Ethical Decision Making

Ethical Decision Making

1. Approaches to Ethical Decision Making

   • Deontological- 'duty bound'
     • - One must do something regardless of the consequences  - Solution is based on a principle understanding e.g. 10 Commandments  - Means justifies the end result  - Loveless Law (completely logical no emotions) 
   • Utilitarianism- 'best for the majority'
     • -Looks at the greater good for society (most intrinsic value) - Emphasis is on the outcomes  - producing good consequences not having good intentions  - End justifies means  - Lawless Love (no rules or guidelines used)
   • Ethical- 'personal virtue'
     • - Achieving good outcomes depends on the character involved  - Character virtues are developed through practice 

2. Main Religious World Views

   • External God created world e.g. Islam, Christianity
   • Created world is an illusion with an ultimate reality e.g. Buddhism, Hinduism
   • Physical world devoid of supernatural forces e.g. secular world view

3. Religious Frameworks

   • Judaism- Torah (10 Comandements)
   • Christianity- 'love thy nieghbour' (Agape- beatitudes)
   • Islam- Qu'ran + Hadith (Five Pillars)
   • Buddhism- Four Noble Truths 'middle way' (Eightfold Path)

4. Life & Death Christian Tradition

   • Limits & Finitude
     • - We are leasing our lives from God -  Death is a 'rite of passage' 
   • Human Life (Body)
     • - Body= 'temple of the holy spirit' - Dualism
   • Ordinary vs. Extraordinary
     • - obligation to conserve life depends if it is ordinary or extraordinary procedure - Ordinary- readily available  - Extraordinary-no general obligation, must be necessary to family, church or society + very probable rate of success
   • Double Effect
     • - All procedures have negative side effects - Benefits must outweigh burden before application (hope of genuine + sufficient benefit) 
   • Personal Dignity
     • - Desires + values of patients  - Moral decision is based on context, experience + personal commitment 
   • Free Will & Autonomy
     • - Freedom to make own choices between good + evil 
   • Caring for the Sick
     • 1. Call to care for sick 2. Integrity of the person is to be respected e.g. sacrifice some parts for the good of the whole 

5. Kohlberg's Theory of Moral Development (Justice + Individual Rights)

   • 1. Pre-conventional Level (external reasoning- reward/ punishment)
     • Stage 1- Punishment + Obedience
     • Stage 2- Individual Self Interest
   • 2. Conventional Level (intermeditate internalisation of morals
     • Stage 3- Seeking approval/ avoiding disapproval within society
     • Stage 4- Law + Order
   • 3. Post- conventional Level (full internalisation of morals
     • Stage 5- Interpretation of the Law
     • Stage 6- Universal Ethical Principles

6. 4 Primary Principles of Catholic Social Teaching

   • 1. Dignity of the Human Person
     • Every human is created in the image + likeliness of God (inherent dignity)
   • 2. Common Good
     • Individual does not have rights at the expense of other nor are they to be undermined in the needs of the group 
   • 3. Subsidarity
     • All people have a right to participate in decisions 
   • 4. Solidarity
     • One human family + common vision for all humans to receive what right belongs to them 
   • 5. Preferential Option for the Poor
     • Poverty is unjust + take up the cause of the poor as our own by putting ourselves beside them 
   • 6. Participation
     • Everyone has a right + duty to participate in society, seek wellbeing, of all especially poor + vulnerable 

7. Gilligan's Stages of the Ethics of Care (Interrelatedness) Responsibility + Care to Others

   • Pre- conventional- Individual Survival (want to survive/ feel better through wellbeing of individual
   • Conventional- Sacrifice Self to Help Others (give themselves for the goodness of another)
   • Post- Conventional- Non Violence (safety + wellbeing of all involved by preventing harm to all)

8. Bioethics in World Religions

   • Judaism
     • - Source of ethics- Halachah (derived from Torah) + 'be fruitful + multiply' - Sexual Ethics- Ascetic view- only appropriate    for procreation (necessary evil) Traditional- prohibitations e.g. women having sex 7days after menstruation   Modern- marriage is central to all sexual relations, respect + concern for dignity of the other + taboos all forms of adultery, incest, homosexuality + beastiality Bioethics- Progressive- don't see Torah as eternally binding allows reinterpretation for modern situations Orthodox- Torah provides answer to all modern issues 'God's law' Birth Control + Abortion-  Only approved to use female contraceptive devices  Traditional- strongly against  Reproductive Technologies -Approval for procreation- 1. context of marriage 2. bearing children to loving parentsGenetic screening is strong supported due to Tay Sachs diseaseStem cell research saves human livesGene therapy acceptable as has potential to save lifeCloning no principle against must follow slippery slope
   • Buddhism
     • Karmic implications are a result of bad actions + prevent attaining Nirvana Bioethics- Abortion- act of violence against a living being that possesses individuality (can reduce by 1. performance of rituals 2. bodhisattva images of foetus) Euthanasia- shortening or lengthening a persons natural life is going against natural order + violates fundamental beliefs about karma  
   • Islam
     • -Source is Shariah (Quran + Sunna of the Prophet) Sunni- Everything narrated by the Prophet Shia- Developed own interpretations, methodology + authority systems (follow independent judgment of Imams) Sexual Ethics Marriage is natural + celibacy is to be avoided (part of nature) Condemns sexual relations outside of marriage + homosexual   -Contraception- is strongly pro family, only in marriage  Conservative Group- contraception is considered a form of abortion (campaigns against) Liberal Group- support use in certain circumstances e.g. 1. Wellbeing of children 2. Family Planning  Bioethics  Important to prevent illness + keep life sacred (duty to save life + grave sin to take) - Organ transplantation is practiced  - IVF is acceptable + commendable in marriage only Artificial Insemination- only husband + wife (no donor) otherwise child is robbed of legitimacy  
   • Catholic
     • Bioethics- Rejects on the basis of violation of human dignity + contrary to God's design Artificial Insemination (by donor)- unnacceptable child must be a fruit of marriage 1. Contrary to unity of marriage 2. Dignity of woman + man (right to be parents through each other) 3. Child's right to be brought up in a marriage  Artificial Insemination (marriage)- unnacceptable deprived of the proper place within sexual act 1. Promotion of love + unity 2. Procreation of children  *Child must be conceived as the 'fruit of parents love' (seen as gift from God with rights + dignity too)

9. Principles in Bioethical Situations

   • Natural Law
     • Humans have a personal intuition of right + wrong which gives them rational wisdom to act ethically (use of reason of humanity) - Known by logic + only applies too moral acts that involve free will of act Theories a. Order of Nature (natural instinct)- biological + physical law b. Order of Reason- Heaven (God) is the ultimate goal of existence + making human life more human
   • Conscience
     • 1. Person should violate one's conscience 2. Rightly formed conscience occurs within understanding of Catholic Teaching  Moral conscience is a person's reason judging choice on God's divine authority  - Have sufficient interior awareness + human dignity - Responsible for actions - Good Decision of Conscience= 'Peace of Mind' Bad Decision of Conscience= 'Guilty Conscience'
     • Freedom of Conscience
       • Respond maturely, experience alternatives + decide destiny within social limitations Developing 'Freedom of Conscience' 1. Reason Reflection (self evaluation) + Dialogue- interactions with self + others (external experience) 2. Natural Law Theory 3. Fundamental Stance- stengthening the relationship with God/ Convent 

10. Genetic Testing + Engineering

    • Dualism
      • Soul is seperate from body
    • Monism
      • Soul + Body
    • Main Types of Gene Therapy
      • 1. Somatic Cell
        • Benefit outweighs harm Dangers of a new virus being created e.g. HIV
      • 2. Germ- Line
        • Alters genes that carry defects  No clear argument as to which genes should be eliminated 
    • Problems with Testing For Genetic Defects
      • 1. Lead to an abortion if defects found
      • 2. Favour keeping one child over another
      • 3. Insurance companies- bad genes would make it very expensive of impossible
      • 4. Hard to attain employment