According to chapter 18, decision criteria fall into two categories: necessary and imperative.

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According to chapter 18, decision criteria fall into two categories: necessary and imperative.

The Categorical Imperative
According to chapter 18, decision criteria fall into two categories: necessary and imperative.
An Ethics of Duty   

(NOTE:  You must read only those linked materials that are preceded by the capitalized word READ.)   

The Categorical Imperative is supposed to provide a way for us to evaluate moral actions and to make moral judgments. It is not a command to perform specific actions -- it does not say, "follow the 10 commandments", or "respect your elders". It is essentially "empty" -- it is simply formal procedure by which to evaluate any action about which might be morally relevant.

Since by nature (according to Kant) the moral law is universal and impartial and rational, the categorical is a way of formulating the criteria by which any action can pass the test of universality, impartiality, and rationality. That is its only function.

It has several forms or expressions and you need to know the first two . Kant believes that these two forms of the CI are, ultimately, equivalent, and that what one forbids the other forbids also. I suppose you might say that they are two ways of looking at the same "moral reality." How are these two forms related? How are they equivalent? Well, they are equivalent because that which makes human beings intrinsically valuable (this is the focus of the second expression of the CI) is reason and freedom, and it is precisely the demands of rationality (which is the precondition of freedom) that provide the criteria for evaluating moral actions in the first expression of the CI. In other words, it is because other people have (universal) reason and freedom that you should never treat them as merely means to your own ends, and it is that rationality which provides the criterion for evaluation found in the first expression of the CI.

Both forms of the CI are intended to be expressions of the common, ordinary moral sense that we (most of us, anyway) have that there are some actions that are simply wrong.

What is the relationship between the two forms of the Categorical Imperative?

An imperative is a command. "Close the door!" "Brush your teeth!" "Study hard!" "Don't forget to button your shirt." According to Kant, however, these commands are abbreviations.

  • "Close the door, so that your father can hear the game."

  • "Brush your teeth, so you don't get cavities."

  • "Study hard, so you can get a good job, and give your poor parents some peace."

  • "Don't forget to button your shirt, so your date doesn't think you're an idiot."


They are "hypothetical imperatives" -- Kant means that the commands depend upon the goals to be fulfilled. These are particular goals that depend upon personal situations, particular human goals and desires and dispositions. Hypothetical imperatives are commands that apply only in particular circumstances, for particular people who happen to have these desires, these goals.

The Categorical Imperative is universal and impartial -- universal because all people, in virtue of being rational, would act in precisely the same way, and impartial because their actions are not guided by their own biases, but because they respect the dignity and autonomy of every human being and do not put their own personal ambitions above the respect that others deserve.

Notice that the above is NOT a description of how everybody does behave -- as an ethical theory, it is concerned to describe how people ought to behave.

Kant is not condemning hypothetical imperatives. In fact, he agrees that these are the sorts of imperatives that we live by are hypothetical in nature. But they are not moral. (They are not immoral -- they are non-moral.)

What is the function of reason?

Reason has a lot of functions. It has a theoretical function (science, for example) and a practical function. We are interested in the practical function -- practical in the sense that reason determines (along with emotions and desires) human behavior and choice. But the practical function can be understood to have two parts -- as a "means-ends" function, and as the moral function. Kant, as it should be clear to you by now, does not equate moral reason with the calculative reason of the utilitarians or the egoists. But he does not condemn this side of practical reason, either. It has its proper place in human life, and it is an exceedingly important place. But calculation of means and ends must be supported with a different type of reasoning -- moral reasoning.

And how does this side of human reasoning work? What is it's nature?

Human reason is principally constituted by the search for universality and necessity. This conception of reason shows Kant to be deeply and profoundly influenced by the Enlightenment, and the Enlightenment's pursuit of natural science. For Kant, this search for "natural laws" in science is the crucial aspect, the constitutive element of rationality per se. And just as the discovery of universal laws is absolutely central to natural science, so is the search for universal laws central to human morality. It is this aspect of reason which is at the heart of the demand for impartiality and justice. When a Judge make his/her decision in applying the law, we hope and trust that s/he is not driven by his or her feelings, or passions, or biases, or ambitions. No, we want the Judge to be rational -- to put aside those personal attachments which might influence his or her ability to ignore such things as the color of your skin, or the shape of your body, or the spelling of your name, or the patterns of your clothing, or the length of your hair. What matters is the law. What matters is the Judge's unbiased reason.

So it is in ethics as it is in law. The Categorical Imperative is devised by Kant to provide a formulation by which we can apply our human reason to determine the right, the rational thing to do -- that is our duty.

Kant’s links

http://comp.uark.edu/~rlee/semiau96/kantlink.html

For Kant the basis for a Theory of the Good lies in the intention or the will.  Those acts are morally praiseworthy that are done out of a sense of duty rather than for the consequences that are expected, particularly the consequences to self.  The only thing GOOD about the act is the WILL, the GOOD WILL.  That will is to do our DUTY.  What is our duty?  It is our duty to act in such a manner that we would want everyone else to act in a similar manner in similar circumstances towards all other people.

Kant expressed this as the Categorical Imperative. 

Act according to the maxim that you would wish all other rational people to follow, as if it were a universal law. 

For Kant the GOOD involves the Principle of Universalizability!  

Kant argues that there can be four formulations of this principle:

The Formula of the Law of Nature: "Act as if the maxim of your action were to become through your will a universal law of nature."

The Formula of the End Itself: "Act in such a way that you always treat humanity, whether in your own person or in the person of any other, never simply as a means, but always at the same time as an end."

The Formula of Autonomy: "So act that your will can regard itself at the same time as making universal law through its maxims."

The Formula of the Kingdom of Ends: "So act as if you were through your maxims a law-making member of a kingdom of ends." 

Never treat a person as a means to an end.

Persons are always ends in themselves.  We must never use or exploit anyone for whatever purpose. 

Video: Beginner's Guide to Kant's Moral Philosophy

Kant in his Critique of Practical Reason wanted to find a basis for ethics that would be based on reason and not on a faith in a god or in some cold calculation of utility that might permit people to be used for the benefit of the majority.  Kant thought carefully about what it is that all humans would find reasonable as a guide for human conduct.  People think it wrong to kill, lie, steal, and break promises.  Why is this so.  Kant arrives at the idea that humans think these acts wrong because they cannot will that others would do these things because it would mean the end of civilized life, perhaps even the life of the actor contemplating the right way to behave.  One can not will that people lie all the time for that would mean the end to human communications if we could not trust what was said to be true most, if not all, of the time.  Kant thought that there would be perfect and imperfect duties. 

Perfect Duty is that which we are all obliged to do all of the time. 

e.g., no killing, no physically harming others, no lies, no theft, no breaking promises 

Imperfect Duties are those which we should do as often as possible but can not be expected to do always.         e.g., be charitable, loving,

COMPLETE OVERVIEW of KANT and the ETHICS of DUTY

Categorical Imperative Catholic Encyclopedia  http://www.newadvent.org/cathen/03432a.htm

On Probabilities of Determining Maxims of Volition:
  Moral Responsibility in Applying the Categorical Imperative
 
by David R. Jenkins 

http://home.earthlink.net/~dave_jenkins/kant/dj_ci.html 

Glossary of Kant’s terms

http://www.hkbu.edu.hk/~ppp/ksp1/KSPglos.html 

The Categorical Imperative is NOT the Golden Rule

Kant’s Deontology is presented in his  Groundwork for the Metaphysics of Morals

Kant in his Critique of Practical Reason wanted to find a basis for ethics that would be based on reason and not on a faith in a god or in some cold calculation of utility that might permit people to be used for the benefit of the majority.  Kant thought carefully about what it is that all humans would find reasonable as a guide for human conduct.  People think it wrong to kill, lie, steal, and break promises.  Why is this so.  Kant arrives at the idea that humans think these acts wrong because they cannot will that others would do these things because it would mean the end of civilized life, perhaps even the life of the actor contemplating the right way to behave.  One can not will that people lie all the time for that would mean the end to human communications if we could not trust what was said to be true most, if not all, of the time.  Kant thought that there would be perfect and imperfect duties. 

Perfect Duty is that which we are all obliged to do all of the time. 

e.g., no killing, no physically harming others, no lies, no theft, no breaking promises 

Imperfect Duties are those which we should do as often as possible but can not be expected to do always.         e.g., be charitable, loving,

COMPLETE OVERVIEW of KANT and the ETHICS of DUTY

READ: http://en.wikipedia.org/wiki/Immanuel_Kant#Moral_philosophy

Internet Encyclopedia of Philosophy

Categorical Imperative

Catholic Encyclopedia

The Categorical Imperative is NOT the Golden Rule

With the Golden rule you are to:   Act as you would have others act towards you. 

The Golden Rule Around the World

The same essential golden rule has been taught by all the major religions (and philosophies) of the world going back approximately 3500 years.

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Why should willingness to be on the receiving end of like action make it permissible? If masochists are willing to suffer others' sadism, would that make sadism right? More generally, can acceptance of being on the receiving end of like action legitimate anything?

Kant's improvement on the golden rule, the Categorical Imperative:

Act as you would want all other people to act towards all other people.

Act according to the maxim that you would wish all other rational people to follow, as if it were a universal law.  

The difference is this.  With the Golden rule a masochist or a sadist would be justified in causing or receiving pain.  This is not what the Kantian Principle would support. 

From Don Berkich:

" Some  make the mistake of thinking that the First Formulation of the Categorical Imperative is but a badly worded version of the Biblical "Golden Rule"--Do unto others as you would have them do unto you. Nothing could be further from the truth.

The Golden Rule, as Kant well knew, is a deeply misguided ethical principle. To see this, consider the following somewhat salacious example.

Because the same result cannot be obtained by application of the Categorical Imperative, it follows that the Golden Rule and the Categorical Imperative are not extensionally equivalent. "

The Categorical Imperative is NOT the Golden Rule

Glossary of Kant’s terms

PROBLEMS WITH KANT”S THEORY  

1. The theory applies only to rational agents.  It would not apply to non-humans or to humans who are not rational, e.g., humans with brain malfunctioning, illness or persistent vegetative coma.  

2. The theory cannot resolve conflicts between duties:

a.     between two perfect duties

b.     between a perfect duty and an imperfect duty  

How would a person resolve a conflict between two perfect duties such as never tell a lie and avoid harming someone?  What if telling the truth were to harm someone?

How would you resolve the conflict between the perfect duty, say to keep a promise to pick your friend up with you auto at a certain time, and an imperfect duty, say to stop on the way to pick up your friend in order to give CPR to someone, a stranger, and save that stranger’s life? 

3. A clever person could phrase the maxim to be universalized in such a manner as to permit almost anything.  By placing qualifiers on the maxim or peculiar definitions on terms a clever actor could satisfy the categorical imperative and yet be acting in a manner otherwise not consistent with it. 

What if someone were to promise to be faithful to his mate and not have sex with another woman.  Then that person engages in oral and anal forms of physical interaction leading to orgasm and yet thinks that the promise was not broken because the meaning of “sex” did not include those forms of interaction.

There are other theories.  We shall move on to examine them.


Page 2

(NOTE:  You must read only those linked materials that are preceded by the capitalized word READ.) 

The first significant and unique contribution to the study of Ethics by an American has been that of John Rawls, a Professor of Philosophy at Harvard University.  He developed a Theory of the GOOD as Justice and Justice conceived as Fairness.  His theory was developed to assist a society in ordering its affairs.  His ideas have influenced many lawmakers and Supreme Court decisions in the United States.  Among many examples are the laws for providing equal access to opportunities for minorities and the disabled. 

Rawls wants to use reasoning which all humans have to arrive at the principle of the GOOD.  He is similar to Kant in this regard. He wants to avoid the problems with Kant's theory and he wants to avoid providing any justification for morally outrageous actions which could be justified on utilitarian principles.  He wants to avoid the disadvantages of those approaches.  His approach places humans in a position wherein they view the moral dilemma or problem without knowing who they are in the situation.  What would rational beings decide was best in situations where not all the humans involved are equal in physical conditions , social or economic circumstance?  Rawls believes that humans would resolve the conflict or problem in such a way that whoever was worst off would be not as bad off as they otherwise might be because the person making the decision does not know whether they are gong to be in the position of the worst off.

The Maxi Min Principle is the Principle of the GOOD

MAXIMIZE Liberty (opportunities)

MINIMIZE Inequalities (differences, disadvantages)

The most widely discussed theory of distributive justice in the past three decades has been that proposed by John Rawls in his seminal work, A Theory of Justice. (Rawls 1971) Rawls proposes the following two principles of justice:

(1) Each person is to have an equal right to the most extensive total system of equal basic liberties compatible with a similar system of liberty for all.

(2) Social and economic inequalities are to be arranged so that they are both:

(a) to the greatest benefit of the least advantaged, consistent with the just savings principle, and

(b) attached to offices and positions open to all under conditions of fair equality of opportunity.

(Rawls 1971, p.302)

First priority rule:

Rawls proposes these principles, along with the requirement that (1) must be satisfied prior to (2), and (2b) must be satisfied prior to (2a). Principle (1) and Principle (2b) may also be thought of as principles of distributive justice: (1) to govern the distribution of liberties, and (2b) the distribution of opportunities. Looking at the principles of justice in this way makes all principles of justice, principles of distributive justice (even principles of retributive justice will be included on the basis that they distribute negative goods).

To understand Rawl’s Theory there are three ideas that need to be understood.  Here is a presentation of those three concepts by Professor R.J. Kilcullen .

The Original Position -John Kilcullen
READ http://web.archive.org/web/20010305220127/http://www.humanities.mq.edu.au/Ockham/y64l13.html

Decisions in The Original Position -John Kilcullen
READ http://web.archive.org/web/20010305220527/http://www.humanities.mq.edu.au/Ockham/y64l14.html  The Liberty Principle -John Kilcullen
READ  http://web.archive.org/web/20030217085732/http://www.humanities.mq.edu.au/Ockham/y64l15.html     

Video: John Rawls Theory of Justice

Video Overview of Rawls's approach to Just Distribution

·         The main moral motivation for the Difference Principle is similar to that for strict equality: equal respect for persons. Indeed the Difference Principle materially collapses to a form of strict equality under empirical conditions where differences in income have no effect on the work incentive of people. The overwhelming opinion though is that in the foreseeable future the possibility of earning greater income will bring forth greater productive effort. This will increase the total wealth of the economy and, under the Difference Principle, the wealth of the least advantaged. Opinion divides on the size of the inequalities that would, as a matter of empirical fact, be allowed by the Difference Principle, and on how much better off the least advantaged would be under the Difference Principle than under a strict equality principle. Rawls’ principle however gives fairly clear guidance on what type of arguments will count as justifications for inequality. Rawls is not opposed to the principle of strict equality per se, his concern is about the absolute position of the least advantaged group rather than their relative position. If a system of strict equality maximizes the absolute position of the least advantaged in society, then the Difference Principle advocates strict equality. If it is possible to raise the position of the least advantaged further by inequality of income and wealth, then the Difference Principle prescribes inequality up to that point where the absolute position of the least advantaged can no longer be raised. 

A great video on John Rawls Theory of Justice.  https://www.youtube.com/watch?v=kZ2CaSI1dvM

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There is no one single main point of  Rawl's A Theory of Justice, but one of its main points is to try to move from equality to justice (hence justice as fairness) by measured steps that rational persons would be able to embrace. In this regard it may be the most plausible theory of justice that doesn't depend on emotion, upbringing, self-serving prejudice, class consciousness, and so on. 

1) All theories of human action, social organization, morality rest on idealized or schematic persons and not real individuals. They are not fully scientific in the contemporary sense but they are as close as you can get in morally relevant contexts. Hence Rawls deals with representative persons and invests them with several qualities - rationality, and reasonable self interest being two salient features. If that shoe can't fit the reader then there would be no reason to read further as nothing else will be entirely agreeable thereafter.

2) Rawls does not advocate in any form the equal distribution of resources or their blind redistribution to the disadvantaged. Everyone who has thought the matter through knows that these are socially wasteful distributions. The idea behind Rawls' difference principle is to arrange before-hand (behind a veil of ignorance) for a system of distribution of resources which will differentially reward the socially useful so long as it will always also be to the advantage of the least well off. So. e.g. if we determine that a sanitation engineer is necessary to a well ordered society because his/her activities will be to everyone's advantage we have reasonable grounds to award him/her a disproportionate portion of the available pool of social wealth, and then so on down the line of socially useful pursuits (we want to reward all socially useful activities, discourage the opposite and improve the lot of those who may contribute little or even nothing). This we do theoretically beforehand so we can in the blind determine what a 'just' distribution would be like. Then we are in position to criticize actual distributions that substantially vary from the distribution we selected as 'unjust'.  - - -Stefan Baumrin,  CUNY     (by permission)

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EXAMPLE of Possible Application of Rawls:

Person P is attempting to reach a conclusion as to whether or not to do action A or which action (B,C or D) would be the morally correct thing to do. Well, for Rawls a person would want to consider whether actions A B C D would support or violate the principle of the moral GOOD which for Rawls is the maxi-min principle:

 Maximize the liberty and freedoms of all involved.  Do not restrict or deny the freedom and choice of anyone involved in the situation.

 Minimize the harms or the plight of the least well off in the situation or minimize the differences in the welfare of the least well off as compared to those who are most well off.  Do not make matters worse for those already most disadvantaged in the situation.

- - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - -

PROBLEMS:

Because there has been such extensive discussion of the Difference Principle in the last 30 years, there have been numerous criticisms of it from the perspective of all five other theories of distributive justice. Briefly, the main criticisms are as follows.

1. Advocates of strict equality argue that inequalities permitted by the Difference Principle are unacceptable even if they do benefit the least advantaged. The problem for these advocates is to explain in a satisfactory way why the relative position of the least advantaged is more important than their absolute position, and hence why society should be prevented from materially benefiting the least advantaged when this is possible. The most common explanation appeals to solidarity : that being materially equal is an important expression of the equality of persons. Another common explanation appeals to the power some may have over others, if they are better off materially. Rawls’ response to this latter criticism appeals to the priority of his first principle: The inequalities consistent with the Difference Principle are only permitted so long as they do not result in unequal liberty. So, for instance, power differentials resulting from unequal income are not permitted if they violate the first principle of equal liberty, even if they increase the material position of the least advantaged group.

2. The Utilitarian objection to the Difference Principle is that it does not maximize utility. In A Theory of Justice, Rawls uses Utilitarianism as the main theory for comparison with his own, and hence he responds at length to this Utilitarian objection and argues for his own theory in preference to Utilitarianism (some of these arguments are outlined in the section on Welfare-Based Principles at   http://plato.stanford.edu/entries/justice-distributive/#Welfare

 3. Libertarians object that the Difference Principle involves unacceptable infringements on liberty. For instance, the Difference Principle may require redistributive taxation to the poor, and Libertarians commonly object that such taxation involves the immoral taking of just holdings. (see Libertarian Principles at  

http://plato.stanford.edu/entries/justice-distributive/#Libertarian

4. The Difference Principle is also criticized as a primary distributive principle on the grounds that it mostly ignores claims that people deserve certain economic benefits in light of their actions. Advocates of Desert-Based Principles argue that some may deserve a higher level of material goods because of their hard work or contributions even if their unequal rewards do not also function to improve the position of the least advantaged. They also argue that the Difference Principle ignores the explanations of how people come to be in the more or less advantaged groups, when such explanations are relevant to the fairness of these positions.

5. The Original Position and the Veil of Ignorance may exclude some morally relevant information. the theory excludes in order to promote rationality and is biased in favor of rationality.  

6. Some criticize it for being similar to Utilitarianism in as much as these two principles could permit or demand inequalities and suffering in order to benefit the least well off.

7. Like Desert theorists, advocates of Resource-Based Principles criticize the Difference Principle on the basis that it is not ‘ambition-sensitive’ enough, i.e. it is not sensitive to the consequences of people’s choices. They also argue that it is not adequately ‘endowment-sensitive’: it does not compensate people for natural inequalities (like handicaps or ill-health) over which people have no control.

8. There is also the difficulty in applying the theory to practice.  It is difficult if not impossible for people to place themselves under the Veil of Ignorance in the Original Position in order to formulate what conduct would be required of them by the MAXI MIN Principle.  

9. Some question whether or not people are rational enough to assume the veil of ignorance and operate under the two principles.

10. The theory was developed more to handle problems within society and there are difficulties in applying the principles to individual decision-making involving specific others.

Detailed Overview of the Theory of Justice -John Kilcullen   

The Plight of the Poor in the Midst of Plenty by Jeremy Waldron  A Review of Rawl’s Collected papers


Page 3

 During the Twentieth Century the advanced technological societies of the West and some in the East experienced a decline in the number of people who practiced their religion regularly and accepted a morality based upon Natural Law Theory.  There was a decline in the belief that:

1.         there is a single reality and that humans can have knowledge of it.

2.         there is objective truth

3.         there are absolutes 

This decline can be attributed to a number of factors:

1.         the increase in information about other cultures and their various practices, beliefs and values,

2.         advances in what science and technology could provide for humans in improvements in their basic living along with an appreciation for material goods,

3.         the spreading influence of ideas from the existentialist and pragmatist movements

4.         the spread of democratic ideals 

In the Post Modern view there are no absolutes of any kind and there are no universal truths nor universal criteria for beauty and nor are there universal principles of the GOOD.  Thus, there is a return of relativism in the sphere of morality.  With that return there is also the threat of chaos which relativism spawns.  As reaction to this trend there is an increase in the numbers of people returning to religion and religious principles as the foundation for their moral lives.  The fastest growing religion in the world is Islam.  Islam is increasing in its population through a birth rate higher than average and through conversions.  Islam fundamentalism is growing in the number of adherents.  Fundamentalists of Islam and of Christianity and Judaism are all declaring their condemnation of the current state of moral decline and the rise of relativism and materialism. 

In moral theory there has developed a number of traditions that extol alternatives to the teleological and deontological approaches based upon reason and the belief that universal principles can be reached through the exercise of reason.  

The Existentialists called for an acceptance of the inescapable role of human emotions. 

The Pragmatists focused on the impossibility of reason reaching beyond the frailties of limitations of human reason. 

Feminist theoreticians have devised a number of approaches to ethics that have at least this much in common: the denial of previous theories as being biased and deluded.

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Existentialism  

READ: Existential Ethics

 Nietzsche

According to chapter 18, decision criteria fall into two categories: necessary and imperative.

Nietzsche on Master and Slave Morality

Nietzsche and Morality: The Higher Man and The Herd

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Omonia Vinieris (QCC,  2002)     Nietzsche’s Will to Power

            Nietzsche’s ethical principle of the will to power makes a claim to the egoistic nature of humanity.  The doctrine asserts that all humans strive to forcibly impose their will upon others as a primal drive in their nature compels them to do so.  Man will relentlessly exercise his will over others as an example of his determination, spirit, and strength of character.  To demonstrate and acquire his power and influence is his inherent motivation to act, even if his actions essentially seem unselfishly provoked.  Nietzsche alleges that no true altruistic deeds exist because humans are wholly egocentric and self-seeking by nature.  We may give the impression that we are considerate, caring, and selfless as we may perform kind deeds for others that regard us as humane, but our innate intensions are truly self-absorbed and do not entail goodness or benevolence.  By this, Nietzsche does not suggest by any means that mankind is innately malicious out of its deceptive intentions, but rather that it is more rapt in its own aspirations or purposes of life.  These aspirations are to be esteemed as an example of human prominence and not mistaken for the malice and deterioration of mankind.

            Conversely, sympathy, generosity, and equality are all qualities that one associates with good moral character, not with contemptibility as Nietzsche does.  The noble spirit that Nietzsche speaks of would not embrace these traditional ethical traits.  To manipulate characters of fragility and frailty, to indulge in one’s supremacy, and to pamper one’s self with praise, are preferably what Nietzsche considers to be the intrinsic and admirable traits of the good.  Traditional ethicists revile these characteristics and see them as they may prompt the decaying of civilization.  Nevertheless, Nietzsche merely suggests that it is instinctive of humans to inflict their will to power.  Analogously, the Darwinist theory of evolution verifies such a claim as it is the survival of the fittest that determines what species endures and what species ceases to exist.  The fittest in accordance to Nietzsche’s ethical principles are the good and those who strive to dominate over inferior beings.  Perhaps this is precisely why many conventional ethicists would refute Nietzsche’s will to power.  It is evident that the fundamental institution of morals into society is to impede many of our natural propensities in order to avert the chaotic unruliness that may arise from them.

            Nietzsche distinguishes between noble (masters) and base (slaves) souls.  The concept of a noble soul originates from Nietzsche’s admiration of ancient Greek culture.  The ancient Greeks were an animated people who paradoxically welcomed the inevitability of death, facing the ordeals and hardships of life, whilst celebrating its magnificence.  The noble soul or master, according to Nietzsche, is a replica of the ancient Greek.  He grows comfortably amidst the suffering and toils of human pain as he confronts life.  This confrontation is natural and only drives him to grow and acquire more.  He may have to exploit the base soul for his own good, but this maltreatment of another being only supplements his pride and his will to power.  In this sense, affliction provides the master with the prospect of extensive growth, and does not hinder his path to power.

            On the contrary, the base spirit or slave trembles in the face of affliction.  He does not challenge the hardships of life, but rather seeks to assuage the pain which he finds intolerable.  Such a being seeks out consolation from others out of his apprehension and despicability.  He considers sympathy, benevolence, and equality to be the essential attributes of goodness because they falsely detract from the injustice and agony of life.  The slaves are inferior to the master in that they do not anticipate growing in a torturous, pain-inflicted world.  Nietzsche considers this base soul to represent the greater part of humanity today.  Thus, his ethical principle of the noble’s will to power over the base epitomizes a complete avant-garde reversal of the nature of bad and good in traditional ethical thought.

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Nietzsche’s anti Ethics 

Nietzsche submits this idea of morality to radical critique.  He believes both that the idea is philosophically insupportable and that when we understand its genealogy, we will see that what actually explains our having it are profoundly negative aspects of human life.  Morality is an ideology.  We can believe it only if we ignore why we do.  Central to Nietzsche’s thought is a fundamental distinction between the ideas of good and bad, on the one hand, and those of (moral) good and evil, on the other. The natural form ethical evaluation first takes, he believes,  is that of excellence or merit.  People who excel, who have merits we admire and esteem, thereby have a kind of natural nobility. 

A.  These are “rank-ordering, rank-defining value judgments.” 

We naturally look up to, we respect and esteem, those with merit.  He calls them “knightly aristocratic values”

B. The “primary” half of the pair is good.  Bad is what is not-good.  What is not worthy of esteem and respect.

C. The “good” features are naturally “positive”:  they affirm and sustain life, vigor, strength, etc., e.g. openness, cheerfulness, creativity, physical strength, agility, grace, beauty, vigor, health, wit, intelligence, charm, and friendliness. 

On the other hand, the “primary” half of the good/evil pair is evil.  The idea of evil is reactive.  It comes from the negation of good.  Indeed, Nietzsche believes that it derives from negating good (natural merit).  And the idea of  moral good is simply the negation of that negation.  It is what is not evil.   The original negation is due to resentment—a psychological process  through which the naturally weak suppress their anger at being slighted by  the strong who consider them of little merit.  Unable to express their anger honestly, they suppress it to an unconscious level, in the “dark workshop” of the human psyche.  It then comes to be expressed not as personal anger, but in an alienated, impersonal form, namely, as moral indignation and resentment.  The strong who disrespect the weak are seen, by virtue of their disrespect, as deserving moral disapproval—as being evil.  

We can see how this process is supposed to work in Nietzsche’s parable of  the lambs and the birds of prey .  The birds see the lambs as their  natural inferiors, as meat.  The lambs are angered by this, but can’t do  anything about it directly by expressing personal anger.  So they express their anger in an impersonal way.  They reproach the birds; they hold them morally responsible for what they lambs see as their evil conduct.  They project the ideology of morality, which is just the impersonal expression of their personal anger and hatred.  Nietzsche is saying that morality is born in denial. 

The problem from Nietzsche’s perspective is that, unlike the birds of prey, the naturally strong have been taken in by this ideology.  Through Judaeo-Christian religion, a “priestly caste” has taken over culture to such a degree that the ideology of morality is now the dominant view.  But in addition to being born in hatred and denial, Nietzsche believes both that the idea of morality is philosophically insupportable (for example, in its assumption of free will) as well as one that has terrible consequences for human culture—it is an ethic of weakness and illness that chokes off genuine human achievement.  

READ: The Ethics of an Immoralist  

PROBLEMS:

a.      Some people feel that the will to power advocated by Nietzsche encourages people to be callous and cruel, ignoring humanity for the sake of gaining power.


b.      Theists argue that it is not the individual who obtains power according to to them; power is something dished out by God.  It is not up to man as to whether or not he will be powerful.  Additionally, God gives rewards for following His ways, not as a result of a power struggle.

c.      Theists can also argue that the will to power can be seen as merely a response to helplessness, as Nietzsche's method for wishing to attain control of a life that is really left up to God.

Sartre - Existentialist Ethics  Professor Zaldiva

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Pragmatism

READ: Pragmatic Ethics by Hugh LaFollette  

For pragmatists the matter of ethics is approached practically.  Our practices are our habits. In pragmatic ethics there is the Primacy of Habits, which empower and restrict.  They explore the Social nature of habits and the relation of habit to will.  For them Morality Is a Habit and being fallibilists, pragmatists know that no habits are flawless.  They also hold that Morality is social and that Changing habits for moral reasons is necessary.

Features of pragmatic ethics

Employs criteria, but is not criterial

Gleaning insights from other ethical theories

Relative without being relativistic

Tolerant without being irresolute

Theory and Practice

“Embracing a Pragmatist Ethic

A pragmatic ethic is not based on principles, but it is not unprincipled. Deliberation plays a significant role, albeit a different role than that given it on most accounts. Morality does not seek final absolute answers, yet it is not perniciously relativistic. It does recognize that circumstances can be different, and that in different circumstances, different actions may be appropriate. So it does not demand moral uniformity between people and across cultures. Moreover, it understands moral advance as emerging from the crucible of experience, not through the proclamations of something or someone outside us. Just as ideas only prove their superiority in dialogue and in conflict with other ideas, moral insight can likewise prove its superiority in dialogue and conflict with other ideas and experiences. Hence, some range of moral disagreement and some amount of different action will be not be, for the pragmatist, something to bemoan. It will be integral to moral advancement, and thus should be permitted and even praised, not lamented. Only someone who thought theory could provide final answers, and answers without the messy task of doing battle on the marketplace of ideas and of life, would find this regrettable”

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Feminist Ethics  

VIEW:Alternative Paradigms: Care Ethics and Feminine Ethics

READ: Feminist Ethics

Journal HYPATHIA  : http://depts.washington.edu/hypatia/

PHILOSOPHY AND FEMINIST THEORY SITES   http://www.library.wisc.edu/libraries/WomensStudies/philos.htm

Feminist Ethics

T

his theory is based on the assumptions that the world is male oriented, devised by men and dominated on a male emphasis on systems of inflexible rules. The goal of feminist ethics is to create a plan that will hopefully end the social and political oppression of women. It is believed that the female perspective of the world can be shaped into a value theory.

Omonia Vinieris (QCC, 2002) on the  Feminist Theory of Care

            It has been conventionally thought by traditional thinkers of ethics that the moral development of females is slow-paced and secondary to that of males.   Standard ethical attitudes entail hostile, aggressive, and masculine principles of authority, supremacy, and social order.  Feminist opponents consider the latter to incite the debasement of women’s moral capabilities and to demoralize the conception of morality altogether.  The “ethics of justice” is often the terminology used to denote moral duty based on the masculine   traits of reason and aloofness.  Feminists strive for vindication by formulating a theory entitled the “ethics of care” to counter its antithetical parallel, the manly principle, “ethics of justice”.

            Ethics of care focus on the morality and integrity of women which primarily center on interpersonal relationships.  Feminine values such as gentleness, sympathy, and genuine caring are devalued and deemed irrelevant to the public world where self-rule and power thrive.  Carol Gilligan, a feminist theorist and psychologist, presumes that the morality of women is merely different from that concerning men’s and that it is not at all inferior as her male counterparts claim it to be.   She profoundly opposes the theories of moral development devised her colleague, Kohlberg, who only confined his study to males.  His study neglects a woman’s ability to possess self-legislated ethical dogma.

Gilligan, in attempt to refute Kohlberg’s philosophy, composes a scale to illustrate the different stages of a woman’s moral development.  In the first stage, the female is only concerned with herself as she is basically helpless and vulnerable and finds comfort in her seclusion.  She steers clear of any type of relation with others.  In the second stage of moral development, she acquires an awareness of others around her and clings on to various personal contacts that she develops.  She feels a sense of responsibility and devotion to care for them.  She essentially cares for and finds interest in the people she relates with.  She is naturally able to sacrifice herself for these people out of her innate goodness.  Finally in the third stage, she masters equilibrium between the first two stages.  She exhibits self concern for herself and others.  In order to essentially care for others, she must care for herself first, and perhaps the reciprocation of care between her and different people is an indication that she cares for herself.  This universal factor of ethical principle verifies a woman’s ability to control the moral principles concerning her, as it also exemplifies the potency she holds in concurrently providing for others.  

Gilligan further goes on to say that an ethics of care is an essential component of ideal moral thought.  Children must be taught to “value their hearts over their heads” (Gilligan) rather than disregard their natural emotions in fear of resorting to subjection which defies the traditional male-oriented “ethics of justice”.  In sum, women and children may exhibit more moral depth than men (Gilligan).

If women are to tolerate the impersonal and “rational” principles anchored in the “ethics of justice” they might as well become merciless, heartless brutes.  However, women are humane and acknowledge the fact that genuine impartiality requires emotive input in ethical reasoning and assessment.  In order to judge morally, we must identify emotionally with the individual to make sense of his or her motives that triggered their actions.  Yet, masculine or “traditional” ethical principles eschew the idea of involving emotion in moral judgment.  Sarah Hoagland comments that traditional ethics undermine rather than promote individual moral ability and agency because the direction of traditional ethics is impersonal and merely focuses on control and social organization.  Thus it does not uphold individual integrity as social organization is acquired through oppressive and authoritative means. 

Unfortunately, feminists realize that in their own quest to incorporate their “ethics of care” principle into the canons of society, society is much too fixated on the masculine tenets of competition and self-interest.  An environment based on interfamilial relations and mutual communication is one where an “ethics of care” ideology will be embraced by its people.  Human emotional responses are now a low key supplement to traditionalist ethical principles, as sensitivity and kindness were never equated with human goodness.  Yet, it still seems that rationale and intellect overpower these feminine aspects in a male-dominated world.    

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Sharon Higgins (SCCC, 2005) on FEMINIST ETHICS

Feminist ethics and care ethics are similar in that both reject abstract rules or principles that judge the morality of certain actions. The feminist ethical focus is on social arrangements and practices instead. One goal of feminist ethics is to reduce or eliminate women being subordinate to men and for gender equality. This is approached by feminist ethics by critiquing practices and institutions that keep women subjected to men and to make society aware of how it is being done. Feminists support efforts to expose the domination of one group by another and view ethics as a continuous effort to help eliminate social inequality. Social equality is the main goal of feminist ethics and there are concerns about social equality occurring in healthcare because women still dominate in positions of nurses, while men dominate in positions as physicians, which leaves women as nurses subordinates on men.

Feminists have questioned the value of healthcare because if food and shelter were equally distributed to everyone, that would help eliminate the need for expensive health care because more people would be kept healthy.

There is controversy between feminists with assisted reproduction. Some feminists feel that the technology that permits otherwise infertile women to have children empowers them while other feminists argue that reproductive technology causes male dominance and can force women to have children.

There is not a lot of consistency with feminist ethics, there are many different opinions and claims from different feminists. This has caused feminist ethics to be criticized fro not being a coherent ethical theory like traditional ethical theories. The relevance of feminist ethics is questioned with traditional ethical theories because some argue that social equality is irrelevant when deciding to terminate life support.

Feminist ethics is about equality of women and to resolve conflicts that arise and to learn about the many different factors that influence the varied views of different feminists.

***************************************************** 

Virtue Ethics | Ethics Defined

Kathy Krisman (SCCC, 2005) on CARE ETHICS

Care ethics is a strand of feminist care ethics. Like feminist ethics the basis for ethics rejects the idea of abstract principles. More accurately it is a conglomerate of beliefs of how values should be seen in people’s character and how they act. Carol Gilligan was a psychologist whose research on morals development contributed to the philosophical ideas of care ethics. She researched the idea that women have a different style of moral reasoning then men have. Women tend to focus on details and personal relationships. Away to resolve conflict for woman would be to avoid harming anyone and to keep everyone in the situation as happy as possible. Men on the other hand tend to analyze the situation and then use abstract rules to guide them in finding a conclusion. Care ethics share general ideas and a point of view as feminist care ethics, but does not concern themselves with feminism as much.

The main idea of care ethics is values not principles. Care ethics says it is not appropriate to think with rules of principles where a type of relationship is concerned. For example a mother should not use a principle to decide to help her child or a friend help another friend. Certain relationships likes these do not need a rule or principle to tell the person what the right decision is. Care ethics understand that situations are complex. The point to care ethics is to resolve the problem with everyone’s concerns in mind. They do not care who is wrong or being treated unfairly. Their main concern is to instill values such as the importance to personal relationships, the respect of individuals and the respect for responsibility. Care ethics sees there as being an obligation to teach all in our society to respond correctly to moral situations with the values above in mind.

When faced with medical issues, care ethics believes everyone should know everyone’s views who are involved in the conflict. Each side should present their concerns and the possibilities of care. Once all the information is provided it may be easier to come to a decision. The decision may be one that they arrive to together completely different from the original two conflicting decisions. Although the outcome is not for certain an educated, informed decision is arrived at. Each person in the situation might get a greater understanding of why the other has the beliefs they have. Care ethics is based on the traditional beliefs that traits like compassion, sympathy, kindness and willingness to take responsibility should be present in human character. Such things like medicine, nursing, and other simpler areas should have these values. We should rely on values of care and not on a principle or a rule to resolve our conflicts.

Although care ethics sounds like a good way to resolve conflict it too has its problems. It has been found that Gillian’s’ research on woman and men’s reasoning is a bit out dated. It has been found though that Gillian’s claims are not detrimental to care ethics. The importance of values is enough to show how care ethics can be used in life situations. Some feel that the basis of care ethics is what traditional philosophical ethics is about. Disclaiming any evidence that care ethics even exists. The biggest reason care ethics is criticized is because there is no obvious way to resolve conflicts. There may not be enough time in a situation to debate it and in the end no real decision can be concluded. The person having to make the decision may have their own reasons for why they choose the decision they do. Many will find the decision based on the care ethics to still be unfair.

Suggested Reading : on Feminist Ethics Rita Manning Just Caring

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PROBLEMS WITH THIS THEORY

1. Some philosophers argue that the ethic of care is based on traditional women's values in a quest for new virtues.

2. Beings other than women may not agree because humans often only understand what they can relate to.

3. Gender free morality may be impossible, according to Nel Noddings. Traditional philosophers believed that women were inferior to men and female goddesses were involved in silence, obedience and service. These female roles can be shaped into an ethnic of care according to many women philosophers.

4. It is politically imprudent to associate women with the value of care. 

5. The theory ultimately disempowers women.

6. A  person cannot truly care for someone if she is economically, socially, and/or psychologically coerced to do so.

7. Criticizes the inconsistency of modernism but hold inconsistent norms themselves.

8. Stresses the irrational.

9. Feminists contradict themselves by relinquishing truth claims in their own writings.

10.Calls for behavior that is tailored to each individual situation. If this is the case, then there is no true theory of ethical behavior because you are changing your view of what is acceptable and what is not to suit your needs at the time. 

11.Feminist theories do not allow for the natural tendencies of men. They do to men exactly what they claim was wrongly done to women for centuries.

12. Cared based approach clouds the basic moral code. Emotions and feelings make it easy to break moral codes.

FEMINISM AND POST MODERNISM            http://www.cddc.vt.edu/feminism/pom.html

Post Modernism and its Critics          http://www.as.ua.edu/ant/Faculty/murphy/436/pomo.htm

These are three of many popular theories concerning the GOOD which hold for no single universal principle of the GOOD.  Instead they relate the determination of such a principle to be an exercise in POWER or self service which is put under a disguise of being a rational exercise of an unbiased mind.  What they have in common is a relativism.  The need for societies to have a moral foundation are not being served well by what are at their base appeals to power as the only basis for the resolution of conflict.  For these theories, morality collapses into self serving exercises. 

What are we left with then? 


Page 4

People need some sort of a moral guide through life.  Many may think that they can get by without one but chances are that they are egoists and do have a principle which is guiding them.  If it makes me feel good, if it makes me happy, if I like it and can live with it then it is all right for me to do it.  That may seem like an attractive principle by which we can make decisions until one starts to think about it.  As a guide for all people that principle would lead and does lead to many conflicts.  What is needed in a moral code is something that will enable humans to live with one another in an order rather than in chaos of self-interested action.   

Which of the many ethical principles is the best or which is the one for me?    

Review of the Principles of the GOOD  

ETHICAL EGOISM

my own pleasure  

UTILITARIANISM

utility- the greatest amount of pleasure for the greatest number of people  

CATEGORICAL IMPERATIVE

Act according to the maxim that you would wish all other rational people to follow, as if it were a universal law.  

NATURAL LAW

 What Is Consistent with the Natural Law Is Morally Right and What Is not in keeping with the Natural Law Is Morally Wrong .  The GOOD is what is morally Right or morally correct. 

JUSTICE AS FAIRNESS

The Maxi Min Principle: MAXIMIZE Liberty (opportunities)      MINIMIZE Inequalities (differences, disadvantages)  

   

EXISTENTIALISM

Act according to your Will to Power

PRAGMATISM

Growth and Success are the Final Good

FEMINIST ETHICS

Act with Caring

If a person is tempted to think that several of the theories could be employed in a single life the result would be a person who would choose which theory to employ to support the decision of what that person was to do in a manner that would provide that person with the outcome that the person most preferred.  This approach is a consequentialist approach, which is centered on the outcome for the decision maker.  In other words the actual principle being used would be EGOISM!  Thus someone who claims to be using one principle on one occasion with one situation and then another principle on another occasion would be using that which pleases that person and provides for the outcome desired by the person claiming multiple ethical principles.  The key factor is that such a person wants the outcome desired.

The CHOICE of a theory is based upon individual judgment but need not be arbitrary.

Each person considers the advantages and disadvantages and the strengths and weaknesses and

chooses consistent with that person's values.

The choice is, perhaps unfortunately, for most:

  • Non-arbitrary

  • Slow

  • Methodical

  • Agonizing

  • Promoting courage

Hopefully, by considering the various theories and examining how they would be applied to the various situations and dilemmas involving medical practices and institutions each person will become more aware of their fundamental values and which of the theories is most in keeping with what they think of as the good. Such a theory would then serve as a source of moral guidance.

People should have some principle by which they make their decisions as to what is the morally correct thing to do.  At times doing the morally correct thing will not make the actor happy except to know that they did what was right.  It is only the Egoist that thinks doing what is correct must always make the actor happy. 

Well you may be correct in thinking that most people in the world are Ethical Egoists (EE) in that they think about what pleases them first. But it may be time for humankind to grow up and mature and use reason and decide what each of us  will live and die for. What will be the principle of the GOOD used to make moral decisions?   Do you want to make decisions with yourself at the center or do you want to THINK and arrive at a principle consistent with your values that you will use to make moral decisions and you will attempt to convince others to use as well so that there can be resolution to moral conflicts. EE lacks logic in that there is no consistency or universalizability. It can not resolve moral conflicts as there is no agreed upon principle of the GOOD amongst EE's in a conflict. RESULT: Power plays and violence. At the United Nations they operate with the principle of UTILITY in an effort to resolve conflicts and avoid violence. There are other principles. The religious fanatics who employ tactics of violence and terror such as the Islamicists use DIVINE COMMAND as their principle. The world community appears clearly unwilling to accept such a principle as the basis for moral conflict resolution.  What will the world use in a effort to avoid the violence?

So, which principle is it that we are to use direct our lives and to give it a meaning and a value through our choice?  Each makes the decision.  In Philosophy the attempt is made to consider the principle that would serve best, the principle, which has the fewest disadvantages, and hopefully to find a principle that is the best to meet the demands of the current world situation and is correct as to setting humans on a path of conduct that serves the core values of the human community.

When people are confronted with their impending deaths they often review their lives.  Few make judgments as to its worth based on how much they own.  Most people regard how they treated others and were treated by them as much more important than possessions of material objects.  One’s sense of morality is then seen in retrospect as one of the most important parts of a person’s life.  Did I do the right thing is seen as more important than did I possess as much as I could have or was I as happy as I could have been? 

It is your decision as to which principles will guide your decisions.  There is advice that others can and do give you but it is your decision.  Choose wisely.  For Plato this was the whole point of Philosophy: to assist someone in choosing wisely, in choosing what truly is the GOOD.

The Dialectical Process

In attempting to reach a conclusion as to the morally correct thing to do responsible moral agents should examine the reasons for the beliefs held concerning what is morally correct .   People should reflect on the beliefs held to determine what principles are involved and what values serve as the base for the belief that one ethical principle is to be placed before or over another.  When taking a position on a moral issue or in attempting to reach a conclusion as to what is morally correct the reasoning and responsible person would give reasons for what they hold to be morally correct and and make arguments for the claims they would make .  Humans should examine the moral arguments in a continuing process of review and reflection.  There must be a critical examination of all arguments offered in support of positions taken and urged on others.   In the ongoing process of inquiry into the basic reasoning and the manner in which principles are used the critical examination would look to see that the reasoning was consistent and coherent.   If the arguments do not appear to be well reasoned or not well supported then revisions would be needed or even the discarding of the first argument in favor of another that was either prompted by the inquiry itself or derived from it.  In turn the new argument in support of the new position becomes itself the candidate for subsequent critical examination.  This continuing process is referred to as being dialectical. 

In the critical examination of arguments or positions on moral issues there is a sort of testing of the arguments as the principles used in the argument are applied to cases either actual or hypothetical in order to examine how well they fit the case and resolve conflicts or if they give rise to further difficulties.  Consider a moral argument that sets a high value on freedom of speech and related to freedom of thought and thought as essential to the moral lives of human beings.  In setting the value of freedom of speech nearly as an absolute value or as a high or , perhaps, the highest value what then becomes of that argument when considering whether or not to allow such freedom on the internet and the presentation of child pornography to any and all viewers?

In entering into the process of moral inquiry, even unto the level of examining the most basic principles and values being used, human beings are developing their skill in ethical thinking and along with that they are growing as responsible moral beings.  As humans do this they are developing and defining the moral aspect of their personalities and their moral personhood. 


The answers or positions arrived at through the process of dialectical inquiry and review are going to be subject to the ongoing process for review and criticism wherein humans will consider as many alternatives as they can.  As long as humans have consciousness and a basic sense of morality and they can reason , then they will use their intellectual faculties to examine and re-examine moral theory and ethical principles.


That the dialectical process does not produce single definitive absolute and eternally unchanging answers to moral questions and resolutions of moral dilemmas should not be discouraging in any way.  The answers to moral problems that have been urged on the communities of people in this world have proven to be in need of revisions over time and adaptations have been made.   The absolutism preferred by some has more often proved to be the basis for what in retrospect appears as atrocious behaviors towards those who disagree.   The ongoing process of continual review of moral thinking and refinement of ethical principles appears to offer the human community the hope for advancement as moral beings.   If there is any hope for the people of planet Earth to arrive at some common understanding about how to resolve moral problems and find resolutions to dilemmas it would appear not to be through insistence on moral absolutes to be imposed on all peoples of the world.  Neither would it be to accept any and all ethical principles and moral reasoning to be of equal worth and use.  The dialectical process does reveal weaker arguments distinguishing them from the stronger and the more useful and more adequate to the tasks at hand and more applicable to situations as we actually encounter them. 


The open ended and ongoing process of moral inquiry offers hope for individual and collective advancement in moral maturity.  Through the process of ongoing moral inquiry we learn more about morality itself and about what we value and how we value and how we can better go about resolving our conflicts and dilemmas.  That process may lead to agreement on the values and principles and the reasoning most acceptable to humans who must find common resolution to moral and physical  conflicts without resort to violence of any sort.

VIEW VIDEO on the Dialectical Process    https://www.youtube.com/watch?v=zziTWJPbYyU

What ethical principles do you have as your own due to your experiences and values?

Try using this Ethics self quiz:  GO TO: http://selectsmart.com/plus/select.php?url=EIHinman

Answer the items ONLY in the center of the page.  DO NOT CLICK on the large buttons on the left or right of the center column.

When you have answered all the questions, continue to the Show Me My Results button below.

Ethical Inventory (Hinman)

A SelectSmart.com Selector
By exodus101
This quiz evaluates personal ethical principles and decision making preferences according to prominent ethical theories. (This originally appeared in "Ethics: A Pluralistic Approach to Moral Theory" by Lawrence M. Hinman) 
This SelectSmart.com Philosophy selector, a free online personality quiz, is a creation of exodus101 and for amusement purposes only. The implicit and explicit opinions expressed here are the author's. SelectSmart.com does not necessarily agree.


This text will now turn towards an examination of those various situations and dilemmas involving medical practices and institutions.


Page 5

Chapter 2 :Ethical Traditions

Section 15. Decision Scenarios

How do the principles of ethics apply to actual cases?

Section 5. Decision Scenarios

Summary of Methodology for Analyzing and resolving Cases involving moral dilemmas in Health Care:

Includes: Methodology: Paradigm for the Method: Sample Case Analysis: Introduction to Clinical Ethics, 4th edition

All are at Department of Bioethics & Humanities at the University of Washington School of Medicine.

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Cases and some leading questions:

1. A surgeon S promises someone P that S will perform an operation on P. The surgeon S has an associate A who needs to learn the new surgical technique used by S. S now is considering whether or not S should tell P that A will actually be doing the surgery. If surgeon S was an ACT Utilitarian how would S go about thinking about the right thing to do? If S were a RULE utilitarian how might S think about it differently?

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2. Physician D is treating someone S who is covered by Medicaid. Physician D thinks that Medicaid does not provide enough financial support for the services being rendered by D to S. Further D wants to do a procedure not covered by Medicaid under its rules which D believes to be antiquated and harmful. D is considering filling out the medical forms in such a manner that would supply financial support for what D wishes to do but in a manner that would not be providing accurate reports of what was actually done. If D is a Kantian and uses the Categorical imperative how would D think about this? What conclusions would be reached?

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3.  A child C has a disease. It is life threatening. A bone marrow transplant might help to save the child's life. The child's mother M is having a hard time finding a matching donor for her child. M is getting desperate and is considering getting pregnant again in order to have a child that might be a compatible donor of bone marrow for her daughter C. If M were to ask for moral guidance from a Kantian what would that advice be?

What would a rabbi or priest advise using Natural Law Theory?

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4.  Doctors at hospital H are asked to participate in the test of a new drug D that will cause people to expectorate the contents of their stomachs. It is to be used when people accidentally or deliberately ingest something that causes severe illness and threatens life. Now such a drug would most often be used in emergency rooms and with those who attempt suicide. The doctors are wondering whether or not to participate in the tests. If they do so they are expected to administer the drug D to those brought into the ER. People brought into the ER who would need to have the contents of their stomachs emptied quickly are likely to be those who have attempted suicide. Now the doctors are wondering if they can inform people who are to receive the test drug of the experiment and get their permission for participating in the test. If they do stop to inform them and get permission many of those people may not give it as they had wanted to die in the first place. Others may not be conscious and rational at a level that they can understand what is being told to them.

If the doctors were to use the principles of John Rawls how might they go about their deliberations? What conclusion would be based on Rawls principles?

===============

5. Doctor O performs corrective eye surgery using laser techniques. Doctor O has been doing so for a number of years. Doctor O advertises in a variety of media. Doctor O's practice is quite large and there are several offices throughout the neighboring counties. The doctor charges a premium price for the procedures because of the reputation the doctor has achieved and the large number of successful operations. Doctor O has taken several other physicians into the practice. People who contact the practice are told that there is a difference in the fee charged for each procedure depending on which doctor performs the operation. Those doctors with more completed procedures charge more. The founder of the practice, doctor O, having done the most , charges the most. $750 per eye for the novice physician and $4000 per eye for doctor O.

Doctor O has a very large annual income and a very nice life style and so doctor O wishes to spend less time in the office and surgical room and more time enjoying life. Doctor charges people the full fee for doctor O's services but without informing the person having the operation the doctor often has another physician do most of the work, sometime all of it, if the person consents to being unconscious for the procedure. Doctor O sees nothing morally wrong with this practice. Doctor O enjoys the income, thinks the practice is good for the other physicians, and thinks that recipients of the procedure are happy with the results. Doctor O thus has no problem with what is going on. Morally doctor O thinks it is a "win win" situation and so quite right.

Doctor O is using what type of moral justification for the practice? Do you accept it? Why or why not? What do you think the doctor should be doing if you disagree with what is being done?


Page 6

© Copyright Philip A. Pecorino 2002. All Rights reserved.

Web Surfer's Caveat: These are class notes, intended to comment on readings and amplify class discussion. They should be read as such. They are not intended for publication or general distribution.