Ethics

Question 1

Why are values important in policy?

Answer 1

Policy is concerned with choice among competing values

Question 2

Values

Answer 2

One’s judgement of what is important or of worth, the assumption of which can be the basis for ethical action

• what we care about

Question 3

Example of the role of values in a public policy setting - speed limits

Answer 3

• Evidence showed lowering speed limits will reduce vehicle and pedestrian accidents
• People may disagree - although it is proven to be good for health, people may have different values regarding this
• People may value getting places faster and accepting the risks over health

Question 4

Why do we not always follow science when making health policies?

Answer 4

• because of differing values
  Ex. closing schools in covid
• science says that schools should close bec it would reduce transmission of infection
  BUT…
• some may want schools to stay open and take the risk of contracting virus bc they value education
• Some might want schools to close bc they value their health over education

Question 5

When do values enter into policy making?

Answer 5

at every step
- when evaluative language is used (right, wrong, good, or bad)
- when establishing policy objectives
- when navigating trade-offs
- when values are invoked (ie. equity, fairness, minimizing harms, autonomy, patient-centred care)

Question 6

Example of values role in navigating trade offs in policies

Answer 6

do we want to vaccinate health care workers, who are more at risk, 1st before the general pop?

• do we want healthcare workers to have both doses and be very protected
  OR
• have the general pop all have 1 dose and having partial protection –> trade off

Question 7

Ethics

Answer 7

The systematic study of moral choices; it concerns the values that underpin moral choices and the language used to describe those choices
- seeks to identify, clarify, and resolve questions dealing with concepts of right and wrong, good and bad

Question 8

What is the is-ought problem?

Answer 8

One cannot logically infer what one ethically ‘ought’ to do simply on the basis of how things ‘are’

• ignores logic and other factors
• The fact that people tend to act in a certain way doesn’t automatically imply that they morally should act that way

Question 9

Example of the is-ought problem

Answer 9

Premise: COVID-19 vaccines are effective in reducing risks of severe disease, hospitalization, death, infection, and transmission

Conclusion: One ought, morally speaking, to be vaccinated

Question 10

How to fix the is-ought problem

Answer 10

• use of science and ethics
• Introduce explicit arguments rather than just leaping to conclusion
• Need mulitple premise supporting - linking ethical argument with facts

Question 11

Example of fixing the is-ought problem?

Answer 11

Premise 1: COVID-19 vaccines are effective in reducing risks of severe disease, hospitalization, death,1 and to a lesser extent, infection and transmission

Premise 2: Being vaccinated against COVID-19 represents a minimal burden for nearly all people

Premise 3: One ought to prevent suffering and death, especially when doing so carries a minimal burden

Conclusion: One ought, morally speaking, to be vaccinated

Question 12

Descriptive Moral Relativism

Answer 12

As a matter of empirical fact, there are deep and widespread moral disagreements across different societies, and these disagreements are much more significant than whatever agreements there may be

Question 13

Metaethical Moral Relativism

Answer 13

• The truth or falsity of moral judgments, or their justification, is not absolute or universal, but is relative to the traditions, convictions, or practices of a group of persons
• no universal truth
  ex; killing is wrong –> what makes this true? is that an opinion?
• they are not absolute, but only relative to particular standpoints

Question 14

Criticism for metaethical moral relativism

Answer 14

• no use of reasoning and making arguments
• arguments are not made with logic, facts, evidence
• self-defeating theory - how is it true that there is no objectivity? is that in itself just an opinion?

Question 15

Ethics is NOT about ____

Answer 15

opinions
- You may have an opinion, but that doesn’t mean it is ‘right’, coherent, justified, or ought to be the basis for policy

Question 16

Ethical dilemma regarding IVF multiple pregnancies in Canada

Answer 16

case of many fetuses
- Risky pregnancy - high chance of spontaneous abortion, risking mothers life
- Common practice in hospital = Some people have option to reduce number of fetuses to 1, less risk
- Zero policies about how they ought to do this - depends on the doctor or nursing staff
- Ethically wrong - undermines idea of fairness if everyone is getting different care depending on the hospital or physician

Question 17

Relationship between policy and ethics

Answer 17

• Policy is a way to treat people fairly and consistently by avoiding unethical situations
• Policy allows to make things systematic - more fair

Question 18

3 major approaches to ethical theory

Answer 18

1. deontological ethics
2. teleological ethics
3. virtue ethics

Question 19

Deontological Ethics

Answer 19

• the study of duty
• concerns rules
• What is a moral rule for which you think there is general agreement?
• science or study of duties
• The ‘right’ is prior to the ‘good
• identify duties/rules and reason from them to determine the right course of action

Question 20

Ex of deontological ethics

Answer 20

ex; government has the duty to stop the spread of infectious disease. if the government does not take action, it is wrong, they are not fulfilling there duties, therefore wrong

Question 21

Teleological ethics

Answer 21

• the study of goals
• study of different ends of objectives we have in life
• What is one thing you believe has high value in life, for which you think there is general agreement?
• The ‘good’ is defined before and independent of, the ‘right’
• look to the outcomes we want to get, and determine the right course of action to achieve this outcomes

Ie. If you care about money, the right thing to do is whatever gets you more money

Question 22

Example of stealing in deontology vs teleology

Answer 22

stealing:
Deontology - don’t steal its wrong
Teleology - if stealing gets you more money and that is the desired outcome, its right

Question 23

Virtue ethics

Answer 23

What kind of person should you be?
are virtues of patience, honesty, how can we practice these virtues?
- acting in such a way that embodies virtues

Question 24

Utilitarianism

Answer 24

• example of consequentialism, where outcomes of actions are the only factor of moral relevance
• Defines the ‘good’ independent (and prior) to the ‘right’
• the greatest happiness for the greatest number, maximizing good for the most people
• act in a way that will produce greats good for the most people
• Whatever is good is what is right

Question 25

Criticism of Utilitarianism

Answer 25

• why should we ignore duties and process that may be unethical
• how is the good distributed? what if it is only distributed to only privileged, people?
  –> not necessarily fair

Question 26

Ethical frameworks

Answer 26

• Articulate morally relevant, ‘mid-level’ values and principles and steps to apply them to inform action
  ex. between theory and practice
• they are ‘mid-level’ bc not foundational theories that tell you what to do
• They say think about this and act in a way that promotes this [particular thing
• Can draw from (multiple) theories, values, and principles in light of practical ethical challenges

Question 27

Harm Principle (John Stuart Mill)

Answer 27

• The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant
• If you are a government, you have power of people, the only just way to intervene is to prevent harm to others, not yourself
  ex. government enforces speed limits, smoke free policies (in public areas so you dont put other people at risk)

Question 28

Precautionary Principle

Answer 28

When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically

• it may take long to generate evidence about something = negative outcomes in the mean time

Question 29

Example of Precautionary Principle

Answer 29

• Don’t need full evidence that people will be harmed if public places stay open
• do not wait to get evidence that shows us that going to restaurants will increase to more covid cases
• invoke the precautionary principle and restrict people from going to restaurants so they don’t cause worth health outcomes

Question 30

Least Restrictive Means

Answer 30

• Canadian government follows this
• the full force of state authority and power should be reserved for exceptional circumstances and that more coercive methods should be employed only when less coercive methods have failed
• Use less coercive means first - education, disincentives/incentives (sermon, carrot)
• unethical to jump straight to coercion without trying other methods first

Question 31

Reciprocity

Answer 31

Once public health action is warranted…[e.g., quarantine; isolation] there is an obligation on a social entity (a public health department) to assist the individual (or community) in the discharge of their ethical duties

Question 32

Ex of reciprocity

Answer 32

ex. isolating during covid
- Society should help the person isolating since they are doing something good
- give money to support them

Question 33

Descriptive ethics

Answer 33

What do people believe is ‘right’ or ‘good’ with respect to a health policy issue?
- describing and analyzing the moral landscape as it exists, without prescribing what people ought to believe or how they ought to behave
ex. survey the public and ask their opinion
tells us empirically about peoples opinions on a topic

Question 34

Theoretical Ethics

Answer 34

What makes a decision or action an ethical one?
- provide guidance on how people ought to behave
provide theory or reason why

Question 35

Normative Ethics

Answer 35

• providing standards or norms for determining what is morally right, wrong, obligatory, or permissible
  What should be done in a specific circumstance?
  considering all factors to make the ethical decision