Introductory unit: Towards Human Rights Ethics
Human rights ethics: combines intuitionism (gut feelings) with rational justification (reasoned
motivational arguments) and the individual personhood of the human being with
social-communal embeddedness.
Morality = a set of deeply held, widely shared, and relatively stable values within a community.
In healthcare there are many moral dilemmas = complex situations that challenge us to choose
between two or more wrongs → how to justify choices we make as moral justified? → in making
choices, there are always restrictive variables (time, context, limits to human capacity), which
limit our rationality in decision-making = bounded rationality (we select choices that are
satisfactory rather than optimal) → need ethics for moral choices.
Ethics = the philosophical reflection on morality, immorality and a-morality in collective and
individual human behaviour → right vs. wrong → descriptive, helps to understand moral choice.
→ aim: introduce a degree of rationality and rigour into our moral deliberations.
→ conventional methods of ethics:
- Duty-based method of ethics (deontological ethics): Immanuel Kant → moral acts stem
from our duty to perform them → categorical imperative = act only according to that
maxim by which you can at the same time will that it should become a universal law (the
source for knowing what our duty is) → FEX. lying is unethical, because we could not
universalize the maxim “one should always lie” → says nothing about how easy or difficult
it is to carry out these maxims, only that it is our duty as rational creatures to do so →
we freely choose to bind ourselves to the moral law → distinction between:
- act-based deontology; most people intuitively know how to choose in moral
dilemmas, so crucial factor in moral choice is personal moral intuition (BUT,
moral arguments based on intuition are hard to justify).
- rule-based deontology; rules based upon moral principles (code of conduct) can
provide guidance in moral choices (BUT, universal applicability of these rules is
unrealistic and different rules might be in conflict with each other).
- advantages; creating a system of rules that has consistent expectations of all
people (everyone has the same duties), which encourages treating everyone with
equal dignity and respect.
- criticism; neglect of the consequences of moral choices (one might have acted
morally, even if there is a bad result), and does not provide for a way to determine
which duty to follow when two or more duties conflict.
- Effects-based method of ethics (utilitarianism): John Stuart Mill → in moral
choice-making good versus bad consequences will be weighed → distinction between:
- act-based utilitarianism; from case to case it must be considered what type of
conduct has the best consequences (BUT, who defines what optimal
consequences of certain choices are? AND difficult to establish what optimal
consequences are under different conditions for different actors).
- rule-based utilitarianism; one finds sufficient similarity between
choice-situations for general rules to be useful (BUT, no unequivocal
understanding of what constitutes the best consequence (effect) for the largest
number of people).
- advantages; it takes the consequences of moral choices seriously.
- criticism; most of the time people cannot know the consequences of their acts,
and risk that beneficial ends justify immoral means, and no consensus on
consequences that serve the common good.
, - Virtue-based method of ethics: Aristotle → happiness and wellbeing (telos) are the
ultimate standard for all our moral judgments, which require 2 virtues; (1) sophia
(theoretical wisdom) and (2) phronesis (practical wisdom) → importance of realising the
standards of excellence that are definitive for cooperative human activity, rather than
focusing on practice-independent obligations of a moral agent (deontology) or the
consequences of a particular actions (utilitarianism) → moral behaviour = whatever a
virtuous person would do in the situation, and we seek to develop similar virtues.
- advantages; takes into account all parts of human experience and their role in
ethical deliberation, as it believes that all experiences, emotions, and thoughts
can influence the development of one’s character.
- criticism; difficult to resolve disputes, as there can often be considerable
disagreement about virtuous traits, and not effective at helping someone decide
what actions to take in a given situation or determine the rules to guide actions.
Additions:
→ context-based approach: need to conceive morality as an evolving social instrument that is
part of a specific cultural context → requires precise interpretation of the moral issue at stake →
proposes a comparative case analysis through which resolutions to new choices are sought by
reasoning from solutions that were preferred in similar situations.
→ discursive (communicative) approach: moral standards are valid only when all those
concerned would give their consent following their common deliberations → moral choices are
communicative acts that are transparent for all those affected by them → seeks those solutions
to moral dispute that optimally accommodate the parties’ interests and principles.
→ intuition-based approach: intuitions come first and that they are justified or explained after
the fact in order to convince others of the legitimacy of our moral decision → reasoning to make
moral conclusions.
Critique conventional ethics: mechanistic format (manuals with instructions for how to apply
rules to concrete problems, BUT we often discover while working it out → so, moral choice is a
non-formal, creative exercise (more arts than craft).
Human rights-based approach = a communal process of deliberation, reflection and evaluation
in which the quality of caring is questioned as “humans in making” → can be used both
retrospectively (reflect upon and learn from moral choices made) and prospectively (assess what
the best moral choice is from a human rights perspective) → accepts there is not always a
satisfactory rational justification of moral choices, there can only be a collective conclusion that
we made the best out of the situation as free and autonomous persons.
UDHR: moral judgement is primarily moved by intuition, but this needs justification on
reasonable grounds → can be guided by the principles dignity, freedom, equality and security →
need to find a balance between intuitionist common sense and justificatory reasoning.
→ we are members of societies communal beings (while conventional ethics is individualistic) →
choices made reflect someone’s community.
Deep dialogue = the speech of genuine conversation in which men understand one another and
come to a mutual understanding → key requirements are trust, patience and freedom, which
have to meet the following human rights standards:
- Communicative dignity = human behaviour avoids the humiliation of persons through
deindividualization, discrimination, disempowerment, and degrading.
- Communicative freedom = people are free to accept or reject each other’s claims on the
basis of reasons they can evaluate.
Human rights ethics: combines intuitionism (gut feelings) with rational justification (reasoned
motivational arguments) and the individual personhood of the human being with
social-communal embeddedness.
Morality = a set of deeply held, widely shared, and relatively stable values within a community.
In healthcare there are many moral dilemmas = complex situations that challenge us to choose
between two or more wrongs → how to justify choices we make as moral justified? → in making
choices, there are always restrictive variables (time, context, limits to human capacity), which
limit our rationality in decision-making = bounded rationality (we select choices that are
satisfactory rather than optimal) → need ethics for moral choices.
Ethics = the philosophical reflection on morality, immorality and a-morality in collective and
individual human behaviour → right vs. wrong → descriptive, helps to understand moral choice.
→ aim: introduce a degree of rationality and rigour into our moral deliberations.
→ conventional methods of ethics:
- Duty-based method of ethics (deontological ethics): Immanuel Kant → moral acts stem
from our duty to perform them → categorical imperative = act only according to that
maxim by which you can at the same time will that it should become a universal law (the
source for knowing what our duty is) → FEX. lying is unethical, because we could not
universalize the maxim “one should always lie” → says nothing about how easy or difficult
it is to carry out these maxims, only that it is our duty as rational creatures to do so →
we freely choose to bind ourselves to the moral law → distinction between:
- act-based deontology; most people intuitively know how to choose in moral
dilemmas, so crucial factor in moral choice is personal moral intuition (BUT,
moral arguments based on intuition are hard to justify).
- rule-based deontology; rules based upon moral principles (code of conduct) can
provide guidance in moral choices (BUT, universal applicability of these rules is
unrealistic and different rules might be in conflict with each other).
- advantages; creating a system of rules that has consistent expectations of all
people (everyone has the same duties), which encourages treating everyone with
equal dignity and respect.
- criticism; neglect of the consequences of moral choices (one might have acted
morally, even if there is a bad result), and does not provide for a way to determine
which duty to follow when two or more duties conflict.
- Effects-based method of ethics (utilitarianism): John Stuart Mill → in moral
choice-making good versus bad consequences will be weighed → distinction between:
- act-based utilitarianism; from case to case it must be considered what type of
conduct has the best consequences (BUT, who defines what optimal
consequences of certain choices are? AND difficult to establish what optimal
consequences are under different conditions for different actors).
- rule-based utilitarianism; one finds sufficient similarity between
choice-situations for general rules to be useful (BUT, no unequivocal
understanding of what constitutes the best consequence (effect) for the largest
number of people).
- advantages; it takes the consequences of moral choices seriously.
- criticism; most of the time people cannot know the consequences of their acts,
and risk that beneficial ends justify immoral means, and no consensus on
consequences that serve the common good.
, - Virtue-based method of ethics: Aristotle → happiness and wellbeing (telos) are the
ultimate standard for all our moral judgments, which require 2 virtues; (1) sophia
(theoretical wisdom) and (2) phronesis (practical wisdom) → importance of realising the
standards of excellence that are definitive for cooperative human activity, rather than
focusing on practice-independent obligations of a moral agent (deontology) or the
consequences of a particular actions (utilitarianism) → moral behaviour = whatever a
virtuous person would do in the situation, and we seek to develop similar virtues.
- advantages; takes into account all parts of human experience and their role in
ethical deliberation, as it believes that all experiences, emotions, and thoughts
can influence the development of one’s character.
- criticism; difficult to resolve disputes, as there can often be considerable
disagreement about virtuous traits, and not effective at helping someone decide
what actions to take in a given situation or determine the rules to guide actions.
Additions:
→ context-based approach: need to conceive morality as an evolving social instrument that is
part of a specific cultural context → requires precise interpretation of the moral issue at stake →
proposes a comparative case analysis through which resolutions to new choices are sought by
reasoning from solutions that were preferred in similar situations.
→ discursive (communicative) approach: moral standards are valid only when all those
concerned would give their consent following their common deliberations → moral choices are
communicative acts that are transparent for all those affected by them → seeks those solutions
to moral dispute that optimally accommodate the parties’ interests and principles.
→ intuition-based approach: intuitions come first and that they are justified or explained after
the fact in order to convince others of the legitimacy of our moral decision → reasoning to make
moral conclusions.
Critique conventional ethics: mechanistic format (manuals with instructions for how to apply
rules to concrete problems, BUT we often discover while working it out → so, moral choice is a
non-formal, creative exercise (more arts than craft).
Human rights-based approach = a communal process of deliberation, reflection and evaluation
in which the quality of caring is questioned as “humans in making” → can be used both
retrospectively (reflect upon and learn from moral choices made) and prospectively (assess what
the best moral choice is from a human rights perspective) → accepts there is not always a
satisfactory rational justification of moral choices, there can only be a collective conclusion that
we made the best out of the situation as free and autonomous persons.
UDHR: moral judgement is primarily moved by intuition, but this needs justification on
reasonable grounds → can be guided by the principles dignity, freedom, equality and security →
need to find a balance between intuitionist common sense and justificatory reasoning.
→ we are members of societies communal beings (while conventional ethics is individualistic) →
choices made reflect someone’s community.
Deep dialogue = the speech of genuine conversation in which men understand one another and
come to a mutual understanding → key requirements are trust, patience and freedom, which
have to meet the following human rights standards:
- Communicative dignity = human behaviour avoids the humiliation of persons through
deindividualization, discrimination, disempowerment, and degrading.
- Communicative freedom = people are free to accept or reject each other’s claims on the
basis of reasons they can evaluate.
