ETHICAL

THEORIES

Vinna Marie Tenorio-Quiñones, MD, FPPS

Asst Professor VI, Department of Medical
Humanities
 OBJECTIVES

• To define ethical theories

• To identify the different ethical theories that can be
used to discuss a medical case
• To explain the individual concepts of Ethical
Principles
• To explain the arguments against the use of theories.
 ETHICAL THEORY

• Deals with the standards and principle of moral

reasoning
• Straightforward approach-ethical theory is starting
point and apply directly to the case
• Rejected by some
 ETHICAL THEORY
• Gives recommendations about practical problems;
• Shows how to test correctness of beliefs, rules, and principles;
• Systematizes and extends beliefs;
• Has some degree of abstractness and generality;
• Is universalizable;
• Is explicit.
• Nussbaum, Martha C., 2000, “Why Practice Needs Ethical Theory: Particularism, Principle, and
Bad Behaviour”, in Hooker and Little 2000: 227–255.
 FORMS OF ETHICAL
THEORIES
• PRINCIPLISM
• CASUISTRY
• UTILITARIANISM (a consequentialist theory)
• VIRTUE
• DEONTOLOGY
 PRINCIPLISM

• an approach to biomedical ethics that uses a

framework of four universal and basic ethical
principles
• most prominently represented in the four-principle
approach to biomedical ethics by Tom L. Beauchamp
and James F. Childress
• respect for autonomy, nonmaleficence, beneficence,
and justice.
 CASUISTRY
• Case based reasoning
• Does not focus on rules and theories but rather on
practical decision-making in particular cases based on
precedent.
• Identify particular features of a case then compare
with other similar cases and prior experiences
• Determine not only the similarities but also the
differences.
 ETHICAL THEORY

• DEONTOLOGICAL – DEON – DUTY

• concerned with right action - doing the right thing simply
because it is the right thing to do.
• Deontological theories focus on whether ethical
decisions per se are right or wrong, regardless of the
consequences or intentions of those ethical decisions.
 ETHICAL THEORY

• TELEOLOGICAL
• telos, which means 'purpose' or 'goal'
• concerned with being good - in other words, with being a
good person with good intentions.
• concentrate on the purpose of - or the intention behind -
human actions. The focus of teleological ethical theories is
on what the goal of a given decision is.
 DEONTOLOGY

• Non-consequentialist
• Attention is on the intrinsic feature of the
action-MOTIVE
• Asks what us our moral obligation in specific
circumstances or according to the general
rules of conduct
 DEONTOLOGY

• Adherence to obligations and duties

• Equates the right or good with our basic
moral duty
• Following obligations to another individual
and society is ethically correct
• Very consistent decisions
 DEONTOLOGY

• In Religious Deontology, the principles derive from

divine commandment so that under religious laws, we
are morally obligated not to steal, lie, or cheat.
• Kantian duty based (deontological) ethics-
CATEGORICAL IMPERATIVE - Act only in such
a way that you would want your actions to become a
universal law, applicable to everyone in a similar
situation
 ARGUMENTS AGAINST
DEONTOLOGY
• Actions as universal law means applicable in all situations like
killing or lying
• Discounts outcome as a valid factor in evaluating the morality of
an action.
• Does not inform us how to develop virtues of character.
 RIGHTS

• Entitlements (not) to perform certain actions, or

(not) to be in certain states; or entitlements that
others (not) perform certain actions or (not) be in
certain state
 RIGHTS
• Who has rights: Children, animals, workers, students,
patients…
• What do the rights pertain to: freedom of expression,
privacy, to remain silent; worship
• Why do we have rights: grounded in moral reasons, based
on societal law
• How a right can be affected by by the rightholder’s actions: The
inalienable right to life, the forfeitable right to liberty, and
the waivable right that a promise be kept.
•
 RIGHTS

• Right as a Privelege/Liberty ex. License to drive

• Right as a Claim – ex in employer-employee relations
• Right as a Power – Changing one’s circumstance ex.
HR determines your job description
 RIGHTS

• A legal system can be seen as a distribution of all of

these varieties of freedom. Any legal system will set
out rules specifying who is free to act in which ways,
and who should be free from which unwanted
actions and conditions. A developed legal system will
also determine who has the authority (and so who is
free) to interpret and enforce these rules.
 ARGUMENTS AGAINST
RIGHTS
• Ex. Freedom of speech – as a right may result to
rallies which may go against the right to enforce
public order
• It can promote selfishness or self-righteousness
• Society has to determine what rights should be
upheld in light of what society’s goals and ethical
priorities are.
• Should be in hand in hand with another ethical
theory
 UTILITARIANISM

• Moral content of an action is determined by the real

and expected consequences of that action.
• An action is morally good if its consequences are
desirable and bad if they are not.
• Actions à to achieve a certain endà with a view to
goal.
 UTILITARIANISM
• Hold that actions should be judged on the basis of
their total costs and benefits for society.
• The action that produces the greatest benefits at the
lowest costs for society is the action we are morally
obliged to follow.
• Pain and pleasure are quantifiable units.
• Intrinsic good or the common good can be
aggregated.
 UTILITARIANISM
• Common good as the moral criterion for action.
• This means that people should act with a view to
maximize the common good for society as a whole.
 UTILITARIANISM

• Rule- utilitarianism tests each action against a rule

that is evaluated against the criterion of utility.
• Seeks to benefit the people through the fairest and
most just means available
• Consequences of an action determine the actions
rightness, but within a framework of a few basic
rules, which tend to maximize good consequences.
 UTILITARIANISM

• The act- utilitarian judges every action separately on

the basis of the criterion of the common good.
• a person performs the act that benefits most people
regardless of personal feelings or societal constraints
• believe that the consequences of an act alone justify
the act’s rightness.
 ARGUMENTS AGAINST
UTILITARIANISM
• The problem of measurement
• The problem of comparison
• The problem of justice
• The problem of rights
 VIRTUE ETHICS

• Object of the analysis is the agent, and the

qualities of the agent
• Intentions and motives
• These qualities determine how an individual will act
in morally problematic situations and can be
evaluated in moral terms..
 VIRTUE ETHICS

• VIRTUE = ARETE; any kind of

excellence, ability to achieve a specific goal
= VIRTU; manliness or bravery,
referring to ability or capability
• Refers to every ethical theory that
formulates norms on the basis of human
characteristics or qualities.
 VIRTUE ETHICS

• Moral virtues are characteristics or qualities. These

qualities
1. are desirable, worthy of pursuing
2. are expressed in actions;
3. have a more or less stable, durable character;
4. are constantly present
5. can be influenced by the subject.
 VIRTUE ETHICS
• Aristotle - The ultimate goal of a human life is to realize
this “highest good,” which is attainable through virtuous
activities. Virtues are the necessary condition for achieving
the highest good, eudaemonia (happiness).
• A virtuous person derives pleasure from acting virtuously.
• A person is virtuous when acting correctly has become
habitual.
• the virtuous individual - aim at the good of others and/or
at certain noble ideals, rather than seek to advance his or
her own well-being.
 ARGUMENTS VIRTUE
ETHICS
• Applicability- cannot produce codifiable principles
• Adequacy – variability between individuals
• Conflict – how to resolve dilemmas
• Self-effacement
• Situationist problems
 USE OF ETHICAL THEORY

• Ethical theories are viewpoints from which

individuals seek guidance for decision making.
• Each theory emphasizes different points – whether
its decision making style or decision rule
• Can be used together or individually
 EXAMPLE

• Dr. Magenta a reproductive health specialist is seeing her

bestfriend’s husband, Mr. Blue, for infertility work up. In the
course of the consult she discovers he has Syphilis. His partner
of course is ignorant of his condition.
• What can Dr. Magenta do in this situation?
 DEONTOLOGY
• “What I may see or hear in the
course of the treatment or even
outside of the treatment in regard
to the life of men, which on no • “I will respect the privacy
account one must spread abroad, I of my patients, for their
problems are not
will keep to myself, holding such
things shameful to be spoken disclosed to me that the
about.” world may know. Most
especially must I tread
• Classical Hippocratic Oath with care in matters of
life and death. Above all, I
must not play at God.”
• Modern version, Hippocratic Oath
 DEONTOLOGY

• Accordingly, the moral requirement that health

professionals protect third parties overrides their
prima facie duties of noninterference.
• Moral requirement=Duty (Deontology)
 DEONTOLOGY

• CODE OF ETHICS OF THE PHILIPPINE

MEDICAL ASSOCIATION
• Article II. Section 6. The physician should hold as
sacred and highly confidential whatever may be
discovered or learned pertinent to the patient even
after death, except when required in the promotion
of justice, safety and public health.
 ASSIGNMENT

• If you were Dr. Magenta, what will you do?

• Pick 1 theory that will help defend your answer
 SOURCES
• https://www.soas.ac.uk/cedep-demos/000_P563_EED_K3736-
Demo/module/pdfs/p563_unit_01.pdf
• Wenar, Leif, "Rights", The Stanford Encyclopedia of Philosophy (Spring 2021 Edition),
Edward N. Zalta (ed.), URL =
<https://plato.stanford.edu/archives/spr2021/entries/rights/>.
• Kaptain,M; Wempe, J; 2002, Three General Theories of Ethics and the Integrative Role
of Integrity Theory SSRN Electronic Journal
https://www.researchgate.net/publication/228174813
DOI:10.2139/ssrn.1940393
• Hursthouse, Rosalind and Glen Pettigrove, "Virtue Ethics", The Stanford
Encyclopedia of Philosophy (Winter 2018 Edition), Edward N. Zalta (ed.), URL =
<https://plato.stanford.edu/archives/win2018/entries/ethics-virtue/>.