From Ethical Theory to
Practice
Robert Scott Stewart, Ph.D.
Professor of Philosophy
Chair, Philosophy & Religious Studies
Cape Breton University
Different Levels of Ethical
Inquiry
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Meta-Ethics: Defining the meaning of moral
concepts. E.g., Are ethical claims relative or
universal? What does the term ‘good’ mean? What
role does reason play in ethical judgments?
Normative Ethics: What principles ought to guide us
making ethical decisions?
Practical Ethics: An examination of particular issues
in ethics. E.g., Is euthanasia defensible? Are clinical
drug trials involving children acceptable? Should we
allow genetically modified foods on the market?
Methods for ethics
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Name the issue(s)
Collect and analyze the facts (all stakeholders
+ law and administrative policies)
Ethical analysis of the issue(s) given the facts
Suggestion of alternatives
Implementation and follow-up (Handbook for
Bioethics Committee Members)
Ethical Theories: Utilitarianism
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The greatest happiness principle:
“Actions are right in proportion as they tend to
promote happiness; wrong as they tend to
produce the reverse of happiness.” John Stuart Mill (1806-1873)
A “consequentialist” theory of value. Actions
aren’t right or wrong in themselves: it always
depends on the context and the (expected)
consequences.
Utilitarianism: Pros
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Straightforward: provides one principle as the
moral test of all actions (monistic theory of
value).
Intuitive appeal: we all seek happiness
Has particular appeal with respect to ‘public’
morality or law. I.e., Social programs ought to
aim for the biggest bang for the buck – high
satisfaction, low cost (cost-benefit analysis:
efficency).
Utilitarianism: Cons
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How do we measure happiness (or pleasure)?
Is my happiness (or unhappiness) comparable
to yours?
Possibly inconsistent with individual rights.
E.g., in cases where trampling of my rights
would produce overall utility.
Possibly inconsistent with other things of value
like loyalty and friendship.
Deontology
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Kant and the first version of the categorical
imperative.
“Act as if the maxim of your action were to
become through your will a universal law of
nature.”
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Immanuel Kant (1724-1804)
A secular version of the golden rule: “Do onto others as
you would have them do onto you.”
I.e., universalize your actions
Deontology
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Kant’s second formulation of the categorical
imperative.
“Always treat humanity, whether in your own
person or that of another, never simply as a
means but always at the same time an end.”
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Kant (1724-1804)
Persons vs. things or mere objects
Dignity and autonomy
Deontology: Pros
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Straightforward: provides one principle (with
two formulations) as the moral test of all
actions (monistic theory of value).
Intuitive appeal: humans do typically feel
special and hence deserving of respect by not
being used and by being allowed to make
decisions over their own lives.
Good ground for individual rights.
Deontology: Cons
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Too restrictive and context independent.
Is it always wrong to lie? Are there no
exceptions?
Should we never assess the morality of our
actions by their consequences?
Offers no clear path when we have conflicting
obligations.
The impact of Utilitarianism and
Kant
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Despite their problems, utilitarianism and
Kantian deontology provided the two main
ethical theories in use until the late 20’th
century (and are still tremendously influential
today).
Alternatives:, (1) care rather than justice, (2)
virtue ethics, (3) case studies (casuistry), (4)
pluralism.
Theories of Care and Feminism
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Carol Gilligan (Harvard), In a Different Voice, 1982
Attacked Kohlberg’s theory of moral development as biased
toward a male perspective who prefer abstractness and
universals over the concrete and relationships .
While males prefer abstract principles (like utilitarianism and
Kantian deontology), females show a preference for
relationships with specific people.
Led to much feminist thought including the “ethics of care.”
Feminism and care have been particularly influential in
biomedical ethics since at the core of health care are special
kinds of relationships b/w health care workers and patients.
Virtue Ethics
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Whereas utilitarianism and deontology emphasize
whether a particular action is right or good, virtue
ethics emphasizes the person making the judgments
or doing the actions. I.e., a virtuous person will make
virtuous decisions and act virtuously.
Has its roots in Aristotle (384-322 BCE): stress on
moral education, moderation, and relationships.
Virtue in Greek is arete, which literally means
“excellence.”
Cases
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Don’t worry so much about theory. Look at
actual cases and formulate principles on the
basis of these.
But is this possible with no guidance from
principles at all?
Pluralism
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W.D. Ross (1877-1971) complained that
utilitarianism and Kantian deontology erred in
claiming that there was only one ethical principle (the
greatest happiness principle or the categorical
imperative). This was the main reason why neither
had been able to secure complete acceptance.
Utilitarianism too forward looking
Deontology too backward looking
A need for plurality of ethical principles which would
incorporate elements of the two main theories.
Principalism
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An increasing interest in applied ethics
through the 1980’s and 90’s.
Recognition (by some) that ethical theory as it
stood not adequate to the task of applied
ethics.
Tom Beauchamp (Georgetown) and James
Childress (Virginia), Principles of Biomedical
Ethics (1979, 5’th ed., 2001)
Four Principles
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Autonomy
Nonmaleficence
Beneficence
Justice
Application and use various contexts: e.g.,
codes of ethics and research ethics.
Tri-Council Policy Statement
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Respect for Human Dignity
Respect for Free and Informed Consent
Respect for Vulnerable Persons
Respect for Privacy and Confidentiality
Respect for Justice and Inclusiveness
Balancing Harms and Benefits
Minimizing Harm
Maximizing Benefit
CNA Code of Ethics for Registered
Nurses
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Safe, Competent, and Ethical Care
Health and Well Being
Choice
Dignity
Confidentiality
Justice
Accountability
Quality Practice Environments
Concluding Remarks
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No single paradigm for ethics: principalism is
one attempt to incorporate various strands into
one comprehensive system
Not meant to be algorithmic
Hardest decisions are ones where principles
clash and we have obligations pointing in
different directions.
Sound judgment and humility required