1. Introduction to Ethical Theory and Moral Decision Making - I n Ethics –Study of right and wrong/good and bad –Central Question = “How should I live?” n Medical Ethics –Study of right and wrong/good and bad in medical contexts.

2. What Do We Mean By Studying Right and Wrong? n Two Approaches: 1. Descriptive: recording the ethical attitudes of particular individuals or groups E.g., what does the CMA Code say? Doesn’t ask whether we should listen to those ethical attitudes, e.g., doesn’t endorse or reject the CMA Code

3. What Do We Mean By Studying Right and Wrong? n Two Approaches 2. Normative: investigating what people’s ethical attitudes (and actions) should be Some would say ‘investigating the facts of morality’ Note: for our purposes ‘moral’ and ‘ethical’ are interchangeable terms

4. Our Project: Normative Ethics n In this class, our focus will be on normative medical ethics, i.e., how people should behave in medical situations –A big question: ‘uhhhh....how people should behave in medical situations, according to whom?’

5. According to Whom? n 1st answer: Normative Ethics ask how we should behave in medical situations if we want to be ethically decent people. –‘OK, but what determines what a ethically decent person is?’ –2nd Answer: Shut up.

6. Ethical Value and Other Values n Ethical value is not the only sort of value –e.g., aesthetic value –Many would claim however that ethical value is the most important sort of value n Another important sort: legal value –What is the relationship between ethics and law?

7. Legal Value n Shares many of the basic concepts of ethical value –rights –obligations –justice n Differs in some respects from ethical value –sanctions and enforcement –source

8. Illegal vs. Immoral 1 n If it’s illegal, is it immoral? –Ethics provides the backdrop for law. In order for laws to be legitimate they must ultimately be ethically defensible. –Some legally prohibited things are clearly immoral (e.g., killing for fun), others only because the legal prohibition is broadly ethically defensible (e.g., driving when the light is red).

9. Illegal vs. Immoral 1 n If it’s immoral, should it be illegal? –Telling lies is in most cases immoral, but should it really be made illegal? n Moral Value is broader than Legal Value –Law is about not being bad. –Morality is about being decent.

10. A Third Sort of Value: Relational n What about going above and beyond the standards of ethical decency? –E.g., being (particularly) kind or empathetic –Call this Relational Value.

11. Legal, Ethical, Relational Legal Ethical Relational

12. The Elements of Moral Discourse n Facts, principles, concepts n When encountering ethical disagreement or conflict, it is important to identify the source of the conflict –Does it arise from differences about facts, principles or concepts?

13. Facts, Principles and Concepts n Facts = the concrete details of the situation being considered n Principles = the moral rules or norms that are relevant to the situation described by the facts n Concepts = the categories that have to be interpreted when deciding what the facts & principles tell us about the situation

14. Playing God I n Fact - e.g., Earl had beaten Kitty on several occasions –What about ‘Kitty was a victim of wife abuse’? –Facts are supposed to be about description, not evaluation –Some, particularly in the late 20th century, asked whether there was any such thing as pure description.

15. Playing God II n Principle - e.g., Do not kill except in self- defence –Next session we will consider the source of such principles n Concepts –e.g., self-defence –victim

16. Playing God III n In an important sense disagreements about facts are the easiest sort of moral disagreement to resolve. n Disagreements about principles may be the hardest sort to resolve –What was the main source of disagreement in your discussion group?

17. Next n Intro to Health Law - Fri. Sept. 6 –No assigned reading n Intro to Ethics II - Mon. Sept. 9 –E/H/HL Foundations - Section 6 –Doing Right - Chapter 1