Ethics of Health Care

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Ethics of Health Care

• 1/12/04

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Schedule

• Applying Kant
• Current Events
• John Stuart Mill and Utilitarianism

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The Boy Who Ate the Pickle

• Veatch Case 1
• What are the issues?
• What potential solutions exist?
• What would Kant say about them?

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Current Events
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Ethics Primer Basic Concepts

• Conseqentialism
• Rightness of an action depends entirely upon the
  effects that the action has.
• Can be Act or Rule based.

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Ethics Primer Utilitarian Ethics

• John Stuart Mill (1806 - 1873)

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Ethics Primer Utility

• An action is right insofar as it tends to produce
  the greatest happiness for the greatest number

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Ethics Primer Utility

• He who saves a fellow creature from drowning
  does what is morally right, whether his motive be
  duty or the hope of being paid for his trouble
  he who betrays the friend that trusts him is
  guilty of a crime, even if his object be to serve
  another friend to whom he is under greater
  obligation.

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Ethics Primer Utility

• It is better to be a human being dissatisfied
  than a pig satisfied better to be Socrates
  dissatisfied than a fool satisfied.

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Ethics Primer Utility

• It is all in the math
• Action A
• Increase Happiness by 5
• Increase Unhappiness by 5
• Action B
• Increase Happiness by 10
• Increase Unhappiness by 9

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Ethics Primer Utility

• One can increase happy units either by
  increasing pleasure OR by decreasing pain.
• Likewise, unhappy units can be derived either
  from an increase in pain or a decrease in
  pleasure.

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Ethics Primer Utility

• The utilitarian doctrine is, that happiness is
  desirable, and the only thing desirable, as an
  end all other things being only desirable as
  means to that end.
• Whatever is desired otherwise than as a means to
  some end beyond itself, and ultimately to
  happiness, is desired as itself a part of
  happiness, and is not desired for itself until it
  has become so.

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Ethics Primer Utility

• A test of utility

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Ethics Primer Utility

• Telling which of two actions are moral
• How can we tell?
• Who decides?

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Ethics Primer Utility

• Two approaches Maximize pleasure vs. maximize
  preferences
• Problem of expensive tastes
• Animalistic pleasure

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Ethics Primer Utility

• A question of scope

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Ethics Primer Utility

• Act
• Each individual action is considered as to how
  much it maximizes utility. No general rules are
  formed

• Rule
• With each action, one thinks about if a
  generalized rule for utility should be made. A
  set of rules is consulted before taking an action.

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Two Questions

• Do we want our ethical theories to be concerned
  with the utility of the whole society, or with
  the interest of the individual?
• What lines do we draw when we think about
  theories?

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Other Questions

• Are some actions wrong even if they produce good?
• Can an action be immoral but still maximize
  utility?

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Utility in Medicine

• When might this be an appropriate measure in
  medicine?
• What would people who disagree with you say?

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Hippocratic Oath

• Correction to Veatch (193)
• The first line should read I swear by Apollo
  Physician and Asclepius and Hygieia and Panaceia

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For Next Time

• Read Veatch
• Read the Codes of Conduct on-line
• Get Copies from Library
• Think about Groups