2011
Marek Vácha
ETHICAL THEORIES
Hedonism
What should I do to live a succesful life?
(hedoné = pleasure, bliss)
 ultimate goal of all our
actions is pleasure
 among human values
pleasure is the highest and
pain the lowest
 actions which increase the
sum of pleasure are right,
and what increases pain is
wrong.
 optimization of calculus of
pleasure and displeasure
Aristippus of Cyrene
(435 – 355?)
 An action is good when it maximises the
amount of pleasure, leading to the
minimum amount of pain.
Utilitarianism
 Jeremy Bentham (1748 – 1832)
 John Stuart Mill (1806 – 1873)
Utilitarianism
 Combination of four principles
 principle of consequences
 principle of hedonism
 principle of tolerance
 social principle
Utilitarianism
 A utilitarian believes in ‘the greatest
happiness for the greatest number.’
 The more people who benefit from a
particular action, the greater its good.
Utilitarianism
„Nature has placed mankind under the governance of
two sovereign masters, pain and pleasure.“
(Jeremy Bentham)
(1748 – 1832)
Jeremy Bentham
 „The blackness of the skin is no reason
why human being should be abandoned
without redress to the caprice of a
tormentor. It may come to be recognized,
that the number of the legs, the villosity of
the skin, or the termination of the os
sacrum are reasons equally insufficient for
abandoning a sensitive being to the same
fate.“

(Bentham, J., (1948) An Introduction to the Principles of Morals and Legislation, Laurence J.LaFleur, ed.
New York, 311)
Jeremy Bentham
 The question is not
 Can they reason? nor
 Can they talk? but
 Can they suffer?

(Bentham, J., (1948) An Introduction to the Principles of Morals and Legislation, Laurence J.LaFleur, ed. New York, 311)
 The cruelty to people, whose nervous system is
the most refined, is worse than cruelty to lower
forms of life, but this is a quantitative difference
only.
 The time will come, when humanity will extend
its mantle over every thing which breathes.“
Utilitarianism
 it is the consequences of human actions that
count
 The principle of utility defines the meaning of
moral obligation by reference to the greatest
happiness of the greatest number of people
 Utilitarianism is a Consequentialist theory of
ethics. Consequentialist theories judge the
rightness (or wrongness) of an action, by
what occurs as a result of doing something.
Utilitarianism
 " . . . actions are right in proportion as they tend to
promote happiness, wrong as they tend to
produce the reverse of happiness. By happiness
is intended pleasure, and the absence of pain; by
unhappiness, pain, and the privation of pleasure.„
(John Stuart Mill)
(1806-1873)
Utilitarianism
 principle of consequences
 „The end justifies the means“
 principle of hedonism
 greatest happiness of the greatest number of
people
What is happiness?
 when highly motivated research scientist
work to the point of exhaustion in search of
new knowledge, they do not appear to be
seeking a professional happiness
 J.S.Mill: such persons are motivated by
success, recognition, or money ( which all
promise happiness)
 Recent utilitarian philosophers: there are also
diverse set of values other than happiness:
knowledge, health, understanding, deep
personal relationship etc.
Critique of Utilitarianism
Critique of Utilitarianism
 the question is, whether human actions
are to be judged right or wrong solely
according to their consequences.
Critique of Utilitarianism
 If a surgeon, for example, could save two
innocent lives by killing a prisoner on
death row to retrieve his heart and liver for
transplantation, this outcome would have
the highest net utility (in the
circumstances), but the surgeon´s action
would be morally indefensible.

(Beauchamp, T.L., Childress, J.F., (2009) Principles of Biomedical Ethics. 6th ed. Oxford University Press,
New York, Oxford, p. 150)
Case Report
 A five-year-old girl has a progressive renal failure and
is not responding well on chronic renal dialysis. The
medical staff is considering a renal transplant, but its
effectiveness is „questionable“ in her case.
Nevertheless, a clear possibility exists that the
transplanted kidney will not be affected by the disease
process. The parent concur with the plan to try a
transplant, but an additional obstacle emerges. The
tissue typing indicates that it would be difficult to find a
match for the girl. The staff excludes her two siblings,
ages two and four, as too young to provide a kidney.
The mother is not histocompatible, but the father is
compatible and has „anatomically favorable circulation
for transplantation.“
Case Report
 Meeting alone with the father, the nephrologist gives him the
results and indicates that the prognosis for his daughter is
„quite uncertain“. After reflection, the father decides that he
will not donate a kidney to his daughter. His several reasons
includes the fear of the surgery, the uncertain prognosis for
his daughter even with a transplant, the slight prospect of a
cadaver kidney etc. The father then requests that the
physician „tell everyone else in the family that he is not
histocompatible“. He is afraid that if family members know
the truth, they will accuse him of failing to save his daughter
when he could have. He meintains that truth-telling would
have effect of „wrecking the family.“
 The physician is uncomfortable with the request, but after
further discussion he agrees to tell the man´s wife that the
father should not donate a kidney „for medical reasons“.
Utilitarian Approach
 probable consequences
 the potential effectiveness is questionable and the prognosis
uncertain
 there is a slight possibility that a cadaver kidney could be
obtained
 the girl probably die without a transplant, but the transplant
offers a small chance for survival
 the risk of death to the father from anesthesia is 1: 10 000 or
1: 15 000
 nevertheless, because the chance of success is likely
greater than the probability that the father will be
harmed, many utilitarians would hold that the father is
obligated to undertake what others would consider a
heroic act that surpasse obligation.
The Problem of Truth telling
 „Even under the guise of benevolent deception, the
idea of not telling the truth to patients is rather suspect.
The suggestion is that the individual is not strong
enough to tolerate the truth, or more time is needed to
prepare the patient for an unpleasant fact.
Unfortunately, this lack of truth telling leads to a
slippery slope, for while it gives comfort to the one
individual, it teaches all others involved – for example
family members, friends, housekeeping staff, and
hospital volunteers – that health care practitioners lie to
their patients. When these others become sick
themselves, they remember the previous deception and
feel they cannot rely on the word of the professionals.“

(Edge, R.S., Groves, J.R., (2007) Ethics of Health Care. 3rd ed. Thomson Delmar Learning, NY, p.62)
Immanuel Kant
(1724 – 1804)
"Act only according to that maxim whereby you
can at the same time will that it should become a
universal law."
 Deontological ethics
 Categorical Imperative
 maxim
 Critique of Pure
Reason
Immanuel Kant
(1724 – 1804)
 Kant's moral theory is
deontological: actions are morally
right in virtue of their motives,
which must derive more from duty
than from inclination.
 The clearest examples of morally
right action are precisely those in
which an individual agent's
determination to act in accordance
with duty overcomes her evident
self-interest and obvious desire to
do otherwise.
Immanuel Kant
(1724 – 1804)
 Of course, human agents
also have subjective
impulses—desires and
inclinations that may
contradict the dictates of
reason.
 So we experience the claim
of reason as an obligation, a
command that we act in a
particular way, or an
imperative.
Immanuel Kant
(1724 – 1804)
 Kant held that morality is derived from rationality,
not from experience, and that obligation is
grounded not in the nature of man or in the
circumstances of the world but in pure reason
 These universal truth applied to all people, for all
times, in all situations
 Human minds works the same way, regardless of
who you are, where you are, or when you are.
 categorical imperative
 categorical = without any exception
Immanuel Kant
(1724 – 1804)
 categorical imperative
 universal application (i.e., binding on every individual)
 unconditionality
 demanding an action
 we must always treat others as ends and not
as means only
Immanuel Kant
(1724 – 1804)
 Categorical Imperative:
 Act only according to that maxim whereby
you can at the same time will that it should
become a universal law.
 we must be willing for the rules we set for
ourseleves to become a „law of nature“
 we must be willing to have such rules apply
universally
Immanuel Kant
(1724 – 1804)
 The essence of immorality, is to make an
exception of myself by acting on maxims that I
cannot willfully universalize.
 It is always wrong to act in one way while
wishing that everyone else would act
otherwise. (The perfect world for a thief would
be one in which everyone else always
respected private property.)
Immanuel Kant
(1724 – 1804)
 "formula of the end in itself" as: "Act in such a
way that you treat humanity, whether in your
own person or in the person of another, always
at the same time as an end and never simply
as a means."
Criticism of Kant
1. The exceptionless character of Kant´s moral
philosophy makes it too rigid for real life.
Real-life situations are so varied that it is
impossible to create rules that can guide us
in all circumstances
2. it is often the spirit of law, rather than the
letter, that provides the arena for rational
decisions
3. even though animals feel pain and pleasure,
they have not any independent moral
standing since they are not rational beings.
 utilitarianism
 deontology
 the end justifies the
 an act in itself would
means
 hodnota jednání
závisí výlučně na
následcích jednání
be either right or
wrong; it could not be
both
 hodnota jednání
závisí výlučně na
způsobu jednání
Not long ago the media told of a family who could not find an
acceptable bone marrow transplant donor for their daughter, who
suffered from a rare form of cancer. In order to gain acceptabel bone
marow, they decided to have an additional child, hoping that the child
would provide the match.
Kantian theorists would find this action unacceptable, inasmuch as
the baby was being used as a means rather than as an end of its
own.
Patients with sensory disorders
 The Universal Declaration of Human
Rights
 Article 7
 All are equal before the law and are entitled
without any discrimination to equal protection of
the law. All are entitled to equal protection
against any discrimination in violation of this
Declaration and against any incitement to such
discrimination.
Common Morality
 is a product of human experience and
history and is a universaly shared product
 is found in all cultures
 is not realtive to cultures and individuals,
because it transcends both

(Beauchamp, T.L., Childress, J.F., (2009) Principles of Biomedical Ethics. 6th ed. Oxford University Press,
New York, Oxford, p. 4)
Virtue Ethics
 Aristotle:
 not „What ought I do?“
 but What should I be?“
 An American medical Association code in
effect from 1957 to 1980 urged the physician
to be
 „pure in character and … diligent and conscientious
in caring for the sick.“
Virtue Ethics
 aretaic ethics (arete = excellence; virtue)
 it is not only important to do right thing but
equally to have right disposition, motivation,
and traits for being good and doing right.
 personal character and moral habit are more
important than a particular action
 without the foundation of individual character
to motivate action, the action-based systems
seemed more mental gymnastics than basis
for morality
Virtue Ethics
 Aristotle: „The moral virtues, then, are
produced in us neither by nature nor
against nature. Nature, indeed prepares in
us the ground for their reception, but their
complete formation is the product of
habit.“
Virtue Ethics
 people become morally virtuous similar to
the way in which people acquire other
excellences and skills, such as driving car
or playing golf, tha is, through practice
 good drivers are not born, but instead
daevelop the skills and instincts necessary to
act intuitively while on the road
 an honest person tells the truth automatically
 a generous person is inclined to share things
with others
Virtue Ethics
 the virtue of courage has two opposites -
cowardice and foolhardiness
 it is possible to have too much fear or too little
Virtue Ethics
 virtue = mean between two extremes
 not every passion has a mean: there is no
mean of murder
Virtue Ethics
 An American medical Association code in
effect from 1957 to 1980 urged the physician
to be
 „pure in character and … diligent and conscientious
in caring for the sick.“
Critique of the Virtue Ethics
 virtue ethics provides little, if any,
guidance for actions
 even kind, honorable, compassionate
beings often do not know the right thing to
do
Aristotle
Kant
man
behavior
virtue ethics
deontology
Bentham, Mill
consequences
utilitarianism