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Chapter Two

Decision Making

in Value Issues

“Am I Sure It Is My Job

to Handle This?”

• Review the case – does the new person

have an obligation?

• Decision making formats require you to

ask yourself:

– What are the facts?

– What values are at stake?

– What options are available to me?

• Evaluate options and select the best one

Examining Value Issues

• Consequence-oriented:

– The right answer would maximize some good

– Utilitarianism

• Duty-oriented:

– Consequences are essentially irrelevant;

rightness or wrongness are inherent in the act

itself

– Kantian ethics

Examining Value Issues (continued)

• Virtue ethics

– Emphasis is not consequences nor

reasoning to a universal truth, but rather

the character of the actor or the duty

associated with the role

– Aretaic ethics

• Divine command ethics

– Right answer in a finite set of rules set

forth by a divine or exemplary being

Consequence-Oriented

Theories

• Utilitarianism

– Jeremy Bentham, John Stuart Mill

– No appeal to an absolute authority or

principle; the only test of rival solutions

lies in the consequences

– The good resides in the promotion of

happiness, or the greatest net increase

of pleasure over pain

Utilitarianism

• Act utilitarianism:

– “Pig philosophy” problem

• Equal consideration of interest

– “Hedonic calculus” problem

• Rule utilitarianism:

– Right action conforms to a rule that has

been validated by the principle of utility

Consequence-Oriented

Reasoning

1. Describe the problem

2. List solutions

3. Compare solutions with UTILITY

• Work the problem of Mr. Jimenez:

case study: Act Utilitarianism

Criticisms of Utilitarianism

• Impossible to calculate all possible

consequences

• Used to sanction unfairness

• Lack of sensitivity to special duties

• Lack of respect for persons

Criticisms of Utilitarianism (continued)

• May allow unacceptable intervention

in private lives of individuals

• If followed, may recommend solutions

that conflict with personal belief

Kantian Ethics

• Immanuel Kant (1724–1804)

– Humans are rational beings

– Morality is derived from rationality; our

obligations are grounded not in our

nature or in circumstances but in pure

reason

– Reason provides the guide to universal

principles that can be applied to all

people, at all times, in all situations

Kantian Ethics (continued)

• Categorical imperatives:

– Universal application

– Unconditionality

– Demanding an action

• An action is either right or wrong; it cannot

be both

• Example maxim for health care providers:

“We must always treat others as ends and

not as means only”

Duty-Oriented Reasoning

Describe problem List Solutions Compare Solutions with

Principles

Possible findings

One Compliant

Alternative

Several Compliant

Alternatives

Compliant/Conflicting

Principles

Correct Answer Select Among

Choices Rank Principles

Select Choice Work case study: Duty-Oriented Reasoning

Criticisms of

Duty-Oriented Reasoning • Exceptionless nature – too rigid for

real life

• Morality not derived from reason

alone

• Disregard of consequences

• Question of concern for nonhumans

• Multiple solutions of equal merit

possible

Virtue Ethics

• Aretaic ethics:

– Taken from Greek arete, which means

excellence or virtue

• Big question:

– “Is it the action or the character of the

agent acting that is the heart of the

matter?”

Virtue Ethics (continued)

• Virtue ethics:

– Emphasis placed on heart of the moral

agent, not the particular action

• If an individual lives a life of good

moral character and develops ethical

habits – ethical response to a

problem expected

Virtue Ethics (continued)

• The question is not “what shall I do?”

in a particular situation, but rather,

“how shall I live?”

Virtue Ethics (continued)

• Modern formulation of virtue ethics:

– Each profession has set of virtues that

practitioners can adopt in practice

– When personal habits, they come

forward when questions arise

• The question: “What would a good

(fill in specialty) do in this situation?”

Reasoning with Virtue Ethics

1. Describe problem

2. List solutions

3. Compare solutions with

professional traditions

4. Correct answer

• Review case study:

Virtue Ethics: Saints and Sinners

Criticisms of Virtue Ethics

• Does not provide specific direction for

problems

• New problems may require new

solutions not covered by traditional

practice

• Relying on tradition may not allow

respect for individual choice or use of

reason

Criticisms of Virtue Ethics

(continued)

• Humans may attempt to respond to

several different role demands at

same time

• Results may not maximize happiness

Divine Command Ethics

• Big Idea:

– Divine or exemplary being has set down

a finite set of rules by which one can

gain guidance when making ethical

decisions

• Specific reference to divine scripture

such as the Ten Commandments

Divine Command Ethics (continued)

• General evaluation of actions based

on a model of perfection

• WWJD – if you are Christian, what

would Jesus do?

• In a similar fashion Muslims and

Buddhists turn to the life and example

of Muhammad and Siddhartha

Gautama

Reasoning by

Divine Command

1. Describe problem

2. List solutions

3. Find appropriate scriptural

reference

4. Follow scriptural admonition

Criticisms of Divine

Command Ethics

• Belief in divine or exemplary beings

can be questioned by non-believers

• Scriptures do not cover all possible

cases that require moral decisions

• Seeming exceptionless nature

Criticisms of Divine

Command Ethics (continued)

• Euthyphro problem

• Recently several beheadings were

justified in the name of God; they

believed God told them to do this

Key Concepts

• Several theoretical positions for solving ethical dilemmas:

– Consequence

– Duty

– Virtue

– Divine command

• Review the illustrations for each position in the chapter and solve a problem using the system

Key Concepts (continued)

• Act utilitarianism:

– Purest form of utilitarian reasoning,

each act evaluated for pleasure

attained, pain avoided

• Rule utilitarianism:

– Develops rules for action based on

previous validation by principle of utility

Key Concepts (continued)

• Equal consideration of interest

important concept to keep

utilitarianism from becoming a purely

self-serving form of reasoning

Key Concepts (continued)

• Kant proposed duty-oriented system:

morality based on rationality, not

experience

• Consequences essentially irrelevant

• Universal truths create obligations for

actions, binding for all people, for all

times, in all situations

Key Concepts (continued)

• The primary focus for virtue ethics is

the heart of the moral agent

• Virtues can be formed as habits,

which in times of question become

our choice of action

• Even in virtue, the ancient Greeks

counseled moderation and the golden

mean

Key Concepts (continued)

• Divine command ethics

– Source of divine guidance or exemplary

being:

• Ten Commandments (Christians and Jews)

• Eight-Fold Path (Buddhists)

– Problem of nonbelievers

– Euthyphro problem