Descriptive Ethics--Stating actual moral beliefs.
Normative Ethics--Study of what is really right or wrong.
Metaethics--Study about field of Ethics.
Metaethics Theories
Objectivism--There are correct and incorrect answers.
Subjectivism--There are no correct or incorrect answers.
Absolutism--All moral rules hold without exception--there is only one truth; opposite of relativism, contrasts with consequentialism.
Rights--Justified claims upon other(s) for actions or non-actions.
Negative Obligation (Right)--An obligation to refrain from something or entitlements to do something without interference from other people. See also autonomy.
Positive Obligation (Right)--An obligation to perform / provide, etc., or entitlements that obligate others to do something positive to assist you.
In rem--Universal rights (obligations fall on all moral agents).
In personam--Restricted rights (obligations fall on selected individuals).
General Obligations--moral requirements of all moral beings.
Role-related Obligations--moral requirements of specific roles, e.g. MD, priest, etc.
Strong Paternalism--Forced acts of beneficence on person able to decide.
Weak Paternalism--Forced acts of beneficence on person unable to decide.
Negative Paternalism--Refraining from doing something to/for someone.
4 Main Ethical Principles / Values
Nonmaleficence--Do no harm; (Primum non nocere - first, do no harm); a negative right.
Beneficence--Do good; promoting the welfare of others; actively avoiding harm; a positive right.
Autonomy--Non-interference with other's choices and freedom to make choices / self determination.
Justice / Social Justice--Equal treatment for all.
Ethical Systems Theories (*Related concepts)
*Consequentialism--The end justifies the means; the rightness or wrongness of any action depends on its consequences.
*Utilitarianism (act)--To act in a beneficial way based strictly on the good
consequences for the most people; case-by-case analysis of each act.
*Utilitarianism (rule)-- To act in a beneficial way (with good consequences for the
most people) based on moral rules; categorical imperative?
Deontologism--It's not whether you win or lose, it's how you play the game; some actions are right or wrong regardless of their consequences; contrasts with consequentialism.
Relativism--it all depends--all points of view are equally valid.
Also: When in Rome, do as the Romans do (cultural relativism).
Beauty is in the eye of the beholder (personal relativism).
*Doctrine of Double Effect--intention is everything; concerns only intended means or ends, not actual means or ends even if predictable (i.e. chemo side-F/Xs).
Patient Relationship Models
Engineering Model--Just the facts, ma'am; healthcare professionals as scientists presenting facts--patients make decisions based on these facts.
Paternalistic Model--Do what I say; decisions are made by healthcare professionals.
Contractual Model--Let's make a deal; healthcare professionals give information--assist patients in decision-making by making recommendations.
Confidentiality--Not divulging information which another has revealed on condition of secrecy; patient's right to privacy (of information).
Deontological Argument for the Obligation of Confidentiality--Respecting confidentiality respects patient autonomy.
Consequentialistic Argument for the Obligation of Confidentiality--Respecting confidentiality protects and promotes well-being of patients.
3 Accepted Exceptions for Divulging a Patient Confidence--Patient not competent, required by law, protect public interest.
Truth Telling (Veracity)--Obligation to tell the truth.
Consequentialistic Case for Telling and Withholding the Truth--Do what will most benefit/least harm patient; truth-telling / withholding truth context dependent.
3 (actually 4) Possible Exceptions to the Truth-Telling Rule--Family request, patient request, for the good of others (less so now), avoiding disastrous consequences (extreme cases).
5 Elements of Informed Consent--Competence, information disclosure, understanding, voluntariness, and authorization.
