What is Bioethics?

Week 1 – Methods and Motivations

What are Arguments?

• Chain of reasoning justifying a conclusion• 2 Parts: Premises and Conclusions

– Premises work together to justify the conclusions

• A Simple Example:– 1. PREMISE: All men are mortal– 2. PREMISE: Socrates is a man– 3. CONCLUSION: Socrates is mortal

Facts and Values in Arguments

• A “fact” claim attempts to DESCRIBE the way the world is:– “The Earth is spherical” is a TRUE fact claim– “The Sun revolves around the Earth” is a FALSE fact

claim – but is still a fact claim!

• A “value” (or evaluative) claim attempts to PRESCRIBE how the world SHOULD be:– There should be universal healthcare– All beings with human DNA are persons (person is a

MORAL term) – This looks factual, but it isn’t

Is-Ought Gap

• If a conclusion is evaluative (a value claim) then there must be a fact-value connection claim:– 1. A human fetus has a brainwave after 25 weeks of

gestation (FACT claim)– 2. A human with a brainwave is a person (FACT-

VALUE connection – “person” is a MORAL term)– 3. Killing a person is morally wrong (VALUE claim)– 4. So, killing a human fetus with a brainwave is

morally wrong (VALUE conclusion)

A Common Mistake

• Explanation of why YOU believe something does not necessarily justify why I should believe it:– 1. I was taught by my parents that abortion is

wrong. (FACT claim)– 2. Therefore, abortion is wrong. (VALUE

claim)• Moral arguments need reasons ANYONE could

believe (even if they don’t in fact believe them)

The Pillars of Bioethics

• 3 Principles, often now understood as 4:– Respect for Persons (or Respect for Autonomy)

• Receiving Informed Consent prior to a Procedure– Beneficence

• Providing a treatment that makes a patient better off– Non-Maleficence

• Not harming a patient, for instance by providing a painful treatment known to be ineffective

– Justice• Providing equal treatment to all patients, regardless of socio-

economic status, etc.

Reasoning with the Pillars

• Each Pillar represents a VALUE claim: Persons should be respected; physicians should not harm, etc.

• Reasoning from the pillars involves– Determining the facts– Connecting the facts to the values– Evaluating all premises

A Simple Case• A physician is deciding whether or not to provide an injection to an unwilling

patient.• Respect for Persons: Is she a person (does she have capacity for

consent/refusal)? – If yes, then giving the injection would disrespect her as a person

• Non-Maleficence: The injection is painful and there may be physical and psychological harm associated with forcing treatment

• Beneficence: The injection will cure the patient’s illness and improve her well-being

• Justice: The injection is the only mode of treatment, so there is no concern over sacrificing treatment for unjust reasons

• Respect for persons and non-maleficence count against administering the injection, while beneficence counts in favor.

• What should the physician do?

Balancing the Principles

• No principle always wins out• You cannot simply count up the number of

principles on either side of the case• Must argue for WHY, based on the

principles, the physician ought to administer or not administer the injection

• THIS IS WHERE THE FUN IS!