenal world) & independent of intellect (noumenal world) -free will is why we need ethics -only true good is good will -actions judged by intention & outcomes -categorical imperative: rational principle for making moral judgements strengths of kantianism correct answer: any person who judges X as morally required in 1 circumstance is committed to view that X is morally required in any relevantly similar circumstance -treating persons as ends in themselves leads to respect for autonomy (respect for persons) problems with Kantianism correct answer: difficulty of reconciling conflicting obligations, over-emphasizes law, under emphasizes relationships, limitations of categorical imperative (hard to apply to specific situations) Kant and Virtue Ethics correct answer: Kantian ethics is absolute in def of duty, virtues ethics allows for grey ares -Kant does not assist with deciding among lesser evils and greater goods -virtue ethics allows the use of tools to make decisions deontology and policy correct answer: health care professionals recognize a duty to the patient -health care managers also have a duty to patient, but have duties to organization and community -conflicting duties must be considered in policy making non-kantians deontology correct answer: John Rawls & Robert Nozick -the idea of justice trough our actions -thinking influences health care reform, public health and other health areas John Rawls correct answer: defined the characteristics of just society -examined justice as fairness & applied it to societies that respect rule of law -work based on social contract btwn members of society Rawls' self-interest & justice correct answer: used hypothetical or mind experiment (original position) to explain why rational people would protect self interests; if all in original position, we would all be equal -included veil of ignorance: help understand why we care about self interests Basic principles of justice correct answer: liberty: priority over all other principles - people should have equal right to basic liberties (bill of rights) justification of inequalities: difference principle to justify when social & economic inequities are appropriate (physicians) Robert Nozick correct answer: deontologist, but opponent of Rawls -represent conservative tradition & has great influence in debate over health care reform -emphasizes autonomy & rights of individual Nozick & Social Goods correct answer: no social good requires sacrifice. we should influence people to take steps to improve their own situations -supports defeat of voluntary agreements Nozick on Distributive Justice correct answer: no principle of distributive justice -finds justice in acquisition & owned resources -historical injustices are not addressed in theory except to suggest that society could be organized to maximize position of least well off Utilitarianism (consequence-based theory) correct answer: Jeremy Bentham & John stuart mill -person ought to act so as to produce the greatest balance of good over evil, everyone considered (principle of utility) -Bentham & Mill were hedonistic utilitarians -values other than happiness have intrinsic worth as well -John mill: pursuit of the common good - promote general good for all principle of utility correct answer: is absolute, no derivative rule is absolute, no rule is unrevisable, even rules against killing in medicine may be overturned or substantially revised Act utilitarianism vs rule utilitarianism correct answer: act: individual acts themselves should increase happiness rule: following good rules will increase happiness consequentialism theory correct answer: your intentions are irrelevant, only outcome counts -Greatest good for the greatest number -2 types: classical/act utilitarianism (each act considered on its own) & rule utilitarianism: develop rules that net the greatest benefit Rule Utilitarianism correct answer: used to make health care policy -exceptions can be made under special circumstances -allows for negative consequentialism or preventing greatest harm for greatest number strengths of utilitarianism correct answer: principle of utility in public policy formation -to ignore consequences is to leave an ethical story half told Problems of Utilitarianism correct answer: apples & oranges of weighing happiness -achieving happiness at expense of other's rights -blurs distinction btwn morally obligatory actions & supererogatory actions -under emphasizes relationships stakeholder analysis correct answer: being sure to assess impact of choice upon the widest variety of people concerned as possible -ex: patient, family, health care staff, hospital, public rights-based theory (liberal individualism) correct answer: Thomas Hobbes & John Locke -anglo-american legal tradition rights protect against oppression, unequal treatment, protect life, liberty, expression, property positive vs negative right correct answer: negative: right to seek health care (liberty right) positive: right to government-sponsored health care (entitlement right) obligations follow from rights violation vs infringement of right correct answer: violation: unjustified action against a right infringement: justified action overriding a right bc of more pressing claim communitarianism correct answer: views everything fundamental in ethics as deriving from communal values, common good, social goals, traditional practices, cooperative virtues -repudiate central tenets of liberal individualism, especially priority of rights strengths of communitarianism correct answer: emphasis on historical traditions, community insight and institutional practices -rediscovery of communitarian writings of Aristotle, Hume, Hegel problems with communitarianism correct answer: unfair account of liberal theories, false dichotomy: autonomy or community, excessive critique of rights feminist ethics correct answer: caring means to care for, having emotional commitment to, & willingness to act on behalf of persons with whom one has significant relationship -Kantian universal rules, individual rights & impartial calculations downplayed -women display ethic of care which centers on responsiveness to the needs of others to whom one is related, while men display an ethic of rights & obligations emphasize feminine perspective on any issue & how issue impacts upon women -reject any ethical system that doesn't see women's experience as source for ethics & normatively human strength of ethics of care correct answer: compassion leads to insight & recognition of problem, emotion has moral role, care corrects two centuries of male ethical theory weakness of ethics of care correct answer: confusion btwn feminism & ethics of care, too contextual & hostile to principles Casuistry correct answer: case history - any valid insight accepted strengths of casuistry correct answer: importance of analogical reasoning, paradigm cases, practical judgement -generalizations often best learned, accommodated, implemented by using case methodology problems with casuistry correct answer: case interpretation & conflicting judgments, overreaction to principles, uncritical view of past precedents