Kindle Notes & Highlights
together we have eighty-plus years of teaching bioethics—
What Are the Philosophical Foundations of Bioethics?
bioethics
asking for the ethical principles that guide moral reasoning in bioethics and justify conclusions.
What is “normative ethics”?
Normative ethics,
asks what makes a right act right, a wrong act wrong.
do not tell us whether people are correct and justified in their moral beliefs.
actions,
Obligations and permissions.
Supererogatory actions.
Moral rights.
people and their character.
virtue theory,
What does a physician have to be to be a good doctor? Among other things, be honest, courageous, and empathetic.
What are some important moral theories for bioethics?
Utilitarianism: consequences.
maximizes the aggregate “utility” (subjective well-being)
Kantian ethics: the inherent nature of the act.
ethic of duties—
Natural Law ethics: intentions and natural goods.
natural goods
How does utilitarian reasoning work?
(heart, lungs, two kidneys, and liver).
We get the idea. But:
On the one hand, "One deceased organ donor can save up to eight lives! Two donated kidneys can free two patients from dialysis treatments. One donated liver can be split to go to two patients on the wait list. Two donated lungs mean another two patients are given a second chance, and a donated pancreas and donated heart are two more patients who will receive the gift of life." (https://www.pennmedicine.org/updates/blogs/transplant-update/2023/april/6-quick-facts-about-organ-donation)
On the other hand, the five "vital organs" are sometimes enumerated as: the brain, the heart, the lungs, the kidneys, and the liver.
But we shouldn’t sacrifice one person in this way to save four, should we?
Pay attention to the logic here. The reasoning is something like this:
1. Utlitarianism implies organ conscription would be ethical.
2. (We know) it's NOT the case that organ conscription would be ethical.
3. Therefore, utilitarianism is incorrect.
Does this argument refute utilitarianism? Perhaps not, as utilitarians can respond defensively. But it at least counts as pressure against it.
A strong informed consent requirement would seem to get in the way of maximizing benefit in situations where a physician or influential family member knows better.
What is the reasoning against utilitarianism offered in this third counter-example? And what, in the discussion that follows, is the proposed utilitarian response to the objection?
What principles are featured in Kantian ethics?
They were not using their new children merely as means.
What does Natural Law ethics contribute to bioethics?
four things are “natural goods”:
any intentional, direct destruction of these goods is simply prohibited. It is always wrong to intentionally destroy a natural human good.
One also intends the means
the “doctrine of double effect” (DDE).
Effects that are not intended, but only foreseen, allow an action to still be permissible if certain conditions are met.
Using morphine in this way is morally permissible.
What is the “principles approach” to bioethics?
principlism)
people confronting an issue in bioethics should consult four moral principles: nonmaleficence, benevolence, autonomy, and justice.
when two or more of them conflict, one emerges as dominant in the actual context—
Concluding thoughts
attempting to discern which theory is correct may be left to ethical theorists