Beneficence and Non-maleficence

Hippocratic Mandate

The individual patient’s welfare is the primary concern. This can mean benefiting

or improving the patient as well as ensuring that minimal to no harm comes to the patient.

Problems with the Hippocratic Mandate

1) What makes something a benefit versus a harm?

• Health in conflict of other goods (donuts)

2) Is it the benefits and harms to the patient alone, or do others count in consideration?

Utilitarianism

Holds the view that we ought to maximize good overall

Act Utilitariansim

Always act to maximize net aggregate (totals of what is left from everyone) social (among all those capable of experiencing utility) utility (happiness/pleasure)

Positives of Utilitarianism

• Consistency (no contradictory outcomes)

• Moral motivation is clear - the experienced feeling of utility

• Cognitive ease — don’t have to grapple with these issues

Problems with Act Utilitarianism

1) Impossibility (performing hedonistic calculus)

2) Evil pleasures

3) Never ending consequences (too soon to tell if there is a positive outcome)

Who created Act Utilitarianism?

Jeremy Bentham

Who created Rule Utilitarianism?

John Stuart Mill

Rule Utilitariansim

always follow a rule that if generally followed will maximize net aggregate social utility.

Two main distinctions between act and rule utilitarianism

• The first obvious distinction from act utilitarianism is that instead of deciding moment to moment which action will produce the most utility you follow a rule (set of rules, moral code, guideline...) that if generally followed would maximize utility.

• (Quality over quantity) The second distinction from this theory is the shift from quantity to quality of pleasures. For Mill the idea wasn't to maximize happiness regardless of the type of pleasure, but rather noble pleasures are the ones that should be maximized. A pushpin is not as good as poetry. There are, for Mill, qualitative distinctions between pleasures.

How do we decide which pleasures are better? (rule utilitarianism)

We ask someone who has tried both to tell us which one was the more noble pleasure. The one they decide (or a majority of those who have tried both decide) is the better pleasure.

Problems with Rule Utilitarianism

1) Pleasure Experts

• So, if I'm trying to gure out if bowling is better than drowning a toddler in a tub I have to ask someone who's done both?!? And what if they went with the tub?!?!

2) Collapse & Rule Worship

• If a general rule that would maximize happiness overall is "don't lie" and we find ourselves in a situation where lying will save millions should we follow that rule?

What two major moral theories depend on religion for their foundation?

Divine Command Theory and Natural Law Theory

Positives of Divine Command Theory

• Don’t have to determine right and wrong for yourself

• provides objectivity to morality

• Don’t need to reason

• Consequences are clear

Negatives of Divine Command Theory

• Won’t work for atheists

• How can you tell if God is speaking to you?

• Is the action right because God approves or does God approve of the action because it is right? (Euthyphro Dilemma)

Euthyphro Dilemma

Is the action right because God approves or does God approve of the action because it is right?

• The action is right because God approves

  • Then right actions are arbitrary— God could change God’s mind

• God approves of the action because it is right

  • Abandons Divine command theory altogether. Then the reason something is right is independent of God