Transcript Health Care Ethics Chapter 1

Ethics, Professional Ethics,
Health Care Ethics
Skip survey of moral theories, pp 1-10 (pp 1-7, 4th ed.).
Note the authors announce, on page 10 (p. 7 4th ed.), that they
are adopting a “holistic approach” that amounts to adding
emotion and cultural sensitivity to the practical wisdom
component of Virtue Ethics.
They call their ethical position “the approach of practical
wisdom.”
Does this buffet, pick and choose approach seem legitimate
for professional ethics? Is there a better alternative?
--you may skim over these “issues”; what are the authors
trying to do here?
The Dignity of Individuals … sounds like what ethical
theory?
The Role of Society … sounds like what ethical theory?
At the top of page 13 (4th ed. 11), do utilitarianism and deontologism really “suggest
if clarity is not possible, ethics is not possible”?
Page 14 (4th ed. 12), under Society and Moral and Legal Rights
The authors say
“a right is a moral or legal claim that an individual may assert against someone else,”
then mid page:
“Any such claim imposes an obligation on another person…”
Note that asserting a right or claim against another imposes an obligation only
 if you are correct in thinking you have a claim or right,
 if the person you make the claim against is sufficiently aware of your claim, and
 if they have no other more important obligation or obligations that conflict
and thereby nullify your claim or right.
Note that asserting a right or claim against another
imposes an obligation only
 if you are correct in thinking you have a claim or right,
 (you loaned me $5 and I agreed to pay it back today)
 if the person you make the claim against is sufficiently
aware of your claim,
 (today has arrived and you remind me to pay up)
 if they have no other more important obligation or
obligations that conflict and thereby nullify your claim
or right.
 (no one has a much stronger claim on that $5, say)
Page 16 (4th ed. 14):
“But our very personhood does not belong to society,
and it would be unjust for society to demand that we
sacrifice our life or our sanity for the common good.”
What ethical theory is this a response to?
What’s wrong with the response?
Under Models of Medicine, pp 25-26 (4th ed. 22-24) :
Ethical Models:
Engineering Model
Paternal or Priestly Model
Collegial Model
Contractual Model
Covenant Model
Ethical Models (compare pp 10-12 in Towsley-Cook):
Which of the 5 are imposable on the patient?
Which of the 5 require cooperation between doctor and
patient?
What are likely impediments to cooperation?
Which of the 5 require a good impression on the patient
by the doctor?
The Patient’s Role (p 25 4th ed. … note, this section has been
dropped in the 5th ed.)
What duties do patients have?
The book says patient’s role “should be a more active one
[than “a sick role”] that respects equality of persons.”
 Isn’t the customer always right?
 Isn’t the patient paying the doctor?
 Isn’t the patient expected to be sick or out-of-sorts?
 Doesn’t it seem odd to impose duties on someone who comes
to you for help?