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Introduction To Ethics

This document discusses three main categories of ethical argument that are relevant to health policy decisions: consequences/utilitarianism, rights/liberalism, and virtues/communitarianism. It outlines some of the key aspects of each approach, including how to measure utility, what rights individuals have, and who defines virtuous behavior. The document also notes problems with each individual approach and the possibility of mixed or combined positions. Overall, it argues that ethical analysis is needed to help identify implicit values, clarify positions, and increase consistency in policymaking.

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Jeric Laurio
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© © All Rights Reserved
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Download as PPT, PDF, TXT or read online on Scribd
143 views

Introduction To Ethics

This document discusses three main categories of ethical argument that are relevant to health policy decisions: consequences/utilitarianism, rights/liberalism, and virtues/communitarianism. It outlines some of the key aspects of each approach, including how to measure utility, what rights individuals have, and who defines virtuous behavior. The document also notes problems with each individual approach and the possibility of mixed or combined positions. Overall, it argues that ethical analysis is needed to help identify implicit values, clarify positions, and increase consistency in policymaking.

Uploaded by

Jeric Laurio
Copyright
© © All Rights Reserved
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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 (1) What makes an act morally right or wrong (a


question of conduct)?
 (2) What makes a person or something good or
bad (a question of value)?
 (3) How to draw the correct conclusion about
what we ought to do or what kind of person we
ought to be?
 (1) and (2) are theoretical/conceptual questions
and (3) is a practical question about moral
reasoning.

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Why Is Ethical Analysis Needed?
 Problems are not just technical
 How do we know which problems
are important?
 How do we know a good solution?

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Ethical Theory Alone Is Not
Sufficient

 Philosophical terms often are not


clearly defined
 Using ethical analysis to guide
decisions requires practice
 Moving back and forth between
cases and theory can help

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Three Categories of Ethical
Argument
 Consequences (outcomes):
 Utilitarianism
 Rights (starting points):
 Liberalism
 Virtues (character):
 Communitarianism

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Each Perspective Has
Unresolved Issues

 How do we measure
consequences?
 Which rights do citizens have?
 Who defines the community and its
values?

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Utilitarianism
 Policies should be judged by their
consequences
 What matters is well-being of individuals
 All individuals count equally
 The best action is decided by adding up
the gains and losses to all individuals
 “The greatest good for the greatest
number”

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 It is better to be a human being
dissatisfied than a pig satisfied; better
to be Socrates dissatisfied than a fool
satisfied.
John Stuart Mill - Utilitarianism

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How Can We Measure Utility?

 Individuals evaluate their own


situation: subjective utilitarianism
 Experts devise an index to
measure everyone’s well-being:
objective utilitarianism objective
utilitarianism
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Subjective Utilitarian

 Ask consumers about their


“willingness to pay”
 Use data about prevalence, costs,
and prices to calculate costs and
benefits

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Problems with Subjective
Utilitarianism

 Suppose consumers are foolish


or uninformed?
 Does “willingness to pay” really
measure changes in well-being?
 How do we account for the fact
that the rich can pay more?

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Objective Utilitarianism

 Construct an index to measure health


(e.g., Disability-Adjusted Life Years)
 Calculate health losses for different
diseases
 Set priorities based on cost-
effectiveness

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General Problems with
Utilitarianism
 Concerned with aggregate
welfare not with distribution
 Lack of respect for individuals
 Can justify inequality
 Technical calculations can mask
values

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Liberalism
 Individualshave the capacity to make
moral choices about life
 Therefore, they are entitled to
respect to choose their own life plan
 Therefore, they have a right to
preconditions for such choices

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What Rights Do People Have?
 Negative rights - to be left alone,
to be free to choose, to speak, buy
and sell: libertarianismtarian

rights – to resources
 Positive
needed for a reasonable range of
opportunity: egalitarian liberalism
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Libertarians

 Right to control your own body


 Right to purchase health care
 Priority to market, with minimal
state limits on individual choice
 No redistribution by state

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Egalitarian Liberals
 Basic right to opportunity: health
itself
 Role of state to redistribute
resources to assure fairness
 Example: Right to AIDS drugs for
worst-off in society

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Problems With Liberalism
 What positive rights to citizens have in the
health care arena?
 Do we treat those who cause their own ill
health?
 What geographic scope for redistribution?
 Are universal rights another form of cultural
imperialism?

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Communitarianism
 Individuals live in society – not in
isolation
 A good society requires citizens
with “virtuous” character
 Society should instill virtue and
create a desirable social order

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Who Decides What Is
Virtuous?
 Each society decides for itself what
is virtue (relative
communitarianism)
 There is one definition of virtue for
all societies (universal
communitarianism)

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Problems for Relative
Communitarians

 How do we know the boundaries of


communities?
 How far can communities go to
suppress dissent?

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Problems for Universal
Communitarians

 Lack of tolerance for local or


minority cultures
 What happens when those with
conflicting visions meet?
 How do we know whose vision is
correct?

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Broader Question of
Justification
 Faith
 Intuition
 Logic
 The World
 There is no justification

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Mixed Positions
 Using more than one theory
 Principled construction of a mixed
ethical position – some examples:
 Utilitarian who respects some rights
 Egalitarian liberal sensitive to local
customs

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Implications (1)
 You cannot make health policy
without values
 Conflicts in values often occur in
making policy decisions
 Conflicts occur even “inside” a
theory because its implications
may be ambiguous

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Implication (2)
 Ethical analysis can help identify
implicit values in varying policy
positions
 Ethical analysis can help someone
clarify their own position
 Ethical analysis can increase
consistency, transparency, and
accountability

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That’s all, folks!

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