06_Open Session - Portsmouth Cathedral

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Open Session
David Carpenter
28th October 2015
Portsmouth Cathedral
16 September 2015
Who is my neighbour 1? The so-called migrant problem.
23 September 2015
Who is my neighbour 2?
World hunger, disease and other challenges faced by developing
countries.
30 September 2015
The perfect person1. The moral landscape of new reproductive
technologies
7 October 2015
The perfect person 2. Worthwhileness of life in the face of
progressive disease and disability. Euthanasia- including assisted
suicide.
14 October 2015
Law and order; crime and punishment. How can the scales of
justice be balanced morally?
21 October 2015
Open session. It is likely that participants will identify further
topics – this session will be devoted to some of these.
Request 1
Can you talk through the concept of ‘the perfect person’? Both
of the last two lectures were entitled ‘The Perfect Person…’ but I
cannot remember how the concept was related to the main
content of the talks. I have read through the powerpoint
downloads on the Cathedral website but they do not cover the
ground that concerns me. It seems to me that the ‘perfect’
person idea has been superceded, in the wake of modern
scientific understandings, by the concept of ‘imperfect’
organisms – and that includes humans. As such it might be
possible to ‘improve’ a person but not to ‘perfect’ in any but the
most partial sense. I suspect that this offers an alternative basis
for ethical considerations. Can you comment on this possibility?
Request 2
Could we ask David Carpenter to explore the ethical
issues relating to the conduct of business between
countries where fundamental political and social
differences exist?
A topical example might be where the UK Government is
seeking huge capital investments in this country by
China. Another example might be on the subject of
Overseas Aid.
………………..there were some very nice compliments
after this
Suggestion from last week
• Medical Ethics
• Case study
Request 1
Can you talk through the concept of ‘the perfect person’? Both
of the last two lectures were entitled ‘The Perfect Person…’ but I
cannot remember how the concept was related to the main
content of the talks. I have read through the powerpoint
downloads on the Cathedral website but they do not cover the
ground that concerns me. It seems to me that the ‘perfect’
person idea has been superceded, in the wake of modern
scientific understandings, by the concept of ‘imperfect’
organisms – and that includes humans. As such it might be
possible to ‘improve’ a person but not to ‘perfect’ in any but the
most partial sense. I suspect that this offers an alternative basis
for ethical considerations. Can you comment on this possibility?
Perfection and Perfectibility 1
• Perfect organism -The perfect person1.
The moral landscape of new reproductive
technologies
• Perfect death - The perfect person 2.
Worthwhileness of life in the face of
progressive disease and disability.
Euthanasia- including assisted suicide.
Perfection and Perfectibility 2
• Technical – perfecting talents and skills
– Teleological perfectibility
– Realising potentialities (where potentialities are seen as
good and evil conceptualised as a failure)
• Moral
– Kant – we know what we ought to be
– Utilitarians
• Christian
– Sinlessness
– Reference to the example of Christ
To assert that man is perfectible may
mean either:
• There is some task in which each and every man can perfect himself
technically technical perfection
• He is capable of wholly subordinating himself to God’s will
obedientiary perfection
• He can attain his natural end teleological perfection
• He can make himself a being who is metaphysically perfect
immaculate perfection
• He can make himself a being who is harmonious and orderly
aesthetic perfection
• He can live in a manner of an ideally perfect human being moral
perfection
• He can become godlike exemplary perfection / deiform perfection
Passmore, J. (1970) The Perfectibility of Man. London: Duckworth
Request 2
Could we ask David Carpenter to explore the ethical
issues relating to the conduct of business between
countries where fundamental political and social
differences exist?
A topical example might be where the UK Government is
seeking huge capital investments in this country by
China. Another example might be on the subject of
Overseas Aid.
………………..there were some very nice compliments
after this
Human Rights
Principle 1: Businesses should support and respect the
protection of internationally proclaimed human rights; and
Principle 2: make sure that they are not complicit in human
rights abuses.
Labour
Principle 3: Businesses should uphold the freedom of
association and the effective recognition of the right to
collective bargaining;
Principle 4: the elimination of all forms of forced and
compulsory labour;
Principle 5: the effective abolition of child labour; and
Principle 6: the elimination of discrimination in respect of
employment and occupation.
Environment
Principle 7: Businesses should support a precautionary
approach to environmental challenges;
Principle 8: undertake initiatives to promote greater
environmental responsibility; and
Principle 9: encourage the development and diffusion of
environmentally friendly technologies.
Anti-Corruption
Principle 10: Businesses should work against corruption in all
its forms, including extortion and bribery.
The extent of the arms embargo on China
An arms embargo is a ban on the export of ‘arms and related material’ - ie military ammunition,
weapons and goods - which may be imposed by a number of organisations, including the UN, the EU
or the Organisation for Security and Co-operation in Europe. It may also be imposed at a national level.
The UK interprets the scope of the China embargo as:
•lethal weapons, such as machine guns, large calibre weapons, bombs, torpedoes, rockets and missiles
•specially designed components of the above and ammunition
•military aircraft and helicopters, vessels of war, armoured fighting vehicles and other such weapons platforms
•any equipment which might be used for internal repression
Civil Society
Civil society is the "aggregate of non-governmental organizations and institutions
that manifest interests and will of citizens."[1] Civil society includes the family and the
private sphere, referred to as the "third sector" of society, distinct from government
and business.[2] Dictionary.com's 21st Century Lexicon defines civil society as 1) the
aggregate of non-governmental organizations and institutions that manifest interests
and will of citizens or 2) individuals and organizations in a society which are
independent of the government.[1]
Sometimes the term civil society is used in the more general sense of "the elements
such as freedom of speech, an independent judiciary, etc, that make up a democratic
society" (Collins English Dictionary).[3] Especially in the discussions among thinkers of
Eastern and Central Europe, civil society is seen also as a concept of civic values.
One widely known representative of this concept is the Polish former dissident Adam
Michnik.
Volunteering is often considered a defining characteristic of the organizations that
constitute civil society, which in turn are often called "NGOs", "NPOs", or CSOs. Most
authorities have in mind the realm of public participation in voluntary associations,
trade unions and the like,[4] but it is not necessary to belong to all of these to be a part
of civil society.
https://en.wikipedia.org/wiki/Civil_society
Overseas Aid
• Deontology – Kant
• Utilitarianism – may have economic as
well as moral ends
• Rawlsian analysis
• Nozickean response – justice in
rectification
Ethics and the NHS
• The golden age of cures
• The growth of treatment
possibilities
• The shift towards
enhancement
Moral Reasoning – Practical Ethics
•
•
•
•
Deontology
Consequentialism
Virtue Ethics
Principlism
–
–
–
–
Beneficence
Non-maleficence
Justice
Respect for autonomy
• Global common good
A Rough
Framework
Cure
Choice
Chance
Enhancement
Historical Position
Cure
Choice
Chance
Enhancement
Historical Position
Cure
Strangely Comfortable
•
Much greater sense of
the spiritual
• Appeal of scepticism
• Limited professional
power
• Virtue and compassion
above professional
knowledge and skill
Choice
Chance
Enhancement
Today
Cure
Strangely Disturbing
Choice
• Displacement of the
spiritual
• Impossible demands
• Limitations of
knowledge and skills
• Compassion
displaced by
helplessness
Chance
Enhancement
Cure
Moral questions
related to
intention / motive
/ duty
Enhancement
Moral questions related to
autonomy and liberty
Choice
Chance
Sworn Oaths and
Declarations
Whatever, in
connection with my
professional practice, or
not in connection with
it, I see or hear, in the
life of men, which ought
not to be spoken of
abroad, I will not
divulge, as reckoning
that all such should be
kept secret.
• About (in)action
• A life of virtue
• Possessing certain
dispositions
• About the actor not the
act
Gradual Shift –from
swearing oaths
• From actor to act
• From being to (not)doing
• From actions to principles
Case Study
M and D
Ought I be doing this?
D – a fairly ordinary case
•
•
•
•
•
•
Nearly 84
Intelligent but under-educated
Gout
Diabetes
Sciatica
Limited mobility
D’s Choices
•
•
•
•
Openness
No heroic treatment
Die at home
Lots of family involvement (actually quite
demanding)
Significant Deterioration
•
•
•
•
Immobility
Shaking
Increased dependency
Extremely hypotensive
VSD – with severe pulmonary
hypertension
•
•
•
•
Should I have been told?
What ought I to tell D?
What ought I to tell M?
What ought I to do – given D’s wishes?
http://www.bbc.co.uk/ne
ws/health-27887292
D deteriorates
•
•
•
•
•
Bed fast
Incontinent
Extreme postural hypotension
Possible UTI
He believes that he is dying
Extreme delirium, confusion and aggression
Diagnosis
• Sepsis
• MI
• Cerebral bleed
Ethical Considerations
• Anticoagulation - ? exacerbated a cerebral
bleed – duty of candour
• CT Scan - ?good use of resources
• What ought to be the goals of any
treatment?
• How much should I be told and how much
should I tell M and D?
Breaches of Confidence
• What were they?
• What role did my knowledge and status
play?
• Were the breaches unethical?
• What would make a breach unethical?
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