1. Utilitarianism
    A system of ethics according to which the rightness or wrongness of an action should be judged by its consequences. The goal of utilitarian ethics is to promote the greatest happiness for the greatest number.
  2. Act Utilitarianism
    the right action is the one which produces the greatest amount of happiness or pleasure for the greatest number of beings
  3. Rule Utilitarianism
    Actions are moral when they conform to the rules that lead to the greatest good, or "the rightness or wrongness of a particular action is a function of the correctness of the rule of which it is an instance."
  4. Deontology
    *dealing with duty, moral obligation, andright action

    *Duties and obligations must be determined objectively and absolutely, not subjectively
  5. Categorical Imperative
    • *apply universally
    • *You tell the truth because it is morally right
  6. Not Categorical
    • *is hyothetical
    • = if _____then______
  7. First Formulation
    • Act as though the maxim of your action were by your will to become a universal law.
    • *emphasis on universal
    • *could you imagine a universe that everybody adopted the same maxim (ex. making promises that nobody could make. Then a promise becomes meaningless. Can not universalize the maxim)
  8. Second Formulation
    Act in a way you always treat humanity

    *treat someone mearly (a person can reasonably accept) as it means

    *Can a person reasonably agree to being lied to? No
  9. Triage
    Distributing scarce medical resources

    *using the resources to the group of people that ned it the most and could die without it.

    *Maximize Aggregate Utility
  10. Coincidence
    • *legal and morally right
    • *legal and morally wrong
  11. Divergence
    • *legal and morally wrong
    • *illegal and morally right
    • -permissible
    • -obligatory
    • -heroic
  12. Morality
    a matter of an opinion
  13. Subjectivism
    there is no distinction between what a person approves/disapproves of and what is morally right

    ex- abortion is wrong, this just shows that a person does not agree with abortion but it is not morally right or wrong.
  14. Linguistic
    Meaning of moral statements

    *moral judgments are just reports or expressions of personal attitudes or feelings
  15. Moral Facts
    are those claims that are justified by moral reasons
  16. Moral Objectivism
    The meta-ethical view that moral judgments are objectively correct(or incorrect) and that the task of moral theory and moral reasoning is to achieve correct moral understanding and make correct moral judgments.
  17. What does it mean when moral judgments are objective??
    it means that there IS a distinction between what people BELIEVE is morally right (or wrong) and what is morally right (or wrong)
  18. What are the 3 ways of formulating subjectivism??
    • *Linguistic
    • *Metaphysical
    • *Epistemological
  19. Subjectivism as a Metaphysical
    Regarding the reality of moral values

    *There are no moral facts (as there are scientific facts); no moral order independent of people's responses of approval/disapproval.

    *Moral right and wrong is just a matter of what people feel is right or wrong
  20. Subjectivism as an Epistemological
    Regarding moral knowledge

    • *Moral judgments are neither true nor false;
    • *They cannot be either confirmed/ disconfirmed
    • *They cannot be either correct/ incorrect
    • *Feelings or attitudes are not the sort of thing that can be assessed as true or false
  21. What are the 2 kinds of subjectivism as a linguistic meta-ethical view??
    • *Simple Subjectivism
    • *Emotivism
  22. Simple Subjectivism
    A moral judgment means nothing more than that the speaker approves/disapproves of the object of moral evaluation. It is simple a report of the speakers attitude.
  23. Simple Subjectivism when All mean: I (speaker) approve of X
    • X is morally right (permissible, obligatory, heroic)
    • X is good, virtuous
    • X ought to be done
  24. Simple Subjectivism when All mean: I (speaker) disapprove of X
    • X is morally wrong (impermissible)
    • X is bad, vicious
    • X ought not to be done
  25. Emotivism
    Moral judgments are nothing other than expressions of approval or disapproval. This is different from the claim that moral judgments are reports of personal attitudes.

    *"Stem cell research is immoral" means: Stem cell research------boo! (or other expression of disapproval)

    *"Stem cell research is permissible" means: Stem cell research-------okay! (or other expression of approval)
  26. Imperfect moral duties
  27. Discretionary
    The manner and occasion of fulfilling the duty is left to each person to decide. They are not owed "to any definite person, nor at any prescribed time."
  28. Perfect moral duties
    • *Non-discretionary
    • *Fiduciary obligations
  29. Non-discretionary
    are owed to definite persons, who have a corresponding moral claim on my conduct.
  30. Fiduciary Obligation
    *are perfect moral duties

    *In professional ethics a fiduciary obligation is the obligation to act in the best interest of a client or stakeholder
  31. Principle of Medical Beneficence
    The goal of medicine is to promote the patient best interest understood from the perspective of medicine

    *the primary obligation of providers of health care is to avoid harm as medicine defines harm
  32. Duties of Medical Beneficence
    *Do no Harm, Duty of non-Maleficence

    *Duty not to inflict harm; not to impose risks of harm

    *Prevent harm, remove harm, promote good
  33. Medical values at stake include the goals
    *To prevent/ remove pain, suffering, handicapping conditions of disease/injury

    *To seek cure of disease/injury where there is reasonable hope of cure

    *To prolong life/ prevent premature death
  34. Medical Values
    Health of the patient-(narrow) absence of disease, absence of infirmity

    a) pain

    b) impaired function
  35. Non-Medical Values
    Psychological, social, aesthetic, economic, religious, cultural
  36. Care as motivation
    mind set of provider: intentions/willingness to benefit; to relieve distress for the patient.
  37. Care as clinical effectiveness
    Skill set of provider: technical competence used to achieve a specifically defined benefit for the patient.
  38. Do No Harm
    Duty of non-maleficence
  39. Harm defined neutrally
    X harmed Y= X caused an adverse effect on Y's interests
  40. Harm defined normatively
    X harmed Y = X wronged Y or treated Y unjustly
  41. Due care is a standard that requires : ....
    FAILURE to exercise "Due Care" violates the principle of non- Maleficence

    *A professional level of training and skill, adequate knowledge and skill for the proper discharge of particular duties, diligence, thoughtfulness, carefulness, and patience in discharging clinical duties.
  42. Types of negligence
    • *Intentional
    • *Unintentional
  43. Intentional
    Knowingly imposing harm and risks that are unacceptable by professional standards
  44. Unintentional
    unknowingly, but carelessly imposing harm and risks below professional standards
  45. Individual are primarily.....

    *forgetfulness, inattention, poor motivation, carelessness, recklessness
  46. Systems are primarily........

    • *Multiple failures of large systems
    • *Poor design of equipment
  47. Paternalistic Model
    Physician takes the role of the parent. Physician has complete authority to make decisions for the patient. Physician gives orders and will be obeyed.

    Patient autonomy- patient may be able to refues
  48. Informative Model
    the physician treats the patient as a consumer. It is the physician's obligation to provide all of the facts, and the patient's values then determine what treatments are to be given. In the informative model, the physician provides the patient the means to exercise control and to make an informed decision as to the course of treatment

    Patient autonomy- up to the patient to figure out the significance what they are receiving
  49. Paternalism
    A violation of another person's autonomy for the sake of that person's welfare
  50. Weak Paternalism
    interference is justified only when the other person is not competent to make his own decisions
  51. Strong Paternalism
    interference is justified even when another person is competent to make his own decisions: in order to promote that person's own good
  52. Anti-Paternalism
    paternalism s never justified; even when other person is not competent and at risk of harming himself
  53. Proposed Standards of competence
    • *Minimal Standard
    • *Outcome Standard
    • *Status Test
    • *Function/Process Standard
  54. Minimal Standard
    Patient is able to express a preference; show evidence of a choice
  55. Outcome Standard
    Patient is judged competent or not on the basis of the content of her choice; judged not fully competent if choice is unreasonable
  56. Status Test
    Assessment of competence is made according to status indicators: age, diagnosis, pain, medication.
  57. Function/Process Standard
    Assessment of competence is based on the decision-makeing functioning of the patient, the process of reasoning that leads to the decision
  58. Individual Autonomy as Self Determination (Senses)
    • * Independence from the will of others
    • *Independence from irrational, unreasonable motivation
  59. Independence from the will of others ='s
    The ability of a person to be the author of her own life; the ability to design one's own life plan, to control the course of one's life
  60. Independence from irrational, unreasonable motivation ='s
    The capacity for conscious, deliberate, reasoned choice about one's actions
  61. Conditions of Autonomous Choice
    • *Freedom from coercion
    • *Freedom from Psychological impairment
    • *Choice must be informed
  62. Freedom from Coercion
    • Physical coercion
    • Coercive options
    • Coercive influence
  63. Freedom from Psychological impairment
    • Needs relevant comprehension of circumstances
    • Needs reasonable motivational response
    • -Sources of motivational impairment: addiction, phobia, physical illness, mental distress
  64. Choice must be informed
    Autonomous choice requires that a person possess adequate information, that is comprehensible
  65. Interpretive model
    works with the patient and their goals and tries to clarify the patients values are. The patients values include medical and non-medical values. Just the medical values are at stake and include them to make the best medical decision possible. Accomadate their values.
  66. Deliberative model
    The physician acts like a teacher or friend. engaging the patient in dialogue on what course of action would be best. Not only does the physician indicate what the patient could do, but, knowing the patient and wishing what is best the physician indicates what the patient should do,what decision regarding medical therapy would be admirable.

    Patient Autonomy- moral self development, the patient is empowered
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