Ethics Notes
Ethics
Ethics, also known as moral philosophy, systematizes, defends, and recommends right and wrong conduct concepts.
Falls under axiology, concerning values, alongside aesthetics.
Seeks to answer questions of human morality.
Related to moral psychology, descriptive ethics, and value theory.
Three major study areas:
Meta-ethics: Theoretical meaning and moral propositions, truth values.
Normative ethics: Practical means of determining moral action.
Applied ethics: Obligations/permissions in specific situations.
Defining Ethics
Derived from Greek "ēthikós" (relating to character) from "êthos" (character, moral nature).
Borrowed into Latin as "ethica", then French as "éthique", and then into English.
Kidder: Standard definitions include "science of ideal human character" or "science of moral duty".
Paul and Elder: Ethics are concepts guiding behavior that helps or harms sentient creatures.
Cambridge Dictionary of Philosophy: Ethics is used interchangeably with morality, sometimes narrowly for moral principles of a group or individual.
Most people confuse ethics with social conventions, religious beliefs, and the law.
Ethics refers to philosophical ethics or moral philosophy.
Williams: Philosophical inquiry involves reflective generality and rational persuasion, addressing how one should live.
Ethics also refers to a common human ability to think about ethical problems, not particular to philosophy.
Churchill: Ethics is the capacity to think critically about moral values and direct actions accordingly.
Ethics can describe a person's idiosyncratic principles or habits.
Meta-Ethics
Examines how we understand, know, and what we mean when discussing right and wrong.
Deals with abstract questions related to a wide range of practical questions.
Example Meta-ethical question: "Is it ever possible to have secure knowledge of what is right and wrong?"
Aristotle: Ethical knowledge is less precise than other knowledge forms, depending on habit and acculturation.
G.E. Moore's Principia Ethica (1903): Discusses the naturalistic fallacy and rejects naturalism, prompting a re-examination of second-order questions.
Hume: Proposed a similar view on the difference between facts and values.
Studies of knowledge in ethics:
Cognitivism: Right and wrong statements refer to facts.
Non-cognitivism: Moral judgments are neither true nor false, expressing emotional feelings.
Ontology of ethics: Focuses on value-bearing things or properties.
Anti-realists (non-descriptivists/non-cognitivists): Ethics does not need a specific ontology.
Realists: Explain entities/properties relevant to ethics, their value, and motivational guidance.
Normative Ethics
Study of ethical action, exploring how one ought to act morally.
Examines standards for rightness and wrongness, unlike meta-ethics which studies moral language and metaphysics.
Distinct from descriptive ethics, which empirically investigates moral beliefs.
Descriptive ethics: concerned with what proportion of people believe that killing is always wrong.
Normative ethics: concerned with whether it is correct to hold such a belief.
Sometimes called prescriptive rather than descriptive.
Moral realism: Moral facts are both descriptive and prescriptive.
Traditionally, normative ethics studied what makes actions right and wrong.
Theories offered overarching moral principles for resolving dilemmas.
Moral theories became more complex at the turn of the 20th century.
Study declined mid-century due to meta-ethics prominence, influenced by linguistic focus and logical positivism.
Stoicism
Epictetus: The greatest good is contentment and serenity.
Apatheia (peace of mind) is highly valued; self-mastery leads to spiritual peace.
Central to this philosophy is "unconquerable will".
Individual will should be independent and inviolate; mental equilibrium should be protected.
Losing control over one's emotions means losing freedom.
Freedom from material attachments is necessary.
Accept that objects break; do not be upset by it.
Accept that people die; hold on to your serenity because loved ones were made of flesh and blood destined to death.
Accept things that cannot be changed and endure in a rational fashion.
Do not fear death but see it as going back to God.
Embrace difficult problems as spiritual exercises.
Avoid sex and sexual desire as threats to mental integrity.
Abstinence is highly desirable.
Remaining abstinent is a victory.
Intuitive Ethics
Also called moral intuitionism.
Views are present in moral epistemology (and metaphysics).
Our intuitive awareness of value or knowledge of evaluative facts forms the foundation of our ethical knowledge.
Foundationalism about moral knowledge: Some moral truths can be known non-inferentially.
Epistemological view implies propositional contents.
Contrasted with coherentist approaches like reflective equilibrium.
Frequently used with variation in its sense.
This article focuses on the commitments of self-identified ethical intuitionists.
Ethical intuitionism can be taken to encompass cognitivist forms of moral sense theory.
Assumes self-evident or a priori moral knowledge, which counts against moral sense theory as a species of intuitionism.
Objections include questioning the existence of objective moral values, disagreements over ethics, and Occam's razor.
Hedonism
Posits that the principal ethic is maximizing pleasure and minimizing pain.
Ranges from indulging momentary desires to pursuing spiritual bliss.
Consideration of consequences ranges from self-gratification regardless of harm to maximizing pleasure for the most people.
Cyrenaic Hedonism
Founded by Aristippus of Cyrene.
Supported immediate gratification or pleasure.
Believed that even fleeting desires should be indulged for fear of missing the opportunity.
Little to no concern with the future, with the present dominating in the pursuit of pleasure.
Encouraged enjoyment and indulgence without hesitation, believing pleasure to be the only good.
Epicureanism
A hedonist form of virtue ethics.
Argued that pleasure, correctly understood, will coincide with virtue.
Rejected the extremism of the Cyrenaics, believing some pleasures and indulgences to be detrimental to human beings.
Observed that indiscriminate indulgence sometimes resulted in negative consequences.
Rejected some experiences out of hand and endured some unpleasant experiences to ensure a better life in the future.
The summum bonum, or greatest good, was prudence, exercised through moderation and caution.
Excessive indulgence can be destructive to pleasure and can even lead to pain; for example, eating one food too often makes a person lose a taste for it, and eating too much food at once leads to discomfort and ill-health.
Pain and fear were to be avoided.
Living was essentially good, barring pain and illness.
Death was not to be feared.
Fear was considered the source of most unhappiness.
Conquering the fear of death would naturally lead to a happier life.
If there were an afterlife and immortality, the fear of death was irrational; if there was no life after death, then the person would not be alive to suffer, fear or worry, and thus it is irrational to fret over circumstances that do not exist, such as one's state of death in the absence of an afterlife.
State Consequentialism
Also known as Mohist consequentialism.
An ethical theory evaluates the moral worth of an action based on how much it contributes to the basic goods of a state.
The Stanford Encyclopedia of Philosophy describes Mohist consequentialism as "a remarkably sophisticated version based on a plurality of intrinsic goods taken as constitutive of human welfare".
Unlike utilitarianism, which views pleasure as a moral good, "the basic goods in Mohist consequentialist thinking are … order, material wealth, and increase in population."
During Mozi's era, war and famines were common, and population growth was seen as a moral necessity for a harmonious society.
The "material wealth" of Mohist consequentialism refers to basic needs like shelter and clothing, and the "order" of Mohist consequentialism refers to Mozi's stance against warfare and violence, which he viewed as pointless and a threat to social stability.
Consequentialism
Refers to moral theories that hold the consequences of a particular action form the basis for any valid moral judgment about that action (or create a structure for judgment, see rule consequentialism).
From a consequentialist standpoint, a morally right action is one that produces a good outcome, or consequence.
This view is often expressed as the aphorism "The ends justify the means".
The term "consequentialism" was coined by G.E.M. Anscombe to describe what she saw as the central error of certain moral theories, such as those propounded by Mill and Sidgwick.
The defining feature of consequentialist moral theories is the weight given to the consequences in evaluating the rightness and wrongness of actions.
In consequentialist theories, the consequences of an action or rule generally outweigh other considerations.
Questions addressed by consequentialist theories:
What sort of consequences count as good consequences?
Who is the primary beneficiary of moral action?
How are the consequences judged and who judges them?
One way to divide various consequentialisms is by the many types of consequences that are taken to matter most, that is, which consequences count as good states of affairs.
Utilitarianism relates to an increase and positive effect for the greatest number.
Eudaimonic consequentialism relates to a full, flourishing life.
Aesthetic consequentialism in which the ultimate aim is to produce beauty.
Pursue an increase in material equality or political liberty instead of something like the more ephemeral "pleasure".
Other theories adopt a package of several goods, all to be promoted equally.
Conflicts and tensions between different good states of affairs are to be expected and must be adjudicated.
Ethical Beliefs
Ethical beliefs shape the way we live, what we do, what we make and the world we create through our choices.
Ethical questions explore what Aristotle called 'a life well-lived'.
Ethics isn't just an exercise for philosophers or intellectuals; it is at the core of everyday life.
We ask ethical questions whenever we think about how we should act.
Being ethical is a part of what defines us as human beings.
We could all make conscious and conscientious ethical choices if we wanted to.
There are times when those questions become challenges we just can't resolve alone.
Complex ethical problems can be individual and private or widespread and systemic, involving groups, organisations or whole communities.
The distress these challenges cause is real and pervasive, leaving people stuck and struggling, anxious or broken.
Ethics provides a framework for answering these questions well.
It allows us to be consistent in our judgements, provide reasons for our beliefs and to critically examine opinions.
Most importantly, ethics allows us to act in a manner that accords with a set of core values and principles.
Ethical people have what philosopher Thomas Aquinas called a ‘well-informed conscience’.
They live what Socrates called ‘an examined life’ – a life particularly associated with being human.
Ethical people try to answer the question of how to live by reflecting on difficult situations.
They then act in a way that is true to who they are and what they believe.
Why Be Ethical?
Ethical questions are an inescapable part of being human.
We think and act according to ethical judgements all the time, whether we want to or not.
Often the things that drive our actions are unknown to us – underpinning habits that lead us to act for good or ill without serious thought.
Ethical reflection helps us make responsible judgements that reflect what we care about most.
It's not all theory and complex dilemmas.
Ethics informs our day-to-day interactions.
Ethics also looks beyond specific actions towards how to structure our lives as a whole - "flourishing".
Ethics helps us to do the right thing, but it also helps us to live a life worth living.
Not every ethical question has one right answer. That's ok.
There is no ethical theory that can resolve every situation perfectly because lots of things in our lives have moral value, sometimes they come into conflict and moral dilemmas are inevitable.
In these cases we need to accept the limits to certainty when trying to decide what we ought to do and may just have to trust our experience and our conscience.
Ethics in a Nutshell
Relationships.
Struggling to develop a well-informed conscience.
Being true to the idea of who we are and what we stand for.
Having the courage to explore difficult questions.
Accepting the cost of doing what we think is right.
Asking one simple question – ‘what ought I to do?’
Ethics and Morality
Ethics is the moral code or philosophy that guides a person's choices and behaviors throughout their life.
Morality extends beyond the individual to encompass what is right or wrong for the community and society.
Ethics is concerned with rights, responsibilities, language use, living ethically, and moral decision-making.
Morals vary, but many are universal, stemming from basic human emotions.
Moralizing seeks to make sense of gut instincts.
Morality and Virtue
Morally good individuals are virtuous, while morally bad ones are wicked, sinful, or criminal.
Aristotle explored moral responsibility and virtue.
Dante Alighieri identified seven deadly vices: vanity, jealousy, anger, laziness, greed, gluttony, and lust.
Individuals associated with vices are seen as having poor character.
Some suggest virtue can disguise hidden vice.
Morality Defined
From Latin "moralis", meaning manner, character, proper behavior.
Differentiation of intentions, decisions, and actions between proper and improper.
A body of standards/principles from a philosophy, religion, culture, or personal belief.
May be synonymous with "goodness" or "rightness".
Moral Philosophy
Includes moral ontology (origin of morals) and moral epistemology (knowledge of morals).
Different systems of expressing morality have been proposed.
Deontological ethical systems: Adhere to established rules.
Normative ethical systems: Consider the merits of actions.
Golden Rule: "One should treat others as one would like others to treat oneself."
Immorality: Active opposition to morality.
Amorality: Unawareness, indifference, or disbelief in moral standards.
Ethics (moral philosophy): Addresses morality questions.
Ethics is commonly used interchangeably with morality or to mean the moral principles of a group or individual.
Deontological ethics sometimes distinguish between ethics (duty, obligation, principles) and morals (virtue-based reasoning).
Justice
In its broadest context includes the pursuit of what is just and philosophical discussions surrounding it.
Based on ethics, rationality, law, religion, equity and fairness.
Discussions usually involve social justice (philosophy, theology, religion) and, procedural justice (application of the law).
Early theories of justice were set out by the Ancient Greek philosophers Plato. The Republic, and Aristotle Nicomachean Ethics.
Throughout history, theories have been established:
Advocates of divine command theory argue that justice issues from God.
In the 1600s, theorists like John Locke argued for the theory of natural law.
Thinkers in the social contract tradition argued that justice is derived from the mutual agreement of everyone concerned.
In the 1800s, utilitarian thinkers including John Stuart Mill argued that justice is what has the best consequences.
Theories of distributive justice concern what is distributed, between whom they are to be distributed, and what is the proper distribution.
Egalitarians argued that justice can only exist within the coordinates of equality.
John Rawls used a social contract argument to show that justice, and especially distributive justice, is a form of fairness.
Property rights theorists (like Robert Nozick) also take a consequentialist view of distributive justice and argue that property rights-based justice maximizes the overall wealth of an economic system.
Theories of retributive justice are concerned with punishment for wrongdoing.
Restorative justice (also sometimes called "reparative justice") is an approach to justice that focuses on the needs of victims and offenders.
Moral Responsibility
In philosophy, moral responsibility is the status of morally deserving praise, blame, reward, or punishment for an act or omission performed or neglected in accordance with one's moral obligations.
Deciding what (if anything) counts as "morally obligatory" is a principal concern of ethics.
Philosophers refer to people who have moral responsibility for an action as moral agents.
Agents have the capability to reflect upon their situation, to form intentions about how they will act, and then to carry out that action.
The notion of free will has become an important issue in the debate on whether individuals are ever morally responsible for their actions and, if so, in what sense.
Incompatibilists regard determinism as at odds with free will, whereas compatibilists think the two can coexist.
Moral responsibility does not necessarily equate to legal responsibility.
A person is legally responsible for an event when a legal system is liable to penalize that person for that event.
Although it may often be the case that when a person is morally responsible for an act, they are also legally responsible for it, the two states do not always coincide.
Good and Evil
A common dichotomy in religion, ethics, philosophy, and psychology.
In cultures with Manichaean and Abrahamic religious influence, evil is usually perceived as the dualistic antagonistic opposite of good, in which good should prevail and evil should be defeated.
In cultures with Buddhist spiritual influence, both good and evil are perceived as part of an antagonistic duality that itself must be overcome through achieving meaning emptiness in the sense of recognition of good and evil being two opposing principles but not a reality, emptying the duality of them, and achieving a oneness.
In a general context, evil is the absence or opposite of that which is described as being good. Often, evil is used to denote profound immorality. In certain religious contexts, evil has been described as a supernatural force.
Elements commonly associated with evil include unbalanced behavior involving expediency, selfishness, ignorance, or neglect.
Modern philosophical questions regarding good and evil are subsumed into three major areas of study:
Meta-ethics concerning the nature of good and evil.
Normative ethics concerning how we ought to behave.
Applied ethics concerning particular moral issues.
Ancient World
In ancient Persia, Zoroaster simplified the pantheon into two opposing forces: Ahura Mazda and Angra Mainyu (Destructive Spirit) which were in conflict.
This idea developed into a religion which spawned many sects, some of which embraced an extreme dualistic belief that the material world should be shunned and the spiritual world should be embraced.
Gnostic ideas influenced many ancient religions which teach that gnosis may be reached by practicing philanthropy to the point of personal poverty, sexual abstinence and diligently searching for wisdom by helping others.
In ancient Egypt, there were the concepts of Ma'at (justice, order, cohesion) and Isfet (chaos, disorder, decay).
This correspondence can also be seen reflected in ancient Mesopotamian religion as well in the conflict between Marduk and Tiamat.
Classical World
In Western civilization, the basic meanings of good and evil are "bad, cowardly" and "good, brave, capable", and their absolute sense emerges only around 400 BC, with Pre-Socratic philosophy, in particular Democritus.
Morality in this absolute sense solidifies in the dialogues of Plato, together with the emergence of monotheistic thought.
The idea is further developed in Late Antiquity by Neo-Platonists, Gnostics, and Church Fathers.
This development from the relative or habitual to the absolute is also evident in the terms ethics and morality both being derived from terms for "regional custom".
Medieval Period
Medieval theology was largely shaped by St. Augustine of Hippo and St. Thomas Aquinas.
According to St. Augustine of Hippo, sin is "a word, deed, or desire in opposition to the eternal law of God."
Many medieval Christian theologians broadened and narrowed the basic concept of Good and evil until it came to have several, sometimes complex definitions.
Modern Ideas
Good is often associated with life, charity, continuity, happiness, love, or justice.
Evil is often associated with conscious and deliberate wrongdoing, discrimination designed to harm others, humiliation of people designed to diminish their psychological needs and dignity, destructiveness, and acts of unnecessary or indiscriminate violence.
The modern English word evil (Old English) and its cognates such as the German Übel and Dutch euvel are widely considered to come from a Proto-Germanic reconstructed form of *ubilaz, comparable to the Hittite huwapp- ultimately from the Proto-Indo-European form *wap- and suffixed zero-grade form *up-elo-.
Many religious and philosophical traditions claim that evil behavior is an aberration that results from the imperfect human condition (e.g. "The Fall of Man").
Theories of Moral Good
Chinese Moral Philosophy
In Confucianism and Taoism, there is no direct analogue to the way good and evil are opposed, although references to demonic influence is common in Chinese folk religion.
Confucianism's primary concern is with correct social relationships and the behavior appropriate to the learned or superior man.
Evil would thus correspond to wrong behavior. Still less does it map into Taoism, in spite of the centrality of dualism in that system, but the opposite of the basic virtues of Taoism (compassion, moderation, and humility) can be inferred to be the analogue of evil in it.
Western Philosophy
Pyrrhonism holds that good and evil do not exist by nature, meaning that good and evil do not exist within the things themselves.
All judgments of good and evil are relative to the one doing the judging.
Spinoza
Proposition 1: By good, I understand that which we certainly know is useful to us.
Proposition 2: By evil, on the contrary I understand that which we certainly know hinders us from possessing anything that is good
Assumes a quasi-mathematical style and states these further propositions which he purports to prove or demonstrate from the above definitions in part IV of his Ethics:
Proposition 8 "Knowledge of good or evil is nothing but effect of joy or sorrow in so far as we are conscious of it."
Proposition 30 "Nothing can be evil through that which it possesses in common with our nature, but in so far as a thing is evil to us it is contrary to us."
Proposition 64 "The knowledge of evil is inadequate knowledge."
Corollary "Hence it follows that if the human mind had none but adequate ideas, it would form no notion of evil."
Proposition 65 "According to the guidance of reason, of two things which are good, we shall follow the greater good, and of two evils, follow the less."
Proposition 68 "If men were born free, they would form no conception of good and evil so long as they were free."
Psychology
Carl Jung depicted evil as the dark side of the Devil. People tend to believe evil is something external to them, because they project their shadow onto others. Jung interpreted the story of Jesus as an account of God facing his own shadow.
Philip Zimbardo suggested that people may act in evil ways as a result of a collective identity.
Religion
Christianity
Evil is any action, thought or attitude contrary to God's character or will.
Good is any action, thought or attitude consistent with God's character or will.
Islam
There is no concept of absolute evil in Islam, as a fundamental universal principle that is independent from and equal with good in a dualistic sense. Within Islam, it is considered essential to believe that all comes from Allah, whether it is perceived as good or bad by individuals.
Judaism
In Judaism, no individual can be defined as categorically, absolutely "good" or "evil."
The Philosopher's Peace: Lasting or Final?
Since the beginning of political philosophy, peace has been considered to be a high if not one of the highest ends of political action, but anyone looking to account for what we mean by peace faces the fact that we seem to understand peace not on its own terms but only in relation to its opposite, war.
Philosophies on Peace
The reason for any common agreement in society is self-preservation, society comes to be considered as merely a means for the preservation of life.
Since it is the peaceful state of political organization which makes it rational to exchange our natural warring relations with civil ones, peace comes to be associated with the principles of good or healthy governance.
Although statehood comes to be associated with peace, nation states themselves remain subject to the state of nature.
This idea comes from the proposal that nation states are, unlike individual citizens, not autonomous entities who can choose to be governed by peaceable rules.
The moral and political duty of sovereign states is solely towards the preservation of its constituents (or its own self-preservation as a necessary condition for the security of its constituents).
Kant on Peace
Kant claims that peace is a genuine end, or indeed the end of politics, because it is desired or willed by everyone.
Kant claims that the authority of republican government rests, and hence so too does the authority of the international League of Nations that is composed of republican states, on the argument that no-one would will the horrors of war on themselves.
Republicanism is the form of government that promotes international institutional security since it is founded on (1) freedom of all, (2) the dependence of everyone upon a single legislation, and (3) legal equality.
Kant’s statements about the political conditions of peace consists of six preliminary precepts or articles for “perpetual peace” between states, and three “Definitive Articles” or principles of world order:
(1) “the civil constitution of every state should be republican”;
(2) “the law of nations shall be founded on a federation of free states”;
(3) “the law of world citizenship shall be limited to conditions of universal hospitality.”
According to this model, all that is required for the spread of republicanism and the eventual peaceableness of the world is for one nation to genuinely embody republican freedoms.
Kant can thus claim that although individuals need not be moral, societies themselves can be, which in turn results in the moral development of the human species.
Kant argues that the simple self-interests of the State (in the narrow sense) will be overturned in favor of a fuller understanding of these interests once Republicanism is established simply because Republican States represent a wider understanding of human interests (specifically interests of wealth and prosperity) than monarchical models do.
States will move towards more just, legal and peaceful relations between other states because: “Nature herself…does it herself whether we be willing or not. Fata volentem ducunt, nolentem trahunt."
Ethical and Practical Considerations of Peace
This results in a shift to an interdiction that governments refrain from exceeding the bounds of permissible legislation by undertaking to ensure citizen’s happiness.
Politics and morality can be reconciled because happiness is not the goal or end of either. The only moral good or end is the good will, and the only political end is freedom within the bounds of what is legally permissible.
Action's 'being good to do' must also be a consequence of its being peaceful.
The rightness of refusing to lie as that no one could be trusted, the basis of all our social agreements, the law, the authority of the state to enforce the law, all would be undermined. Relationships would be frayed, the fabric of society torn, and the war of all against all ensue.
The decision not to break a moral maxim is reasonable only if it is the case that peace is preferable to war.
Fundamental Ethical Principles
The Principle of Respect for autonomy
The Principle of Beneficence
The Principle of non-maleficence
The Principle of justice
The Principle of Respect for Autonomy
Autonomy is Latin for "self-rule"
We have an obligation to respect the autonomy of other persons, which is to respect the decisions made by other people concerning their own lives. This is also called the principle of human dignity. It gives us a negative duty not to interfere with the decisions of competent adults, and a positive duty to empower others for whom we’re responsible. Embrace honesty in our dealings with others & obligation to keep promises.
The Principle of Beneficence
We have an obligation to bring about good in all our actions. We must take positive steps to prevent harm.
The Principle of Non-Maleficence
We have an obligation not to harm others: "First, do no harm."
Where harm cannot be avoided, we are obligated to minimize the harm we do. Don't increase the risk of harm to others, and do not waste resources that could be used for good.
Combining beneficence and non-maleficence: Each action must produce more good than harm.
The Principle of Justice
We have an obligation to provide others with whatever they are owed or deserve.
In public life, we have an obligation to treat all people equally, fairly, and impartially.
Corollary principle: Impose no unfair burdens.
Combining beneficence and justice: We are obligated to work for the benefit of those who are unfairly treated.
Common Ethical Problems and Dilemmas:
Breaches of confidentiality.
Over treatment and poor quality dental treatment.
Requests for fraudulent documentation.
Requests for narcotic medications.
Requests for inappropriate treatment.
Deceptive dental marketing and advertisements.
Impaired or dishonest colleagues.
Challenges with capacity and informed consent.
Conflict or unethical behavior among clinicians.
Challenges arising from management, finance or legal issues.
Ethical Decision-Making Model in Hypothetical Case
New clinician in a clinic with patients from different immigrant groups, using interpreters and dental assistants from various communities.
One day, an interpreter is concerned about the new family of three children she interviewed because they are healthy, well-adjusted and pleasant but have obvious serious dental problems.
The oldest child, nine year old Angie has anterior decay across all her maxillary teeth and the youngest, three year old Sophie has only black stubs for teeth. The mother is pleasant and very caring for her children. She invites you to their church for a special festival - a feast and a dance to celebrate the end of the harvest. She talks about what she would like to cook for you and the nice people in the office.
This family was referred from a local church which has been helping a number of immigrant families in the community.The interpreter tells you that you should inform child protective services (CPS) because of this high level of neglect.After your examination of the three children, you too are very concerned about the level of dental disease you have observed as they fit the definition of dental neglect in your state.
Applying the Ethical Decision-Making Model
Step 1. What is the ethical question? Should the clinician report to child protective services the dental neglect found in the children? Is this dental neglect or dental ignorance? What is the responsibility of the clinician in this case to the children and the parent?
Step 2. Collect information Determine the history of the family and the length of time they have been in the US because they are from a small country in Eastern Europe and have been in the US for six months. The dental practice appears to have a relationship with the local church, what guidance do they provide for these folks and do they cover the cost of care because a clerk at the church helps set up appointments and the church pays for basic care. The children are healthy, happy and well- adjusted because Mom is involved, cooks and cares for them and is present in the dental office. The interpreter and the clinician have observed that dental disease is present and meets the definition of neglect – what would the likely course of action be from child protective services for these children based on history and information. CPS workers usually take one to two weeks to respond on non-emergency issues, according to the website.
Step 3. State the options
Treat the children.
Call child care services and report the cases of dental neglect in these two children.
Call child care services for information and guidance.
Wait until the children can be seen for treatment; monitoring their return visits to assure that dental care is provided in a timely manner.
Begin education with the mother about dental disease and prevention.
Step 4. Apply the principles
Treat the children if and when they present for treatment would be acknowledging the autonomy of the parent to choose for her minor children.
Call child care services and report the cases of dental neglect in these two children. This option would be honoring the principle of nonmaleficence, removing harm as dental disease is harmful and veracity as it would also meet the legal statute of the state for reporting negligence.
Call child care services for information and guidance. This option would be honoring the principles of beneficence, determining how to restore oral health to these children, especially if basic costs are exceeded. It could also meet the intent of the legal statute.
Wait until the children can been seen for treatment; monitoring their return visits to assure that dental care is provided in a timely manner. This option would be honoring the principles of autonomy, respecting the mother’s understanding and choice for care for her children.
Begin education with the mother about dental disease and prevention. This option would honor beneficence, educating the mother and children about oral health. It would also acknowledge justice, as this was new information to the mother having come from a culture that did not understand or possibly value oral health.
Step 5. Make the decision #4 is the first option chosen in this situation because the children are in the dental office and all indications are that the Mom will proceed with treatment. Informing CPS would most likely not get dental care any faster for these children. Option #5 would be also be part of the treatment plan.
Step 6. Implement the decision Provide dental treatment to the children.
Ethical Theories
Ethical theories are used to determine ethical behavior.
Rae suggests that ethics are a process that is both an art and a science.
There are generally three philosophical approaches, or what may be considered the science, to ethical reasoning:
utilitarian ethics
deontological ethics
virtue ethics
When people talk about these areas, they are usually discussing an area of ethics known as normative ethics, or the process of considering and determining ethical behavior.