Health Sciences 2610F/G Chapter Notes - Chapter 1: Immanuel Kant, Cultural Relativism, Casuistry

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
Principles of Medical Ethics Code emphasized on: a set of principles: not only
non-malecence (not harming) but also benecence towards patients.
Bioethics: a discipline that combines biological knowledge with knowledge of
human value systems.
Bioethics is the study of the ethical dimensions of medicine and the biological
sciences  emerges from the intersection of science, medicine, and ethics.
Before the second half of the 20th century, those principles were applied
paternalistically, meaning that the physician alone determined what happens to
the patient.
Late, a shift in this authority towards recognizing the patients right as well.
This shift lead to the development of the principal of autonomy, which is the
capacity and the right to self-determination (to formulate your own plans and
make your own decisions).
Respect for autonomy derives from two fundamental principles from two distinct
traditions of moral theory:
1) Immanuel Kant’s principle of respect for persons as autonomous ends in
themselves.  We have the capacity for reason and we can apply the law to
ourselves.  This is the core of the deontological tradition.
2) John Mill’s principle of liberty  says that a person is sovereign over his or her
own body and mind.  core of liberal tradition
Throughout time  more medical advances occurring due to medical technology
improvement
The principle of Justice then emerged as the 4th principle of medical ethics.
So far the 4 principles are: 1) Non-malecence 2) Benecence 3) Autonomy 4)
Justice.
More medical development allows us to sustain life longer, which caused a shift
in the denition of death and what is the main focus of death (brain vs.
heart/lungs)
The Need for Theories
In order for us to be able to answer ethical questions regarding medical
practices, we need to appeal to ethical theories in giving reasons and arguments
to justify a particular action or policy.
Ethical theories provide a framework that enables us to critically re9ect and
rene the intuitions generated by issues and cases. This process will enable us
to ve reasons for or against a position/argument.
Arguments need to be consistent and logical
The argument must provide strong logical reasons. The stronger the reasons, the
more convincing the argument, and the stronger the justication’s for doing it.
An action can be obligated, prohibited, or permitted.
Obligated  there is an ethical reason supporting it.
Prohibited  there is an ethical reason against it.
Permitted  there is no ethical reason against it.
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What is biomedical ethics??  It is the study of what one is obligate or
permieeted to do, or prohibited from doing in di<erent contexts of biotechnology,
medial practice an medical research.
Biomedical ethics is a “species” of normative ethics.
What is normative ethics??  it is the discipline that is concerned with how
people ought to act, what sort of person one ought to be. Or what sort of policies
ought to be implemented.
Normative  because it sets “standards” or “norms” on what is considered wrong
or right.
We use the principles of normative ethics to justify if a specic action is wrong or
right.
On the other side descriptive ethics  deal with how people actually behave NOT
what they should be behaving like ethical wise.
Normative and descriptive ethics however, have to be distinguished from meta-
ethics.
Meta –ethics deals with the formal question of the pint of ethics, focusing on the
broader meaning of “good” vs. “bad” right vs. wrong.


Most normative ethical theories have 2 criteria in common:  !"#
where the right course of action is based on the best reasons for doing it, and
where these reasons are universally accepted facts
$%  each person’s needs and interest are equally important.
For us to make a judgment about a specic action (ethics) we need to have an
understanding about the terms good vs. bad, right vs. wrong (meta-ethics)
&'(
The four ethical principles that we have mentioned are representative of those
two theories.
)!) *&
that are concerned with beneting and not harming patients and bringing in the
best outcome of treatment.
+ *'( focused on patient’s rights, values,
and dignity. Ex: a patient refusing to get a treatment would have to be respected
and the doctor can’t do it.
, *!) *It is concerned with what is due or
owed to persons in terms of the distribution of benets and burdens among
them.
Ethical principles are not absolute, but rather prima facie  which is a moral
obligation that is binding unless it is overridden or outweighed by a competing
moral obligation.
In case of those 4 principals, they all need to be considered in a situation and
some might be outweighed in important more than others in that situation
specically.
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