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1. Introduction To Ethics
Ed Horowicz
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2.  To gain an understanding of the concept of ethics.
 Introduction to contrasting theoretical ethical approaches.
 Introduction to the application and scope of BIOETHICS.
 Introduction to key bioethical principles.
 To gain a basic understanding of the relationship between
ethics and law in healthcare.
 Gain an understanding of how ethics relates to
professional practice.
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Objectives

3.  Ethics is the concept of interpreting morality.
 How should we behave?
 What choices should we make about how we live our
lives?
 What do we consider acceptable in our society?
However!!!
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What is Ethics?

4.  Religions
 Intuitive Feelings
 Cultural Norms
 Laws and Policies
 Professional Codes of Conduct
 Coercion
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What Factors Affect How We Find
Answers?

5.  Looks beyond intuition and the ‘unquestionable
notion’ of influential factors.
 Critical evaluation of ethical arguments in order to
come to a conclusion based on reason.
 Considered as a discipline of moral philosophy
supported by sociology, theology, law, anthropology
and economics.
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The Academic Discipline of Ethics

6.  “Ethics is the enterprise of disciplined
reflection on the moral intuitions and
moral choices that people make”
(Veatch, 1989, p1).
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7.  Should termination of pregnancy be
morally permissible?
 You will have strong feelings over whether this is
ethically acceptable.
 A ‘gut feeling’ based on many influences.
 Through a critically evaluative approach you can move
beyond this to provide a reasoned argument and
rationale for rejecting an alternative position through
the study of ethics.
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Consider…

8.  Consequentialism looks at whether an action is
ethically right or wrong by the consequences it
produces.
 If we are faced with two courses of action then we
should choose the one with the best overall
consequences.
 Considered the ‘common sense’ approach but we
have to consider what is the best or a good overall
consequence. Who decides?
 What happens when we do not know what the
consequences will be? 8
Consequentialism V Deontology
Consequentialism

9.  Utilitarianism is a consequentialist approach which
looks at human happiness.
 The action that leads to the greatest amount of
human happiness is the preferred action.
 Consider resource allocation-
Should we give one person a very expensive treatment
or fund treatment for twenty other people?
Should we open one more ITU bed or two HDU beds?
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Consequentialism-Utilitarianism

10.  Deontology- Holds that certain things are right or
wrong regardless of the consequences.
 Eg- Telling the truth may cause happiness or upset but
is considered the right thing to do.
 Often deontological principles are absolute rights and
fundamental principles, for example the ECHR.
 Key principle is that you cannot justify the breach of a
fundamental or absolute principal just by the
consequences.
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Consequentialism V Deontology
Deontology

11.  Virtue Ethics considers the moral character of the
person performing the act.
 This approach is not concerned with the consequence
or whether the act is carried out in accordance with
moral duties.
 What matters is whether the person carrying out the
act does so in accordance with qualities that are
considered to be virtuous, in other words good moral
intentions.
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Virtue Ethics

12.  Identify the basic consequentialist and deontological
approaches to the following scenario;
 A twelve year old requires a bone marrow transplant
for any chance of survival but the only compatible
match is a thirty year old male who is in prison for
violent offences and refuses to donate his bone
marrow.
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Task

13.  Bioethics is the investigation of ethical issues that arise in
life sciences by applying moral philosophy principles.
Bioethics covers;
 Medicine
 Healthcare
 Genetics
 Biology
 Research
 Pharmacology
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Bioethics

14.  Bioethics is a form of applied ethics. Contemporary
issues include;
 Abortion
 Euthanasia
 Cloning
 Stem Cell Research
 Xenotransplantation
 Genetic Engineering for ‘designer babies’
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Bioethics

15.  Beauchamp and Childress (2008) describe four
principles that should be applied for bioethical issues.
 Autonomy
 Beneficence
 Non-maleficence
 Justice
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Key Bioethical Principles

16.  What does autonomy mean?
 There is no single definition of autonomy.
 Broadly it is the recognised fundamental right that a
person has to self-determination with respect to
choices they make.
 In summary Harris defines it as,
“a form of ‘self government’, where a person should be
able to control their own lives, including their own bodies,
by exercise of their own faculties”(Harris, 1985, at p195).
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Autonomy

17.  Respect for autonomy does present us with ethical
dilemmas.
 What if a decision will cause harm?
 What if that person is mentally incompetent to make
a decision?
 How autonomous should children be?
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Autonomy

18.  What is paternalism?
 Ethical principle whereby the choices of an individual
are overridden by another person in authority in
order to benefit or avoid harm to that individual.
 Is paternalism ever justified?
 Consider children or mentally incompetent patients?
 What if morally we as a society do not agree with a
decision?
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Autonomy and Paternalism

19.  This is the principle that means healthcare
professionals must do good for their patients.
 Positive obligation
 Not without criticism as it can be said to encourage
paternalism and as a result is rarely legally enforced.
 What has to be considered is what is good for that
patient and not what is good for the healthcare
professional.
 In short it is the principle of acting to achieve a
greater good than harm.
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Beneficence

20.  The principal of ‘doing no harm’.
 What though do we mean by doing no harm?
Consider the discomfort of IV cannulation or the potential
postoperative pain that surgery may cause.
 We have to accept that we cannot avoid all harm, so it
is best considered as being that the whole
intervention should not cause harm.
 It appears to mirror Beneficence.
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Non-maleficence

21.  This does not relate to legality but to equality
and fairness in bioethical considerations.
 In other words it encompasses issues such as;
 Equality of action,
 Financial considerations to achieve equality,
 Socio-economic factors affecting access to
healthcare equality.
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Justice

22.  The study of bioethics affects how healthcare evolves
and is delivered.
 Healthcare, medicine and research are regulated by
law. Consider the consequences of research without
ethics in the second world war.
 Often the outcome of medical advancement can be
unknown.
 It is essential to recognise that law and bioethics are
not always a reflection of each other.
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Relationship Between Law and
Bioethics

23.  Simply because something is illegal does not
always mean it is morally wrong.
 Consider the arguments for euthanasia.
 Likewise, because something is legal does not
mean that it is morally right.
 Consider the opposition arguments to abortion
and cosmetic surgery
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Law and Bioethics

24.  Why are ethics part of professional practice?
 Professional codes of conduct exist as a result of the
ethical and legal duties and responsibilities expected
of practitioners.
 Through ethically reasoned argument we establish
what is considered right and a positive obligation, or
what is considered wrong and prohibited.
 Provides a moral standard that patients and staff can
expect from us.
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Ethics and Professional Practice

25.  How do the principals of bioethics apply to advocacy
within your role as an ODP?
 Autonomy
 Beneficence
 Non-maleficence
 Justice
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Task

26. ?
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Questions

27.  Beauchamp.T. and Childress.J. Principles of Biomedical
Ethics. 2009. 6th Edition. Oxford: Oxford University
Press.
 Harris.J. (Ed). 2001. Bioethics. Oxford: Oxford
University Press.
 Mason.J. and Laurie.G. 2013. 13th Edition. Law and
Medical Ethics. Oxford: Oxford University Press.
 Pattinson.S. 2011. 12th Edition. Medical Law and Ethics.
London: Sweet and Maxwell.
 Veatch.R. 1989. Medical Ethics. New York: Jones and
Bartlett.
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References