Ethics in the Life SciencesChapter 1Ethical Theories and Principles

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Learning Objectives

• Explain the basic premise of each major theory of ethics.• Identify appeals to each of these theories when they are

presented in a discussion about patient care.• Discuss the strengths and failings of each theory as they

apply to particular situations.• Explain the basic premise of each principle.• Apply each of these principles to specific patient care

cases.• Identify conflicts among principles when applied to a

case.• Weigh conflicting principles against one another and

determine which is most compelling in a given case.2

Ethical Theories

Utilitarianism• Concerned with the Outcomes of Actions• An action itself is considered right or wrong,

not the performance of the action. • The action is judged based on the

consequences. If the action results in good consequences then the action would be considered good.

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Ethical Theories

Deontology• Actions judged right or wrong if they satisfy a

moral obligation or duty.• The amount of good is not of concern,

maximizing the good is only a side benefit. • Concerned with what is morally right and the

conforming of moral duties and obligations.

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Ethical Theories

Feminist Ethics• Instead of focusing on a single viewpoint or

issue, feminist ethics challenge traditional assumptions about the way the world works.• Challenge hierarchical structures many times

associated with male dominance and systemic practice that results in oppression of any one group of people. • Often question utilitarianism and deontology

with a belief that these ethical theories reflect hierarchical thinking.

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Ethical Theories

Communitarianism• Based on the idea that all people and

principles owe their existence to by a community.• Belief that people and principles are made up

of communities and that outside of the community they can not be understood.

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Ethical Principles

Nonmaleficene• Fundamental consideration in every conception of

moral and ethical life.• Asserts an obligation to not inflict harm on others. • Presents challenge in medicine as it is not always

possible to avoid harm while trying to restore health.

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Ethical Principles

Derivative Principles of Nonmaleficence• Due Diligence- Reasonable person exercises same

judgment in same given situation to ensure no harm is done to a person. • Double Effect- Acts have both a beneficial and a

harmful outcome. To be justified• Good effect should be intended and harmful should be

unintended.• Act should be good or morally neutral. • Harmful effects may not be a means to beneficial or

good effects. 8

Ethical Principles

Beneficence• Requires that one does or produces good for

others, as integral to the practice of nursing.• The ultimate goal is to make the lives of

individuals better.

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Ethical Principles

Derivative principles of Beneficence• Compassion- Depends on the way the action is

done.• Veracity- Honesty or truth telling.• Fidelity- Faithfulness in relationships and maters

of trust.• Paternalism- Overriding patients wishes in effort

to achieve best outcome for patient. • Proportionality- Choose actions that confer a

greater good than harm or produce a greater benefit than burden.

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Ethical Principles

Autonomy• Respect for autonomy requires acceptance of free

and informed choices of competent patients or their designated decision-makers.• Practitioners abide by choices made by patients,

regardless of whether they coincide with the practitioners personal values or assessments.

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Ethical Principles

Derivative Principles of Autonomy• Privacy and Confidentiality- Respect and obligation

for privacy and confidentiality. • Advocacy- Ensure patients needs and values are

heard and respected.• Informed Consent- Justified by respect for

autonomy and requires patient receive all pertinent information about their health condition and the options for treatment and that they explicitly choose their own treatments. 12

Ethical Principles

Justice• Allows a more encompassing view of a situation.• Justice may relate to public level ethics or

individual level ethics. • Public level ethics and the affect on groups or

groups of people.• Individual level ethics has to do with one person

even though there may be indirect effects on others.

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Ethical Principles

Derivative Principle of Justice• Respect- Primary derivative of justice. It is the

efforts to help patients to maintain or preserve dignity or protect them from anything that threatens to impinge on their rights.

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Summary

• Only four of many theories have been reviewed.• The four reviewed have the highest impact on

western medical ethics. • One theory in itself provides a complete and

coherent view of the world. • Each theory contributes to the way medical

professionals think about professional conduct and ethics.

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