1. Philosophy 2803 – Health Ethics Andrew Latus

2. Introduction Ethics Study of right and wrong/good and bad A Branch of Philosophy Central Question = “How should I live?” Medical Ethics (Health Ethics) Study of right and wrong/good and bad in ‘medical situations’.

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

4. What Do We Mean By ‘Studying Right and Wrong’? 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

5. Our Project: Normative Ethics Our focus will be on normative medical ethics, i.e., how people should behave in medical situations We will be taking a philosophical approach to this project i.e., we will be seeking to provide reasons or arguments for our claims about how people should behave Contrast with approaches that rely on some authority, either religious or human

6. A Big Question 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?’ We’ll spend the first two weeks of the course considering this question.

7. Moral/Ethical Value A Big Question: ‘uhhhh....how people should behave in medical situations, according to whom?’ Short answer: how people should behave from the standpoint of moral value This gives us part of the picture. Whatever morality is about, it’s about evaluating people and their actions from a certain viewpoint (i.e., the viewpoint of morality) Notice that there are other sorts of value judgment

8. Other Sorts of Value Judgment Based on aesthetic value E.g., Creed should never be allowed to make another album. Based on legal value E.g., It’s wrong to possess marijuana. An important question: What is the relationship between ethics and law?

9. A Brief Aside: Law & Ethics It’s impossible to talk about medical ethics without talking about the law But ethics and law are not the same thing They share many concepts Rights, obligations, justice But differ in other respects Sanctions, enforcement, source

10. Illegal vs. Immoral 1 If it’s illegal, is it immoral? Not necessarily 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).

11. Illegal vs. Immoral 2 If it’s immoral, should it be illegal? Not necessarily Telling lies is in most cases immoral, but should it really be made illegal? Moral Value is broader than Legal Value Law is about not being bad. Morality is about being good.

12. Making Ethical Evaluations If morality is all about evaluation, it makes sense to ask how those evaluations are supposed to be made. One possible answer: ‘Making moral evaluations is just about going with your gut feeling. There’s no such thing as getting the evaluation right or wrong. It’s all subjective.’ Contrast aesthetic value with legal value

13. Moral Facts? We certainly talk about moral value as though it involves more than just a gut reaction. We tend to talk as though it is possible to be wrong in our judgments about moral value. i.e., we tend to talk as though it is possible to get the ‘moral facts’ wrong. Another big question: what is the source of those facts?

14. Two Views of Morality 1. Moral Relativism: What is morally right or wrong depends on what the prevailing view is in the society or culture we happen to be dealing with. The ‘moral facts’ are relative to culture. The ‘moral facts’ may change over time. There’s no such thing as right or wrong period.

15. Two Views of Morality 2. Moral Objectivism: What is morally right or wrong doesn't depend on what anyone thinks is right or wrong. 'Moral facts' are like 'physical facts'. They simply have to be discovered just like the laws of physics.

16. Objectivism or Relativism? Moral Relativism has been an increasingly popular view since the late 20th century. Did this change at all with Sept. 11? But is it correct? Remember that for us this is a question about what sort of argument can be offered in support of this view.

17. The ‘Cultural Differences’ Argument for Moral Relativism This is the most common argument offered in support of moral relativism. Notation: arguments considered in this class will often be presented as a series of premises (or reasons) leading to a conclusion. Premises will be abbreviated as P1, P2,… Conclusion will be abbreviated as C

18. The Cultural Differences Argument P1: There are huge differences in moral beliefs from culture to culture and era to era. E.g., Some cultures endorse the killing of elderly members of the tribe, we condemn such actions. Therefore… C: There must be no objective fact as to which of these beliefs is correct, morality is relative.

19. Assessing an Argument Is the Cultural Differences Argument convincing? Any time we are asked to consider an argument, we need to consider two questions: 1. Are its premises true? 2. If its premises are true, do they give us good reason to believe its conclusion is also true?

20. Two Problems with the Cultural Differences Argument 1. Are there really such huge differences in moral beliefs as P1 says? Perhaps what we see in considering different cultures is not so much disagreement about moral principles, as about their application in particular circumstances. How would we act if we lived in conditions of great scarcity?

21. Two Problems with the Cultural Differences Argument 2. It is a mistake to conclude based only upon differing opinions about some issue, that there are no facts about that issue. Consider this parallel argument: P1: There is widespread disagreement about the shape of the earth. Some people say it's flat, others say it's spherical. C: There is no objective fact about what the shape of the earth is. It's all just a matter of opinion.

22. What Do These Problems Show? It’s clear that the cultural differences argument does not make a convincing case for moral relativism. This doesn’t prove that moral relativism is false. It does prove that the cultural differences argument isn’t a good reason for believing in moral relativism. A general rule for philosophy/ethics: if you don’t have a good reason for holding a particular belief, you should question that belief.

23. Next Our next move could be to look for other arguments for moral relativism, but next class we will take a different approach. Objectivists say there are moral facts. But what are they? We will consider some influential theories that attempt to tell us how to figure out what the moral facts are. This should help you consider how plausible moral objectivism is.