MODULE 4

DETERMINANTS OF MORALITY

GENERAL EDUCATION 8/GENERAL ETHICS

1ST SEMESTER SY 2020-2021

LYKA BERNADETTE T. VERSOZA

Contact No.: 09093509081
Facebook: Lyka Bernadette Versoza
 CARAMOAN COMMUNITY COLLEGE
Caramoan, Camarines Sur

MODULE 4

DETERMINANTS OF MORALITY

OBJECTIVES

A. To identify the role of feelings in moral decisions

B. To explore the ways in which we make reasoned and impartial decisions
C. Evoke immediate responses to moral dilemmas;

TOPICS COVERED

FEELINGS AND MORAL DECISION MAKING

• Why they can be obstacles to making right decisions
• How they can help in making the right decisions
REASON AND IMPARTIALITY AS MINIMUM REQUIREMENTS FOR MORALITY
• Reason and impartiality defined
• The 7-step moral reasoning model

FEELINGS AND MORAL DECISION-MAKING

Do you believe that following our emotions or feelings in the face of moral dilemmas is
completely wrong? What are the risks of allowing our emotions to influence our decisions? What
about the dangers of relying solely on logic without considering our emotions?
So, why do we experience emotions? “Human beings are the most self-aware animals,”
allowing them to develop “basic emotional responses” and devise more rational survival
strategies. The distinction between humans and animals is this. (I. Simons, 2009) The Role of
our Emotions, according to Philosophy Professor Jordi Valverdu, is for survival and innate social
responsibilities.

When our ancestors lived in the desert without the protective gear that we have today,
their primary tool for survival was the “fight or flight” mode in their bodies. Their bodies became
tense, their muscles tightened, their lips dried, and their consciousness became alert in this
mode. Fear, which people experience when they perceive a potential threat or hazard, triggers
this response. In order to survive, our forefathers relied heavily on their emotions and feelings.
For example, when we are afraid, our bodies go into fight mode, which is then triggered by a
sense of danger around us. As a result, feeling isn't always a bad thing in humans.

Charles Darwin was one of the pioneers in the study of human emotions and feelings.
He claims that, in addition to surviving, we use our feelings to communicate with one another.
Fear, in the preceding example, is a useful tool for preventing us from being hurt in the past.
What about our other feelings?

There are three principles to consider when understanding emotions as a response to an

experience, according to Charles Darwin. The principles of functional habits, antagonistic-thesis,
and involvement of the enthused nervous system are the three of them. Emotional responses
are useful expressive habits based on experience, according to the Principle of Functional
Habits. They serve a purpose. The raising of eyebrows when stunned, the gnarling of teeth
when furious, and the sneer when enraged are examples of this. The purpose of these
emotional responses, according to the Principle of Antagonistic-Thesis, is for communication
clarity. It's the total opposite of useful habits. This principle is demonstrated by the gaping
mouth, which indicates wonder or a lack of understanding, and the shrugging of shoulders,
which indicates passive expressions. Finally, there is the Principle of Enthused Nervous System
Involvement, which states that the nervous system must discharge excess energy.

Darwin’s 3 Principles – Difficulties

So, can we make decisions solely based on our emotions? Regrettably, the
answer is no. We have already recognized the importance of feelings and emotional
responses in our survival. Today, having some emotions is beneficial because it
provides us with motivation and curiosity. However, an overabundance of these
emotions can cloud our judgment, especially if we are experiencing extreme happiness,
sadness, or fear. The irritability of rage, for example, causes us to be dissatisfied. These
feelings also prevent us from hearing other people's ideas and opinions. Anger can also
cause you to make hasty decisions. Excessive self-assurance can lead to a lack of
critical thinking.

Requirements of morality

The ability to see the interconnectedness of things and the logic behind the
processes involved is the reason for this. Reason seeks out the causes and effects of
actions, as well as evidence to support a hypothesis.
Impartiality is the principle of removing oneself from all forms of bias and prejudice in
order to develop an objective criterion free of unfair and unequal treatment of one group
of people over another.

So, should we stop listening to our feelings completely? Well, No. We must learn
to balance our emotions with our rational minds. Our emotions allow us to connect with
our humanity. It aids us in empathizing with others and considering how a particular
action would most likely affect them. Reason and impartiality, on the other hand, help us
see things more clearly by forcing us to be objective and separate ourselves from our
selfish desires.

REASON AND IMPARTIALITY AS MINIMUM REQUIREMENTS FOR MORALITY

Genuine moral or value judgments should be supported by compelling evidence.

Furthermore, they must have the quality of objectivity, which means that personal
feelings or inclinations should be suppressed if necessary.

Reason and Impartiality Defined

Moral truths are truths of reason. A moral judgment is true if it is espoused bybetter
reasons than the alternatives.

Reason is the basis or motive for an action, decision, or conviction. As a quality, it refers
to the capacity for logical, rational, and analytic thought; for consciously making sense of things,
establishing and verifying facts, applying commonsense and logic, and justifying, and if
necessary, changing practices, institutions, and beliefs based on existing or new existing
information. Reason spells the difference of moral judgments from mere expressions of
personal preference. Moral deliberation is a matter of weighing reasons and being guided by
them. Truth in Ethics entails being justified by good reasons. Being defined by good reasons,
moral judgments are objective in the sense that they are true no matter what we might want or
think. Reason commends what it commends, regardless of our feelings, attitudes, opinions, and
desires.
Impartiality involves the idea that each individual’s interests and point of view are
equally important. It is also called evenhandedness or fair-mindedness. Impartiality is a principle
of justice holding that decisions ought to be based on objective criteria, rather than on the basis
of bias, prejudice, or preferring the benefit to one person over another for improper reasons.
Impartiality in morality requires that we give equal and/or adequate consideration to the interests
of all concerned parties. From the impartial standpoint, to say that no one is seen as intrinsically
more significant than anyone else, is not to say that there is no reason whatsoever for which an
individual might demand more moral attention or better treatment than others.

The 7-Step Moral Reasoning Model

Contemporary author Scott Rae proposes a model for making ethical decisions. His
suggested 7-step model introduces the use of reason and impartiality in deciding on moral
matters. Rae starts presenting his model by telling the case of a twenty-year-old Hispanic male.
A twenty-year-old Hispanic male was brought to a hospital emergency room, having suffered
abdominal injuries due to gunshot wounds obtained ingang violence. He had no medical
insurance, and his stay in the hospital was somewhat shorter than expected due to his good
recovery. Physicians attending to him felt that he could complete his recovery at home just as
easily as in the hospital land he was released after only a few days in the hospital. During his
stay in the hospital, the patient admitted to his primary physician that he was HIV positive,
having contracted the virus that causes AIDS. This was confirmed by a blood test administered
while he was hospitalized.

When he was discharged from the hospital, the physician recommended that a
professional nurse visit him regularly at home in order to change the bandages on his still
substantial wounds and to ensure that an infection did not develop. Since he had no health
insurance, he was dependent on Medicaid, a government program that pays for necessary
medical care for those who cannot afford it. However, Medicaid refused to pay for home nursing
care since there was someone already in the home who was capable of providing the necessary
care. That person was the patient’s twenty-two-year-old sister, who was willing to take care of
her brother until he was fully recovered. Their mother had died years ago and the sister was
accustomed to providing care for her younger siblings. The patient had no objection to his sister
providing this care, but he insisted that she not be told that he had tested HIV positive. Though
he had always had a good relationship with his sister, she did not know that he was an active
homosexual. His even greater fear was that his father would hear of his homosexual orientation
and lifestyle. Homosexuality is generally looked upon with extreme disfavor among Hispanics.
Now here lies the moral dilemma – the patient’s doctor is bound by his code of ethics that puts a
very high priority on keeping confidentiality. On the other hand, the patient’s sister, without
knowing the truth, is putting herself at risk by providing nursing care for him. So, if you were the
physician, what would you do in this case? Would you reach the rule of confidentiality to
safeguard the patient’s sister or would you keep confidentiality to protect the patient from harm
that would come to him from his other family members, especially his father?
For Rae, the question “What would you do in this situation?” is probably as good as the
question “How would you decide what to do in this situation?” He believes that the process of
making a moral decision can be as significant as the decision itself. He admits that the model is
not a formula that will automatically generate the “right” answer to an ethical problem but a
guideline in ascertaining that all the right questions are being asked in the process of ethical
deliberation.

Step 1: GATHER THE FACTS

This is the indispensable first step prior to any ethical analysis and reflection on the case. In
examining a case, we want to know the available facts at hand, as well as any facts presently
not known but that need to be determined.
The relevant facts in the case of the twenty-year-old Hispanic for Rae are as follows:
 The patient is a young man, infected with HIV and an active homosexual.
 He suffered fairly severe abdominal wounds but is recovering well.
 Homosexuality is looked down upon in Hispanic communities.
 The patient has insisted that his physician maintain confidentiality about his HIV status.
 The patient is afraid of rejection by his father if his homosexuality is discovered, an
understandable fear given the way that homosexuality is viewed in the Hispanic
community.
 He was wounded by gunfire in gang violence. It is not clear but is a reasonable
assumption that he is a gang member. As a result, he likely fears rejection and perhaps
retribution from his fellow gang members, especially if they discover that he is HIV
positive.
 He is uninsured and cannot afford home nursing care by a professional.
 Medicaid refuses to pay for professional home nursing care.
 The patient’s sister is willing and able to provide the necessary nursing care for her
brother. She is accustomed to providing maternal-like care for her brothers and sisters.
 The patient has specifically requested that his sister not be told of his HIV status. She
does not know that he is an active homosexual
 The patient’s sister would be changing fairly sizable wound dressings for her brother and
the chances are high that she would come into contact with his HIV infected blood. The
probability of her becoming infected with the virus from this contact is difficult to predict.

Step 2: DETERMINE THE ETHICAL ISSUES

The moral issues should be correctly stated in terms of competing interests. It is these
conflicting interests that practically make for a moral dilemma.
The conflict in the case of the twenty-year-old Hispanic is the need for patient confidentiality
versus the duty to warn the sister of risk of harm.

Step 3: IDENTIFY THE PRINCIPLES THAT HAVE A BEARING ON THE CASE

In any moral dilemma, there are sure moral values or principles that are vital to the rival
positions being taken. It is very significant to recognize these principles, and in some cases, to
decide whether some principles are to be weighted more heavily than others.
The case is about a conflict of rights, a conflict of duties that the physician has toward his
patient and toward his sister. Two principles are thus dominant. First is the widely
acknowledged principle that patients have a right to have their medical information kept
confidential especially when the information could be used to harm them if it would be revealed.
Second is the duty of the physician to warn interested parties other than the patient if they are at
risk of looming and considerable harm. No doubt, the principle of confidentiality is deemed
virtually sacred in the medical profession and most physicians will argue that it is necessary to
keep confidentiality if patients are to trust their physicians and continue coming for treatment.
However, confidentiality is often measured as subordinate to the duty to warn someone who will
likely be harmed if that information is not revealed. The crucial question in weighing the two
conflicting principles is the degree of risk that the patient’s sister is taking by providing nursing
care for her brother. Considering that the sister has volunteered to perform a very self-
sacrificing service for her brother, it can be argued that self-sacrifice is an additional factor that
weighs the duty to warn principle more heavily. Some would even claim that the patient’s HIV is
an example of “reaping what one sows,” and that all the more minimizes consideration of the
patient’s desire for confidentiality. Another element that should be considered in the deliberation
is that the risk to the patient, though it may have a higher probability of happening, is not as
severe as the risk to the sister.

Step 4: LIST THE ALTERNATIVES

This step involves coming up with various alternative courses of action as part of the creative
thinking included in resolving a moral dilemma.
One option is to tell the sister that her brother is HIV positive. A second option is to refuse to tell
her that information. One alternative is for the physician to warn the patient’s sister in general
terms about taking suitable precautions for caring for these types of wounds. Another alternative
is to request the patient to inform his sister of his condition. If the patient declined, then the next
step might be to say to him in effect, “If you do not tell her, I will.”

Step 5: COMPARE THE ALTERNATIVES WITH THE PRINCIPLES

This step involves eliminating alternatives, according to the moral principles that have a bearing
on the case. As a matter of fact, the purpose of this comparison is to determine whether there is
a clear decision that can be made without further deliberation. The alternative of “encouraging
universal precautions for the sister but not telling her why” comes very close to satisfying all
pertinent principles.

Step 6: WEIGH/ASSESS THE CONSEQUENCES

If the principles do not produce a clear decision, “then a consideration of the consequences of
the remaining available alternatives is in order. Both positive and negative consequences are to
be considered. Each option/alternative in consideration has effects on the sister, the patient and
the physician. The option of telling the sister (or insisting that the patient tells his sister) has the
following likely consequences:
 The sister would be properly warned about the risks of taking care of her brother,
minimizing the risk of her contracting HIV, and saving her from the risk of developing a
fatal illness.
 The brother’s HIV status would be out in the open, leaving family and gang friends to
draw their own conclusions about his homosexuality. Should they draw the right
conclusion, which is likely, he suffers significant psycho-social harm from his gang
members, and possibly (though not certainly) from his family.
 Trust with the physician and the patient suffers and he may refuse to see that physician,
or any other one again until a dire medical emergency. This would be unfortunate since
due to his HIV status, he will need ongoing medical care. In the alternative of the
physician refusing to disclose the information, the following may be estimated as the
likely consequences:
 The sister would not know about the risks she is taking, making her vulnerable to
contracting an infection for which there is no cure. The degree of risk that she is taking is
open to debate, but some would argue that if the degree or risk is any more than
minimal, that justifies warning her since the virus produces a fatal disease.
 The patient’s HIV status is a well-kept secret, as his homosexuality. But it is not likely
that either his HIV status or his homosexuality can be kept a secret forever, since as HIV
develops into full-blown AIDS, both are likely to come out at some point in the future.
 Trust between the physician and patient is maintained. Now, if the alternative of telling
the sister to take general precautions is adopted, the following are the likely
consequences:
 She may exercise appropriate caution in taking care of her brother, but she may not.
She may treat the precautions casually and unknowingly put herself at risk. If the
physician tells her about the precautions in very strong terms to ensure her compliance,
that may start her asking questions about why the doctor was so insistent on her
following his precautions. In fact, one of the motives of the physician might be to nudge
her toward asking some of those questions, of her brother, to further minimize the risk of
contracting HIV.
 In general, the patient’s HIV status and homosexual orientation are kept secret, and
confidentiality is honored, but the question of how long it will remain a secret is unknown
and it is likely that it will become known eventually.
  Trust with the physician and patient is maintained. However, if the sister is nudged to
ask her brother some pressing questions about why these precautions are so important,
he may conclude that the physician has prompted his sister to ask these questions,
leaving him feeling betrayed.

Step 7: MAKE A DECISION

Since deliberation ought not to go on forever, a decision must be made at some point. Normally,
the decision that is made is one that possesses the least number of problems or negative
consequences. Rae offers no definite decision under this final step but instead leaves us the
following further guiding questions:
 What would you decide in this case?
 Which principles are the weightiest?
 Are there others that you would include?
 Which alternatives are the most viable?
 Are there others that you would suggest?
 Which consequences seem to you the most severe?
 Are there others that you think will occur?

Indeed, it is significant to understand that at some point, we must stop deliberating and
decide, as uncomfortable as that may be. For one thing, Rae’s model is good in the sense that
it has room in it to accommodate a whole host of different moral and ethical perspectives,
considering the ethnic and religious diversity of our society. The model is not necessarily tied to
anyone specific perspective, but can be employed comfortably with a variety of ethnic, cultural
and religious backgrounds. Finally, it promotes the primal consideration of reason and
impartiality in ethics without necessarily eradicating the role of feelings in ethical deliberation.

TEST YOU KNOWLEDGE

Name of Student: ____________________ Section: ___________________________

Course Code: GE 8 Instructor: Lyka Bernadette T. Versoza
Course Title: Ethics No. of lecture hours per week: 3 hours
Term: First Sem. 2020-2021 Google Class Code: ywvbpuy
Date: _________________________

Activity | Case Analysis

Direction: Use the 7-stepmoral reasoning model to solve the following case:

Juan Dela Cruz is a healthcare worker attending to the call of duty in the midst of the
COVID-19 pandemic. He is the breadwinner of his family. He takes care of his aged parents and
he has young children. Every health care worker counts during these times and there have been
instances where entire hospitals have been forced to shut down because of presumed exposure
or suspected status of one health care worker. In such an all hands-on deck scenario, to try to
push oneself to the limits of endurance, neglecting physical symptoms and needs, is par for the
course. In the hospital where Juan is working, there is limited availability of personal protective
equipment (PPE) and inequitable distribution of available equipment like ventilators. How
should he balance his ethical duty to care for his patient against genuine concerns of contacting
COVID-19 and spreading it to his family? If he thinks he has some respiratory symptoms and he
thinks he may have been exposed, should he open up about his symptoms and stay at home,
risking social and workplace discrimination, or continue to go about his work as usual, risking
his colleagues’ health, until his test comes positive?

REFERENCES
A. Online Resources:
Reason and Impartiality as Minimum Requirements for Morality/Michael Angelo F.
Empizo/Saint Louis College, City of San Fernando, La Union Memorial of Saint
Athanasius, Bishop and Doctor of the Church. Retrieved from May 02, 2020
https://www.scribd.com/embeds/482313051/

B. Printed resources:
Ethics/Paul J. Glenn/Published 2010
Ethics: Principles of Ethical Behavior in Modern Society by Jens Micah De Guzman et al.