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Ethical Analysis
Holly Taylor, MPH, PhDJohns Hopkins University
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Ethical Analysis
Topics to be covered– Introduction to ethics– Framework for ethical analysis– Supplementing the framework
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Section A
Introduction to Ethics
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Normative Ethical Theory
Person(s)ActionsConsequences
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Normative Ethical Theory
Virtue theoryConsequentialist theoryNon-consequentialist theory
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Virtue Theory (Aristotle)
Focus on personCultivation of virtuous traits
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Virtue Theory (Aristotle)
“A just person—that is a person with the virtue of fairness—not only has the disposition to act fairly, but when so acting has a morally appropriate desire to do so. The person characteristically has a moral concern and reservation about acting in a way that would be unfair (p. 214).”
Source: Beauchamp, Tom L.(1991) Philosophical Ethics: Introduction to Moral Philosophy Continued 8
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Virtue Theory (Aristotle)
Practical virtue
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Consequentialism(John Stuart Mill)
Focus on consequences of action(s)– Action(s) are right in
proportion as they tend to promote happiness, wrong as they tend to produce the opposite of happiness
Utilitarian
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Consequentialism(John Stuart Mill)
Maximizing principleImpersonal perspective
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Consequentialism(John Stuart Mill)
Utility can conflict with other values– HIV vaccine example
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Non-Consequentialism(Immanuel Kant)
DeontologicFocus on action(s) takenMotive to act
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Non-Consequentialism(Immanuel Kant)
Categorical imperativeRespect for persons– Individuals should not be treated simply as
means to an end
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Section B
Framework for Ethical Analysis
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Framework for Ethical Analysis
Belmont Report (1978)Clinical practice vs. researchThree principles
1. Beneficence2. Respect for Persons3. Justice
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Beneficence
Moral requirements– Do no harm– Maximize benefits/minimize harms
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Beneficence
Practical applications– Study design– Risk/benefit ratio
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Respect for Persons
Moral requirements– Acknowledge autonomy– Protect those with diminished autonomy
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Respect for Persons
Practical ApplicationsInformed consent
1. Information2. Comprehension3. Voluntariness
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Respect for Persons
Practical ApplicationsInformational privacy and confidentiality– Primary data collection– Secondary data analysis
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Justice
Moral requirement– Equals should be treated equally– To each an equal share– To each according to effort– To each according to societal contribution– To each person according to merit
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Justice
Practical ApplicationsFair procedures for selection of study subjects– Individual– SocialGender/minority equity
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Supplementing Framework
Casuist perspective (Jonsen and Toulmin)Relationship paradgim (King, Henderson, Stein)
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Supplementing Framework
Principlist ParadigmBalancing principlesEthical universalismAtomistic focus
Relationship ParadigmLayering of relevant relationshipsContext-basedCross-cutting issuesNarrative focusContinuityChange
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Summary
Goal—create thoughtful principlists
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