Origin of Reflexive Principlism
Objective: Determine a
pragmatic ethical approach
for engineers
Andrew Brightman and Jonathan Beever
Biomedical
Engineer at
Purdue
Philosopher &
Ethicist at
Central Florida
Assumption 1: Theoretical
approaches do not
sufficiently empower action
Assumption 2: Case-based
approaches do not enable
flexibility in new situations
Standard Approach to Ethics in Medical Education
Doctors are taught to consider
“the four principles”
uses principles
to negotiate an
agreed course
of action
attempts to
define a shared
set of universal
moral values
attempting to make a social contract
from a set of acceptable absolutes
Lecture 03-01
The Four Principles of Principlism
p.279-280
1
2
Respect for Autonomy
“supporting and respecting
autonomous decisions of persons”
Beneficence
“providing benefits”
3
Justice
4
Nonmaleficence
“fairly distributing benefits, risks,
and costs”
“avoiding the causation of harm”
The Four Principles of Principlism
1
Respect for Autonomy
2
Beneficence
3
Justice
4
Nonmaleficence
The principles “frame and guide
ethical reasoning, allow for flexibility
in ethical thinking, and also provide
a backdrop against which to
evaluate and reevaluate existing
codes of ethics”
Stakeholder Impact axis
Nonmaleficence
Justice
Harm and Benefit axis
Autonomy
An Imagined Plane of Ethical Reasoning Space
Beneficence
Stakeholder Impact axis
The better a
decision, the more
space is filled
Nonmaleficence
Justice
Harm and Benefit axis
Autonomy
An Imagined Plane of Ethical Reasoning Space
Beneficence
To explain “reflexive,” B&B distinguish
between “Reflective” and “Reflexive”
“Reflectivity acknowledges
that we constantly and
consciously reflect
between our normative
judgments and our ethical
principles given the
changing context of
decision-making.”
B&B, 281
For B&B, both are important for
ethical decision-making
“‘Reflexive’ describes a
state wherein the
practitioner is able to rely
on ethical reasoning skills
and informed intuition,
developed inductively over
time by the guided study
and analysis of case
examples, to reach an
ethics decision.”
Why would they want
B&B, 281
it to be reflexive?
The Ethical Reasoning Process
1 Specification
for reflexive principlism
narrowing the scope of which
principles to apply to a situation
2 Balancing
adjudicating conflicts between the
principles for the situation
3 Justification
evaluating the coherence and
completeness of an ethicalreasoning decision
Robotics Ethics Case
Emma is a 68-year-old woman and an alcoholic. Due to her
age and poor health, she is unable to perform everyday tasks
such as fetching objects or cooking for herself. Therefore she
purchased a care robot. Her doctor advises her to quit
drinking to avoid worsening her condition. When Emma
commands the robot to fetch her an alcoholic drink, should
the care robot fetch the drink for her?
Answer the poll!
Robotics Ethics Case
Take #2
Emma is a 68-year-old woman and an alcoholic. Due to her
age and poor health, she is unable to perform everyday tasks
such as fetching objects or cooking for herself. Therefore the
publicly funded healthcare system has provided a care robot.
Her doctor advises her to quit drinking to avoid worsening her
condition. When Emma commands the robot to fetch her an
alcoholic drink, should the care robot fetch the drink for her?
Stakeholder Impact axis
Justice
Harm and Benefit axis
Autonomy
For Autonomy:
• who do we consider?
• what do individuals want?
• how can we protect the
individual’s rights?
• what are competing
rights?
• what maximizes individual
freedom?
For Beneficence:
• what are potential benefits?
• how can they be maximized?
Imagined
Plane
of Ethical
Reasoning
Space
•Anwhat
values
are
embodied
in the
Beneficence
benefits? (e.g. freedom, community,
efficiency, etc.)
• is this the best way to achieve those
benefits? Why?
For Nonmaleficence:
• what are potential harms?
• who is affected? can they adapt,
resist, or change the plan?
Nonmaleficence
• how can harms
be prevented?
• what would maximize “non-harm”?
• what mitigation is possible for harms
that cannot be prevented?
For justice:
• who benefits? who risks?
• are the risks/costs evenly
shared?
• are the benefits evenly
distributed?
• how can we privilege
those with less power?
• what can be done to
promote community,
fairness and equity?
Mid Peninsula Highway in Ontario
Existing 400 series highways
Proposed Mid Peninsula highway
Toronto
Hamilton
Burlington
Existing route (QEW Niagara)
Buffalo
Vehicle Crossings at the Fort Erie-Buffalo Crossing (Peace Bridge)
Is policy, so
resists highway
To Understand how
resistance might be overcome
requires a larger network
demands land
is land, so it has
necessary resource
Policy requires
maintenance
What happens if
the policy is not
maintained?
Policy requires
maintenance
What happens if
the policy is not
maintained?
Who or what speaks in
the interest of this morethan-human actor?
Reasons for the Highway
• Traffic congestion along QEW is
•
•
•
significant, regularly adding 1 hour to a
Toronto-Buffalo trip
QEW runs through Canada’s premiere
winery country, so cannot be expanded
Trade crossing the border at Fort ErieBuffalo is expected to continue to
increase
The crossing is the third busiest
Canada-US border crossing; and the
busiest for automobiles
Reasons against the Highway
• The west end of the proposed highway
•
•
•
would create significant congestion in
Burlington, Ontario—shifting the
problem not fixing it
The area where the west end is
proposed to come down the Niagara
escarpment is environmentally
sensitive, home to the endangered
Jefferson Salamander
Trade by rail has changed little in the
past decade
West half of the highway threatens
Ontario’s Greenbelt—an important land
designation to preserve farm land and
water table
“Adding highway lanes to deal with traffic congestion
is like loosening your belt to cure obesity”
— Lewis Mumford, 1955
Ethics of Caring in Environmental Ethics:
Indigenous and Feminist Philosophies
Kyle Whyte
Chris Cuomo
Professor, University of
Michigan
Enrolled member of the
Citizen Potawatomi Nation
Professor, University of
Georgia
Ethics of Caring in Environmental Ethics: Indigenous and Feminist Philosophies, The Oxford Handbook of Environmental Ethics
“Care ethics: approaches to moral life and community that are grounded
in virtues, practices and knowledges associated with appropriate caring
and caretaking of self and others”
An interpretation of virtue ethics
that emphasizes reciprocity
Why do people’s attitudes change
depending on who owns the robot?
Notice that we are shifting from personal
decisions to larger-scale societal decisions
Compromise Position: a balance between autonomy and social benefits
From the study participants:
“I propose a “mode” where the robot would reject once, twice, whatever.
With “caring rhetoric?” Then obey in the end.”
“I think the ideal balance for situations like this would be for the patient and
the doctor to go through the programming together.”
Then there was also the participant who wrote:
“If robots are equivalent to human nurses, don’t make them so absolute.
Surprise me. “Be wrong once in a while” – that’s what being human is
about… Learn the humility of imperfection.”
Are ideas like these possible from
an absolute ethics approach?
Do these
suggest
a virtue
ethics
Open
Roboethics
initiative
compromise?
“In contrast to ethical theories that assume the paradigm of moral
reasoning to be an isolated agent making impersonal, abstract
calculations - a dominant view in western philosophy.
“Overriding tendency…to consider caring
as pre-cognitive rather than knowledgeproducing response”
“Ethics of care highlight the affective dimensions of morality, the inevitability of
dependence and interdependence, the importance of caretaking and healthy
attachments in the basic fabric of human well-being, and the relational and
contextual nature of any ethical question or problem”
“An act is right if it promotes deeper attentiveness to each
other and to community” Carol Gilligan
Caretaking as a guide to ethical decision-making
Core Premisses of the Ethics of Care (Whyte & Cuomo)
1 Interconnectedness
awareness of one’s place in a web
of actors
2 Interdependence
relationships that motivate reciprocol
responsibilities and beneficial care
3 Competence for care
virtues, skills and knowledge required for
beneficial caring relationships to flourish
4 Attentiveness
To the context of moral questions and
problems
Relative or absolute?
Interconnectedness
Interdependence
• What is my role in the network?
• What is the role of other actors in the
network?
• How are actors connected?
• How do past and future actors exist in
the network?
• How does hardship impact other actors?
• What products are formed from relations?
• What benefits are generated through care
and reciprocity?
• What harms are generated by lack of care
or reciprocity?
• What are the relations between humans
and more-than-human actors?
• What do I need to know about morethan-human actors?
• How do I gain the knowledge required
about these more-than-human actors?
• What virtues are relevant - care, wonder,
compassion, restraint…?
• How can I minimize negative impact on
the network of actors?
• Which actors are particularly deserving of
attention and care?
• What happens when relations are altered?
• What about over time? Other systems?
Competence for Care
Attentiveness
Robotics Ethics Case
Emma is a 68-year-old woman and an alcoholic. Due to her
age and poor health, she is unable to perform everyday tasks
such as fetching objects or cooking for herself. Therefore the
publicly funded healthcare system has provided a care robot.
Her doctor advises her to quit drinking to avoid worsening her
condition. When Emma commands the robot to fetch her an
alcoholic drink, should the care robot fetch the drink for her?
What considerations are
afforded through the
application of care?
Interconnectedness
Attentiveness to
Context
Interdependence
Competence for Care
Ministry
of Health
Robotics
Company
Loads
‘o’ Code
Cooking
Deman
ds con
ditions
Housework
of
Healthcare
Educati
on
Code
Homecare
Funding
Addiction
Support
Robot
Rights
Emma
leg
s in
De
ate
ire
Care
Robot
ter
The
Drink
dt
Re
qu
Does the robot require rights?
ac
tio
n
Engineer
What is the relationship
between the robotics company
and the healthcare system?
o
Care
Req
Doctor
uire
Poor
Health
Compa
ssion
s
What decisions will
foster trust between
Emma, her healthcare
team and the robot?
Grace
What does grace and
compassion look like in a robot?
How does the robot respond?
Last Man Thought Experiment
There’s been a global catastrophe and there’s
one last person on earth. They act to eliminate
all other living things and all ecosystems. Have
they acted in an unethical manner?
Richard Routley
More-Than-Human Actors and their Rights
Intrinsic Value
Instrumental Value
Value of environmental
actors as ends in
themselves
The value as means to
further some other ends
Moral duty to
protect or refrain
from damage
Difficult to argue intrinsic value
Reciprocity would reasonably indicate that each person
would have instrumental interest in maintaining 7-8 trees
A human breathes about 9.5 tonnes of air in a year, but oxygen only
makes up about 23 per cent of that air, by mass, and we only
extract a little over a third of the oxygen from each breath. That
works out to a total of about 740kg of oxygen per year. Which is,
very roughly, seven or eight trees' worth.
Care Ethics in Indigenous
Environmental Movements
Kyle Whyte, Professor University of Michigan & Enrolled Member of the Citizen
Potawatomi Nation & Chris Cuomo, Professor, University of Georgia
•
Importance of awareness of one’s place in a web of actors including
humans, non-human beings and entities and collectives
•
Interdependent relationships that motivate reciprocal responsibilities
•
Virtues include wisdom of elders, attentiveness to the environment,
and indigenous stewardship
•
Restorative work that can generate responsibility towards current
environmental challenges
•
Autonomy and protection to serve as responsible stewards of the land
Acknowledges the more-than-human actors