BASIC ETHICAL THEORY

PART B - POSSIBLE GROUNDING

OF ETHICS

DR. MOHAMMAD KASHIF SHAFIQ

Course Text book:

Ethical Questions in Dentistry, Second Edition (2004)
by James T. Rule & Robert M. Veatch; Quintessence Books
ISBN: 0-86715-443-8
POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

 Ethics and Morals are established in relation to a

certain identified standard or reference.

 Various standards/references are applied based on

the nature of the moral evaluations.
POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

1. Cultural Relativism

Nothing more than judgments of our culture; must simply

meet one’s cultural standards.

Different cultures differ & hence different judgments.

Problem with cultural relativism – difficulty in identifying

one single relevant culture due to multiple types of
cultures (religious, national, ethnic, familial or
educational).
POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

2. Personal Relativism

A behavior or character is considered good or right

when it is in line with one’s personal standard.

Here, the Individual, and not culture, is considered the

standard of reference.

Would be logically impossible to establish the basis of

morals and ethics as this would just mean following
people’s individual standards.
POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

3. Professional Codes

Historically, professions have generated their own

codes of ethics and have been responsible for
resolving of disputes.

Hippocratic Oath – loyalty oath + code of conduct ; may

be considered as the foundation of healthcare ethics.
POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

3. Professional Codes

Different reasonings–
 Profession by its very nature creates its own ethical
standards; profession is the single, universal source of
ethics for itself.

 Profession is only one possible source and other groups

and sources would also be involved – religion, culture,
social standards, law.

 Becoming a professional by itself teaches the individual

the ethical standards of that profession.

Idea is becoming increasingly controversial.

POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

4. Universal Standards

A moral judgment is based on some universal source that, in

principle, everyone can relate to.

For religious groups: An action or character is ethical when it

conforms to the moral standards of GOD.

Other bases for a universal standard:

 By reasoning (facts and understanding).
 By human nature (through learning and experience).
 By intuition (inner feeling)

Disagreements – some consider these as merely expressions of

emotion; ef forts to somehow reach an agreement, or for
directing the behaviors of others.
POSSIBLE GROUNDING OF ETHICS
(BASIS/ORIGIN OF ETHICAL BELIEFS)

Probably, no single theory which convinces us about

the ultimate basis of moral judgments!!

Hence, each one needs to think and judge for him or

herself; but that doesn’t in anyway mean that ethics
is only a matter of opinions.
POSSIBLE GROUNDING OF ETHICS

Alternative Theories of Normative Ethics

Normative Ethics – based on logical reasonings as to what

makes actions, policies, rules, or character right and
wrong, good or bad. It does not take into account the
origin, justification and standard of reference.

3 general kinds of judgments:

 which kind of actions or rules are right – Action Theor y
 which nonmoral things are good or bad – Value Theory or
Axiology
 which traits of character are desirable – Vir tue Theor y

(Text book reading – Ch. 3: Page 81)

ACTION THEORY

Action Theory (Theory of Right Action)

Most obvious ethical question – whether a certain

behavior/action is morally acceptable.
This theory states the principles that tend to make actions right
or wrong:
 Beneficence – doing good
 Nonmaleficence – avoiding harm
 Veracity – truth telling
 Fidelity –faithfulness, including keeping promises
 Respect for autonomy
 Avoidance of killing
 Justice – fairness and equality

Ethics requires converting these general principles to judgments

about specific situations.

(Text book reading – Ch. 3: Page 81)

ACTION THEORY - 2 Sub theories

Action Theory is essentially composed of 2 sub theories:

a. Consequentialistic Theory

Mostly dominant in healthcare ethics; ‘What really matters is the

consequences’.

Dominant principles – beneficence & nonmaleficence; doing

good & avoiding harm are the only relevant features of
action.

The definitive principle of ethics is that an action is right if it

does as much or more good than any alternative action.

Healthcare ethics, including dental ethics, places great emphasis

on consequences.
ACTION THEORY - 2 Sub theories

b. Deontological Theories

The ‘right’ action is not only determined by the

consequences alone.

Right action, rule, or practice is determined, at least in

part, by principles other than those which focus on
consequences.

The principles that do not focus on maximizing net good

consequences include: Veracity, Fidelity (including
keeping promises), Avoidance of killing, Justice.
VALUE THEORY

Value Theory

An account of what is considered a ‘good’ or a ‘harm’ for

the patient.

Some opinions based on subjective choices; others are

more objective.

Takes into consideration the relation between healthcare &

other aspects of the a patient - economic, social,
psychological, familial, legal and spiritual.

Certainly, it is difficult to exactly know what will maximize

the general well-being of a particular patient.

(Text book reading – Ch. 3: Page 84)

VIRTUE THEORY

Virtue Theory

In healthcare, we are also interested in the character as

much as in behavior.

Virtues – Traits of character that are judged as good or bad.

Virtue theory focuses on character rather than the behavior

or action.

Virtues tend to correlate with the action and its outcome.

e.g. : Virtue of benevolence – beneficence (doing good)

(Text book reading – Ch. 3: Page 85)