QuizWas Chase justified in causing Dibala to die?

Answer with reference to at least 2 of the following 3 ethical systems:

1) Virtue ethics2) Kantian ethics (deontological ethics)3) Utilitarianism

(morning group)

Quiz – The Transplant CaseCould a doctor be morally right to kill a cancer patient who has only 6 months to live in order to give his heart to a heart patient. Without the new heart, the heart patient will die in 2 hours. With the new heart, he could live for 30 healthy years. No other heart is available.

Answer with reference to one of these three ethical systems:

› Virtue ethics› Kantian ethics (deontological ethics)› Utilitarianism

What would someone who disagree with you say?

(afternoon group)

Paternalism vs.

Individual Rights

Debates (morning group)

February 21: Smoking should be banned in public places

February 28: Apes should be granted basic human rights

March 13: It is wrong to eat meat

Debates (afternoon group)

February 21: Smoking should be banned in public places

March 6: It is wrong to eat meat

Videos Videos should be like a short documentary on a

topic related to the course

15-20 minutes for 3 people groups 20-25 minutes for 4 people groups

Some video clips from other sources may be used, but the source must be clearly indicated. No more than 30% from other sources

You should give me your proposed topics today

PaternalismWe know what’s best for you.

The state should protect people from themselves.

The state is modeled after the family

Very popular historical understanding of the state’s relationship to its citizens

Aristotle compared the family to the state, the head of household to the monarch, the wife, children and slaves to the subjects

Confucius

Five relationships:

1) Ruler to Subject2) Father to Son3) Husband to Wife4) Elder Brother to Younger Brother5) Friend to Friend

In every relationship except friend to friend, the relationship is hierarchical, with the former using his wisdom and power to govern, guide and protect the latter.

Individual RightsJohn Stuart Mill “On Liberty” 1859

Rejected paternalism in favor of freedom

Proposed the harm principle:

That principle is, that the sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number, is self-protection. That 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 sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right... The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.”

Justification of the Harm Principle

Utilitarianism (Mill)

› Mill’s view: if the harm principle is followed, the greatest good for the greatest number will result

› Problem: is that true? What if violating rights leads to an increase in the general welfare? E.g. putting an innocent person in jail to avoid violent riots, likely deaths

Lockean justification

› People by nature are free and equal› Everyone has an inborn right to life

and liberty

The Declaration of Independence“We hold these truths to be self-evident, that all men are created

equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness”

Self-evident:

Known to be true by immediate understanding or by definition and requiring no proof or explanation, e.g. “I think therefore I am”

Obviously true to all right-thinking people, esp. morally self-evident

Inalienable:

Cannot be denied, surrendered or taken away

Concrete issues regarding paternalism vs. individual rights

Suicide/euthanasia Motorcycle helmets Smoking in public places Smoking privately Illegal drugs, e.g. marijuana, cocaine,

heroin Refusing life-saving medical treatment on

religious grounds for yourself/your children

Case studies of rights 1) The right to free speech 2) Euthanasia 3) Heroin 4) Cigarette smoking in public places

(debate next week) 5) Medical marijuana (debate?)

Freedom of speech In the ideology of the United States, freedom of

speech is one of the most important freedoms

Even in the U.S., though, there are restrictions on freedom of speech, e.g.

› Slander› Shouting fire in a crowded theater› Calling for overturn of the government› Revealing state secrets› Inciting a riot› Perjury (lying under oath)

More restrictions to free speech

Many countries have more extensive restrictions to free speech. E.g. Germany the following are illegal:

Insult Malicious gossip Hate speech Holocaust denial Rewarding and approving crimes Insulting faiths and religious beliefs

Setting boundaries What kind of limits to free speech are justifiable?

Is causing offensive considered causing harm (hence falling under the harm principle?)

What about offensive language, pornography, satirizing political and religious leaders

Some use of symbols are protected by freedom of speech laws and some aren’t, e.g. wearing a swastika, burning the flag, defacing a picture of the king

Promoting bad ideas Ideas, like people, need defense The public are the judge, not the state or a state-

appointed authority Seemingly wrong ideas should be defended as

vigorously as possible, so the public can make an informed decision

Examples: communism is good, capitalism is good, women are inferior, smoking is not bad for your health, gun control is unnecessary

Defending ideas legitimately can involve promoting controversial views and philosophies, finding and promulgating evidence and putting facts into favorable contexts, but not lying.

Mill’s defense of the free promulgation of mistaken or morally repugnant ideas

1) An idea that seems wrong might be right. Only open debate can ensure that we eventually arrive at the truth.

2) Outlawing the expression of a wrong-headed idea doesn’t get rid of the idea, but just drives it underground.

3) Countering wrong-headed ideas requires the correct ideas to be clarified and sometimes improved

“…there ought to exist the fullest liberty of professing and discussing, as a matter of ethical conviction, any doctrine, however immoral it may be considered…. If all mankind minus one were of one opinion, and only one person were of the contrary opinion, mankind would be no more justified in silencing that one person than he, if he had the power, would be justified in silencing mankind.” (Mill, On Liberty)

“I disapprove of what you say, but I will defend to the death your right to say it” (Evelyn Beatrice Hall, describing the beliefs of Voltaire)

“Let a hundred flowers bloom, let a hundred schools of thought contend” 百花齐放，百家争鸣 (Mao Zedong)

Euthanasia “Good death”

Voluntary: with patient’s consent/at patient’s request

Non-voluntary: patient is unable to request/consent

Involuntary: against the explicit desires of the patient

Necessary conditions for Voluntary Euthanasia

“Advocates of voluntary euthanasia contend that if a person

1) is suffering from a terminal illness;2) is unlikely to benefit from the discovery of a cure for that illness

during what remains of her life expectancy;3) is, as a direct result of the illness, either suffering intolerable pain,

or only has available a life that is unacceptably burdensome (because the illness has to be treated in ways that lead to her being unacceptably dependent on others or on technological means of life support);

4) has an enduring, voluntary and competent wish to die (or has, prior to losing the competence to do so, expressed a wish to die in the event that conditions (a)-(c) are satisfied); and

5) is unable without assistance to commit suicide”Stanford Encyclopedia of Philosophy, Voluntary Euthanasia

Active vs. Passive Active euthanasia

› Assisted suicide› Lethal injection, provision of lethal substances, suicide

machine

Passive euthanasia

› Voluntary refusal of food and fluids› Voluntary refusal of life-saving treatment

Borderline› Toxic/lethal dosage of pain relieving drugs (e.g. opioids)› The doctrine of double effect

Not classic euthanasia Refusal of medical treatment

Ceasing life support for brain dead/legal dead patient

Ceasing life support for patients in persistant vegetative state

“Do not resusitate” (DNR) orders via living will or family decision

Legality Illegal in most countries

Legal or decriminalized in:

› The Netherlands› Albania› Germany (passive) (as of June 25, 2010)› Belgium› Luxembourg› Switzerland› The U.S. states of Washington, Oregon and Montana

Many other countries with unclear or contested laws, e.g. Canada, Japan

Washington Initiative 1000Washington State

2008

Public referendum

85% turnout 58% for 42% against

Some arguments for euthanasia

Right to privacy and autonomy › the harm principle

Equal access

Humanitarian: reduce pain, suffering, loss of dignity

Economics› utilitarianism

Some arguments against euthanasia

Effect on doctors and doctor-patient relationship

› Original Hippocratic Oath includes “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan”

Hope of cure or “medical miracle”

Open to abuse

› Possibility of patients being pressured by hospitals or families

Slippery slope: eroding our idea of the sanctity of all human life

HeroinHighly addictive

High fatality rate of users

2004 U.K. Study

Heroin: 744 deaths/40,000 users (1.9%)Cocaine: 147 deaths/800000 users (.018%)Tobacco: 114,000 deaths/12.5 million users

(0.9%)Ecstasy: 33 deaths/800,000 users (0.004%)

Arguments for Legalization Ideological argument

Harm principle

› People have the right to do whatever they want with their own lives and bodies as long as it doesn’t harm other people

› Heroin only directly harms the user› So, people have the right to choose

whether or not to take heroin

Arguments for Legalization (cont.)

Practical arguments:

› Criminalization does more harm than good

Waste of resources High rate of relapse among ex-prisoners Forces users into criminal activites/criminal

world Makes it hard for people to seek treatment HIV infection rate higher where heroin is

illegal

Arguments against Legalization

Arguments against ideological argument

1) Denying the harm principle:

People need to be protected from themselves

2) Claiming the harm principle doesn’t apply here:

a) Heroin does harm others, e.g. families, societyBut is this kind of harm covered by the harm principle?

b) Harm principle is supposed to protect individual autonomy, but addictive substances erode autonomy

Arguments against Legalization (cont.)

Argument against practical arguments

Decriminalization would be even more harmful than criminalization

(contentious)

Required reading Stanford Encyclopedia of Philosophy, at:

http://plato.stanford.edu/ entry on Paternalism

Suggested readings: J.S. Mill, “On Liberty”, full text at:

www.serendipity.li/jsmill/on_lib.html

Ronald Bayer, “Ethics of Health Promotion and Disease Prevention” at: www.asph.org/UserFiles/Module6.pdf