Introduction to Ethical Theory
and Moral Decision Making - I

Ethics
– Study of right and wrong/good and bad
– Central Question = “How should I live?”

Medical Ethics
– Study of right and wrong/good and bad in
medical contexts.
What Do We Mean By Studying
Right and Wrong?

Two Approaches:
1. Descriptive: recording the ethical
attitudes of particular individuals or groups
• E.g., what does the CMA Code say?
• Doesn’t ask whether we should listen to those
ethical attitudes, e.g., doesn’t endorse or reject
the CMA Code
What Do We Mean By Studying
Right and Wrong?

Two Approaches
2. Normative: investigating what people’s
ethical attitudes (and actions) should be
• Some would say ‘investigating the facts of
morality’
• Note: for our purposes ‘moral’ and ‘ethical’ are
interchangeable terms
Our Project: Normative Ethics

In this class, our focus will be on
normative medical ethics, i.e., how
people should behave in medical
situations
– A big question: ‘uhhhh....how people
should behave in medical situations,
according to whom?’
According to Whom?

1st answer: Normative Ethics ask how
we should behave in medical situations
if we want to be ethically decent people.
– ‘OK, but what determines what a ethically
decent person is?’
– 2nd Answer: Shut up.
Ethical Value and Other Values

Ethical value is not the only sort of value
– e.g., aesthetic value
– Many would claim however that ethical
value is the most important sort of value

Another important sort: legal value
– What is the relationship between ethics
and law?
Legal Value

Shares many of the basic concepts of
ethical value
– rights
– obligations
– justice

Differs in some respects from ethical
value
– sanctions and enforcement
– source
Illegal vs. Immoral 1

If it’s illegal, is it immoral?
– Ethics provides the backdrop for law. In
order for laws to be legitimate they must
ultimately be ethically defensible.
– Some legally prohibited things are clearly
immoral (e.g., killing for fun), others only
because the legal prohibition is broadly
ethically defensible (e.g., driving when the
light is red).
Illegal vs. Immoral 1

If it’s immoral, should it be illegal?
– Telling lies is in most cases immoral, but
should it really be made illegal?

Moral Value is broader than Legal Value
– Law is about not being bad.
– Morality is about being decent.
A Third Sort of Value: Relational

What about going above and beyond
the standards of ethical decency?
– E.g., being (particularly) kind or empathetic
– Call this Relational Value.
Legal, Ethical, Relational
Relational
Ethical
Legal
The Elements of Moral Discourse

Facts, principles, concepts

When encountering ethical
disagreement or conflict, it is important
to identify the source of the conflict
– Does it arise from differences about facts,
principles or concepts?
Facts, Principles and Concepts



Facts = the concrete details of the
situation being considered
Principles = the moral rules or norms
that are relevant to the situation
described by the facts
Concepts = the categories that have to
be interpreted when deciding what the
facts & principles tell us about the
situation
Playing God I

Fact - e.g., Earl had beaten Kitty on
several occasions
– What about ‘Kitty was a victim of wife
abuse’?
– Facts are supposed to be about
description, not evaluation
– Some, particularly in the late 20th century,
asked whether there was any such thing as
pure description.
Playing God II

Principle - e.g., Do not kill except in selfdefence
– Next session we will consider the source of
such principles

Concepts
– e.g., self-defence
– victim
Playing God III


In an important sense disagreements
about facts are the easiest sort of moral
disagreement to resolve.
Disagreements about principles may be
the hardest sort to resolve
– What was the main source of
disagreement in your discussion group?
Next

Intro to Health Law - Fri. Sept. 6
– No assigned reading

Intro to Ethics II - Mon. Sept. 9
– E/H/HL Foundations - Section 6
– Doing Right - Chapter 1