all bioethics

Ethics

A branch of philosophy that studies right and wrong, the principles behind moral judgments, and how we make ethical decisions.

Socrates’ contribution to ethics

He shifted philosophy toward moral and political questions, especially how to live well, laying the foundations of virtue-based ethics.

Plato and Asristotle contribution

They developed Socrates' virtue-based approach, emphasizing goodness, virtue, and human well-being.

Morality vs Ethics

Morality consists of customs, values, norms, and beliefs about behaviour. Ethics critically examines whether those beliefs are right or wrong.

Moral Behaviour vs Ethical Behaviour

Moral behaviour may follow inherited or cultural beliefs without questioning them. Ethical behaviour critically examines beliefs using reason and impartial principles.

Obeying laws vs ethics

Laws and social customs do not always establish what is morally right, although obeying just laws is often part of ethical behaviour.

Moral Reasoning

A rational, systematic process of making and defending moral judgments using ethical principles and reasoned arguments.

Meta-Ethics

The branch of ethics examining the nature, meaning, and justification of moral claims, including whether objective moral truths exist.

Normative Ethics

The branch of ethics establishing standards, principles, and rules for judging right and wrong, such as the Principle of Utility or Categorical Imperative.

Applied Ethics

The application of ethical theories and principles to practical issues such as abortion, euthanasia, animal rights, business, and environmental concerns.

Consequentialist ethical theories

Theories that judge actions primarily by their consequences. Examples include utilitarianism, ethical egoism, and common-good theories.

Non-consequentialist ethical theories

Theories that focus on considerations other than consequences, including duties, rights, justice, or intentions. Examples include deontological and divine command theories.

Agent-centred ethical theories

Theories focusing on the moral character or ethical status of individuals. Examples include virtue ethics, feminist ethics, and agapistic ethics.

Bioethics

A branch of applied ethics examining moral issues in medicine, biomedical research, public health, healthcare delivery, life sciences, and technology.

Medical Ethics vs Bioethics

Medical ethics focuses more narrowly on ethical problems in medical practice; bioethics includes broader issues involving healthcare, research, public health, and technology.

Bioethical Dilemmas

Abortion, euthanasia, cloning, stem-cell research, informed consent, animal experimentation, life support, and fair allocation of scarce organs.

Medical Ethics Historical Documents

The Code of Hammurabi (1750 BCE), Vaidya's Oath (15th century BCE), Hippocratic Oath (ancient Greece), and Advice to a Physician (10th-century Persia).

Factors that contributed to emergence of modern bioethics

Mid-20th-century medical advances; recognition of unethical medical experimentation; and social and cultural changes during the 1960s.

Nuremberg code (1947)

It established early research-ethics guidelines following the Nazi medical atrocities and Nuremberg Doctors' Trial.

Henry Beecher (1966)

Beecher published 'Ethics and Clinical Research,' exposing ethical problems in clinical studies, especially failures to inform patients of experimental risks.

Danial Callahan (1973)

In 'Bioethics as a Discipline,' he argued for establishing bioethics as a distinct academic field devoted to examining medical ethical dilemmas.

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Institution that established bioethics discipline

The Hastings Center and Kennedy Institute helped develop bioethics through research, ethical theory, training, and academic discussion during the 1970s.

International association of Bioethics

The International Association of Bioethics (IAB) is an organization founded in 1991 that promotes bioethics research, education, and international discussion of ethical issues in healthcare and medicine.

UNESCO’s 2005 univeresal declaration on bioethics and human rights

An international declaration promoting ethical principles including human dignity, autonomy, informed consent, privacy, justice, equality, protection of vulnerable people, social responsibility, and environmental protection.

What does Ethos Mean?

Character. Ancient Greek ethics emphasized developing good character and living a virtuous life.

Utilitarianism

A consequentialist ethical theory that judges actions by their outcomes, aiming to maximize happiness and minimize suffering.

Utilitarianism Philosophers

Jeremy Bentham (1748–1832) and John Stuart Mill (1806–1873).

Principle of Utility

Actions are right when they promote the greatest happiness and least harm for the greatest number of people.

Happiness and Unhappiness

Happiness is pleasure and the absence of pain; unhappiness is pain and the absence of pleasure.

Consequence vs intentions

Because an action's morality depends on the good or harm it produces, not simply the intentions or duties behind it.

Trolley problem

Choosing whether to divert a trolley to kill one person instead of five. It illustrates the conflict between maximizing good outcomes and avoiding harm to individuals.

Organ-Transplant thought experiment

Whether killing one healthy patient to save five patients needing organs is morally permissible. It tests the limits of consequence-based reasoning.

Hedonistic utilitarianism

The view that pleasure or happiness is the good we should maximize and pain is what we should minimize.

Bentham’s quantitative approach to pleasure

Pleasures can be measured and compared by their amount, rather than by whether they are intellectually or physically superior.

Bentham’s Hedonistic Calculus

A method for evaluating actions by measuring their expected pleasure and pain using seven criteria.

The seven criteria of Benthams Hedonistic Calculus

Intensity, duration, certainty, propinquity, fecundity, purity, and extent.

Intensity, duration and certainty

Intensity = strength of pleasure; duration = how long it lasts; certainty = likelihood it will occur.

Propinquity and fecundity

Propinquity = how soon pleasure occurs; fecundity = likelihood that pleasure will produce further pleasures.

Purity and Extent

Purity = likelihood pleasure will not be followed by pain; extent = number of people affected.

Problems with Benthams approach

Pleasure is difficult to quantify, consequences are hard to predict, and pleasure alone may be too shallow a measure of morality.

Mills vs Benthams

Bentham emphasizes the quantity of pleasure, while Mill argues that some pleasures are higher in quality than others.

Higher and lower pleasures

Higher pleasures are intellectual; lower pleasures are primarily physical or bodily.

“Better to be a Socrates dissatisfied than a fool satisfied”

Intellectual pleasures are more valuable than physical satisfaction, even when they involve dissatisfaction.

Individual vs society’s happiness

Individual happiness should be in harmony with the greater happiness of society.

Utilitarianism view on self-sacrifice and impartiality

Sacrifice is valuable only if it increases overall happiness; everyone's happiness must be considered impartially.

Act Utilitarianism

Evaluating each individual action by whether it produces the greatest overall happiness. Most associated with Bentham.

Rule Utilitarianism

Following general rules whose widespread adoption produces the greatest overall happiness. Most associated with Mill.

Dying patient problem (act vs rule)

Act utilitarianism might permit it if overall utility increases; rule utilitarianism rejects a general rule allowing it because it would undermine public trust.

Principle of beneficence

The duty to maximize good and promote others' well-being.

Principle of Non-malfeance, Harm Principle

Non-malfeasance means minimizing harm; the Harm Principle permits restricting someone's liberty to prevent harm to others.

Advantages of Utilitarianism

It provides a practical way to resolve moral conflicts and offers concrete guidance by focusing on happiness and reducing suffering.

No-rest and absurd-implications objections

No-rest: maximizing happiness could demand endless personal sacrifice. Absurd implications (W. D. Ross): it may justify actions like lying when they produce better outcomes.

Integrity and justice objections

Integrity (Bernard Williams): it may require violating deeply held principles. Justice: it may justify harming innocent individuals for greater overall benefit.

Who developed the nursing metaphors

Janet L. Storch.

Nurse-patient relationship vs physcician-patent relationship

Nurses provide more continuous care and occupy a different position within the healthcare hierarchy.

Gendered Nursing metaphors

Nursing has historically been associated with feminine roles such as mother, sister, and caregiver.

Images used to described nurses

Mother, sister, friend, lover, guardian angel, and army sergeant.

Categories of nursing metaphors

Limiting metaphors, misguided metaphors, and helpful metaphors.

Limiting metaphors

Metaphors that capture certain aspects of nursing but overlook other important aspects.

Three limiting nursing metaphors

Nurse as parent/mother surrogate, nurse as friend, and nurse as servant.

Nurse as parent, mother, surrogate

Nursing is viewed as nurturing and caring, emphasizing trust, dedication, integrity, and promise-keeping.

Criticism of mothor surrogate metaphor

It undervalues nursing knowledge and skills and limits nurses' decision-making power and moral agency.

Nurse as a friend metaphor

Viewing the nurse–patient relationship through the personal connection and trust associated with friendship.

Nurse as a servant metaphor

Nurses are viewed as professionals who serve others using their knowledge and skills.

Criticisms of servant metaphor

It can lead to exploitation, unquestioning obedience, and loss of nurses' moral agency.

Moral Abdication in nursing

Giving up independent ethical judgment and simply following institutional or professional orders.

Two Misguided nursing metaphors

Nurse as Technician/Engineer and Nurse as Physician Extender/Surrogate.

Nurse as technician/engineer metaphor

Nursing is viewed mainly as performing technical procedures and tasks.

Criticism of technician/engineer metaphor

It reduces nursing to technical tasks and ignores holistic care, judgment, and patient assessment.

Nurse as physcian extender/surrogate metaphor

Nurses are viewed primarily as assistants who carry out physicians' responsibilities.

Misleading in physician extendor metaphor

Nurses have distinct professional goals, knowledge, and care processes that complement physicians' work.

Nurses and physcians monitoring roles difference

Physicians monitor to diagnose; nurses monitor to plan care related to patients' rest and comfort.

Helpful nursing metaphors

Nurse in a Covenantal Relationship, Nurse as Healer, and Nurse as Client Advocate.

Nurse in covenantal relatinnship metaphor

A relationship based on mutual responsibility, trust, faithfulness, and nurses' commitment to benefit patients and prevent harm.

Reciprocal responsibility in covenantal mode;

Society grants nurses professional authority in exchange for their expertise and commitment to serving others.

Nurse as healer metaphor

Nurses promote healing through their continuing presence, care, and support of patients.

Nurse as client advocate metaphor

Nurses protect, inform, support, speak for, coordinate care for, and empower patients.

Two forms of patient advocacy

Legal advocacy, which focuses on legal matters, and deeper advocacy, which includes understanding, supporting, coordinating care, and giving patients a voice.

Criticisms of patient advocate metaphor

its meaning is unclear, legal roles may need revision, patients may not accept it, and advocacy can create conflicts of interest.

Why does Storch consider the helpful metaphors superior

They emphasize nurses' moral commitments, therapeutic presence, relationships, patient support, and empowerment.

Femenist Ethics

An ethical approach that challenges traditional moral theories by emphasizing women's experiences, gender inequality, and relationships.

Concerns of Feminism

Equality between women and men, recognition of women's different experiences, and liberation from patriarchal oppression.

Carol Gilligan

A psychologist who challenged traditional theories of moral development and emphasized the ethics of care.

Argument of Gilligan (1982)

Traditional moral development theories overlook relationship-based moral reasoning and may wrongly judge it as less mature.

Gilligans criticism of moral development

Lawrence Kohlberg's theory, which emphasized justice, rules, rights, and logical reasoning.

Heinz Dilemma

A husband must decide whether to steal an unaffordable drug to save his dying wife.

Jake and Amy in Gilligans Study

Two 11-year-old children whose responses to the Heinz dilemma illustrate different approaches to morality.

Jakes Approach to Heinz Deliemma

He argues Heinz should steal the drug because human life is more important than property rights.

Moral Reasoning from Jake

Justice-based reasoning emphasizing logic, individual rights, rules, and autonomy.

Amys approach to Heinz Dilemma

She suggests communication, borrowing money, or negotiation instead of stealing, to protect both life and relationships.

Amys Moral Reasoning

Care-based reasoning emphasizing relationships, compassion, communication, and responsibility

Difference between Amy and Jake

Jake sees a conflict between life and property rights; Amy sees a breakdown in relationships that needs to be repaired.

Gilligans Disagreament with Kohlbegs assesment of Amy

Amy's relationship-focused reasoning represents a different moral perspective, not necessarily a less mature one.

Ethics of Care

An ethical theory emphasizing empathy, compassion, relationships, and responsibilities toward others.

Ethics of Care vs Traditional Ethical theories

It focuses on specific relationships and circumstances rather than abstract rules, impartiality, and universal duties.

Ethics of justice vs ethics of care

Justice emphasizes rights, fairness, and impartiality; care emphasizes compassion, relationships, and personal responsibility.

Partiality in ethics of care

Giving special moral consideration to people with whom we have close relationships, such as family and friends.

Ethics of Care in Healthcare

Healthcare requires empathy, attentiveness, trust, and understanding each patient's individual needs.

Femenist ethics in healthcare

By considering women's bodily experiences and social circumstances, including inequality and discrimination

Feminist ethics healthcare issues

Abortion, contraception, reproductive rights, maternal-fetal conflicts, assisted reproduction, and medical experimentation.