Florida National UniversityBiomedical Ethics: Week 1
Critical Reflection Paper: Chapter 1
Objective: To critically replicate you’re thoughtful of the readings and your competence to rub
on them to your Health care ethics.
ASSIGNMENT GUIDELINES (10%):
Students will judgmentally appraise the readings from Chapter 1 on your textbook. This
assignment is intended to help you assessment, examination, and spread over the readings to
your healthcare ethics as well as become the foundation for all of your remaining assignments.
You need to read the article (in the additional weekly reading resources localize in the Syllabus
and also in the Lectures link) assigned for week 1 and develop a 2-3-page paper reflecting your
appreciative and ability to apply the readings to your ethics. Each paper must be typewritten with
12-point font and double-spaced with standard margins. Follow APA format 7th Edition, when
referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1. Introduction (25%) Provide a short-lived summary of the undertone (not a description) of
each Chapter and articles you read, in your own words.
2. Your Critique (50%)
What is your response to the content of the articles?
What did you absorb about the Types of Ethics? Mention and explain two examples where you
can apply them.
What did you obtain about the key features of the natural law?
What is Deontology Theory and its principles? Apply them your future carrier.
Mention and describe all the principle of ethics and mention example of them that apply to your
professional life.
3. Conclusion (15%)
Fleetingly recapitulate your thoughts & postulation to your analysis of the articles and Chapter
you read. How did these articles and Chapters impact your thoughts about the principles of
ethics?
Evaluation will be based on how clearly you respond to the above, in particular:
a) The clarity with which you critique the articles;
b) The depth, scope, and association of your paper; and,
c) Your conclusions, including a description of the impact of these articles and Chapters on any
Health Care Setting.
Originality: SafeAssign submission required
ASSIGNMENT RUBRICS
Assignments Guidelines
Introduction
Your Critique
Conclusion
Total
1.0 Points
2.5 Points
5.0 Points
1.5 Points
10 points
10%
25%
50%
15%
100%
ASSIGNMENT GRADING SYSTEM
A
B+
B
C+
C
D
F
Dr. Gisela LLamas
90% – 100%
85% – 89%
80% – 84%
75% – 79%
70% – 74%
60% – 69%
50% – 59% Or less.
Chapter One
Theory of
Health Care
Ethics
2
Why Study Ethics?
• Because health care is changing, you need
tools for making necessary and difficult
decisions.
• It will help you better understand patients,
fellow professionals, and the system in
general.
• It will assist you in building and maintaining
your career.
3
Types of Ethics
• Normative ethics
• Is the study of what is right and wrong.
• Metaethics
• Is the study of ethical concepts and theories.
4
Types of Normative Ethical
Theories
• Authority-based
• Egoistic
• Natural law
• Deontological
• Teleological
• Virtue
5
Ethical Relativism
• Ethical relativism purports that there is no absolute
theory for ethics.
• However, this lack of a complete theory does not
mean everything is relative.
• People need to make rational decisions about
ethics-based issues.
• Therefore, ethics theories are useful.
6
Egoism as Ethics Theory
• Egoism is based on the idea that one’s self interest
is the basis of one’s ethics decisions.
• Theory is not helpful in health care ethics because
professionals are taught to set aside self-interest.
• The interests of the patient should come first.
7
Authority-based Ethics Theory
• Decisions about ethics (right or wrong) are based
on central authority such as in a theology or an
ideology.
• For health care ethics, there may be difficulty
deciding which authority is the correct one.
• However, knowing this view of ethics helps with
understanding patients and health policy decisions.
8
Virtue Ethics Theory
• Is founded in the writings of Aristotle.
• Everything moves from potentiality to actuality.
• Character development allows you to actualize your
highest good.
• Eudaimonia should be sought as the highest good.
9
Virtue Ethics Theory
• Eudaimonia means that you seek to build your
character and increase virtue.
• Professional education seeks to develop people of
high character.
• People who work toward eudaimonia become
persons of practical wisdom.
10
Virtue Ethics Theory
• Principles of ethics can help to define your
character and assist with your actions. See Chapter
Two for more.
• Virtue ethics is criticized as being elitist.
• Virtue ethics requires the balancing of conflicting
obligations.
• People with practical wisdom can make appropriate
ethical decisions.
11
Natural Law Theory
• It is founded in the writings of St. Thomas Aquinas
• It assumes that nature is rational and orderly.
• Humans are part of the natural world and are given
the ability to be rational.
• Our natural reason allows us to distinguish right
from wrong.
12
Natural Law Theory
• Reason is also action in that humans can choose to
do good or evil.
• The Principle of Double Effect helps us decided
which action is good.
• Good is also defined as that which helps to
maximize potential such as preserving life, gaining
wisdom, and knowing God.
13
Natural Law Theory
• In natural law, there are some acts that are not
ethical because they violate the ability to reach
one’s potential.
• People who support social responsibility can use
natural law as a foundation for deciding actions.
• Understanding natural law also assists with patient
relations.
14
Deontology Theory
• Comes from the Greek word “deon” meaning
“duty.”
• It is sometimes called duty-based ethics.
• One of the main theorists is Immanuel Kant.
15
Deontology Theory
• The world exists in the form of things we can
experience directly (phenomenal world) and things
that and that exists independent of the intellect
(noumenal world).
• Free will makes ethics possible and without it we
would not need ethics.
16
Deontology Theory
• Areas of character can be used for good or evil.
• Therefore, the only true good is good will.
• The ability to choose to do good is what makes us
human.
17
Deontology Theory
• Actions are judged by their intention and not just
their outcomes.
• Kant attempted to define a rational principle for
making moral judgments.
• The principle is the categorical imperative.
• People can never be used as a means to an end;
they must be respected.
18
Deontology Theory
• The Golden Rule is not a synonym for the
categorical imperative.
• Kant believed that we must act based on duty to
moral law and not on the consequences of our
actions.
• Practicing this in its pure form is difficult in modern
society.
19
Kant and Virtue Ethics
• Pure Kantian ethics is absolute in its definition of
duty but virtue ethics allows for grey areas.
• Kant does not assist with deciding among lesser
evils and greater goods
• Virtue ethics allows the use of tools to make these
decisions
20
Deontology and Policy
• Health care professionals recognize a duty to the
patient,
• Health care managers also have a duty to the
patient, but
• They have duties to the organization and
community as well.
• Conflicting duties must be considered in policy
making.
21
Non-Kantian Deontology
• Recent proponents of the deontology tradition
include John Rawls and Robert Nozick.
• These theorists deal with the idea of justice
through our actions.
• Their thinking influences health care reform, public
health, and other health areas.
22
John Rawls
• John Rawls worked to define the characteristics of a
just society.
• He examined justice as fairness and applied it to
societies that respect the rule of law.
• His work is based on the idea of a social contract
between members of a society.
23
Self Interest and Justice
• Rawls used a hypothetical or mind experiment
called the original position to explain why rational
people would protect everyone’s self interests.
• In this mind experiment, he also included the
concept of the veil of ignorance to help us
understand why we would care about self interests.
24
Self Interest and Justice
• If we were in the original position, we would all be
equal.
• Therefore, we could all be treated in the same way
in a society.
• Therefore, it would be in our self interest to make
sure that everyone is given an equal share of
benefits and burdens.
25
Basic Principles of Justice
• The first principle of justice for Rawls is liberty.
• This principle is also a priority over all other
principles of justice.
• People should have equal right to basic liberties
(see the Bill of Rights).
26
Basic Principles of Justice
• The second principle for Rawls is justification of
inequalities.
• He uses the difference principle to justify when
social and economic inequities are appropriate.
• Physicians are a classic example of the difference
principle.
27
Rawls’ Opponent
• Robert Nozick is also considered to be a
deontologist.
• He represents the conservative tradition and has
great influence in the debate over health care
reform.
• Nozick emphasizes the autonomy and the rights of
the individual.
28
Nozick and Social Goods
• For Nozick, there is no social good that requires
sacrifice.
• We are only “other people”.
• We should influence people to take steps to
improve their own situations.
• Theories like Rawls supports defeat of voluntary
agreements.
29
Nozick and Distributive Justice
• For Nozick, there is no principle of distributive
justice.
• He finds justice in acquisition and owned
resources.
• Historical injustices are not addressed in his
theory except to suggest that society could be
organized to maximize the position of the least
well off.
30
Consequentialism Theory
• Through Mill’s work, this theory is also known as
utilitarianism.
• For this theory, your intentions are irrelevant; all
that counts is the outcome.
• Greatest Good for the Greatest Number is often
used as a summary of the theory.
31
Consequentialism Theory
• Has two main types
• Classical or act utilitarianism.
• Each act considered on its own
• Rule utilitarianism.
• Develop rules that net the greatest benefit
32
Consequentialism Theory
• Rule utilitarianism is used to make health care
policy.
• Exceptions can be made under special
circumstances.
• Rule utilitarianism also allows for negative
consequentialism or preventing the greatest harm
for the greatest number.
33
Consequentialism Theory
• Preference utilitarianism argues that good is
honoring preferences and bad is frustrating
preferences
• Preferences must be known or a substituted
judgment can be used
34
Consequentialism Theory
• Criticisms of utilitarianism include
• The minority is not protected when the greatest good
for the greatest number is the goal.
• Some say this theory means that the ends justifies the
means.
• These criticisms are not valid because respect for
autonomy and liberty is essential to the theory.
35
Use of Ethical Theories
• There is no pure ethical theory; each has strengths
and weaknesses.
• However, health care professionals must make
complicated ethics decisions
• The ability to understand theory enhances your
decision making tool kit.
36
In Summary…
37