Professional Ethics

Surendra Arjoon, PhD

Professor of Business &
Professional Ethics
 Principles
Fundamental norms for directing behavior

Serve as a starting point for deducing and inferring

specific norms

Express the moral duty to behave rightly

Not proven/demonstrated

Considered self-evident/taken for granted

Standard to be observed not because it will advance

an economic, political or social interest
Principle of Integrity
If a collective body of statements
contains one false statement, then
the body of statements is not a body
of true statements, but it is a false
body
Someone who does not accept one
statement of a body of statements
does not accept the body of
statements

A person’s actions should be

consistent with his or her beliefs
Principle of Human Dignity/Autonomy
Self-Determination
Human beings should never be treated as a
mere means to an end – do not perform actions
that violate a person’s dignity (negative
formulation)
Persons should be treated not only with
respect but also with benevolence and care –
promote and foster human dignity by creating
an environment that enables people to respect
themselves and others (positive formulation)

Guides inter-personal relationships

Principle of Human Dignity/Autonomy
Self-Determination
Labor has an intrinsic priority over
capital

Subject of the work has a priority

over the object of work

Respect for the inherent freedom

and dignity of each person
One’s actions ought not to
interfere with the freedom of
others
 Respect for Human Dignity/Autonomy: Practical
Suggestions

Differences (cultural, stereotypes,

harassment, discrimination, ethnicity)

Respect values (avoid values imposition,

moral sensitivities)
Professional behavior (protect privacy,
avoid curiosity, never undermine others,
confront irregularities)

Watch that tongue

Respect for Human Dignity/Autonomy:
Practical Suggestions
Encourage independence (support right
to make autonomous choices, never
encourage dependence or undermine
freedom, understand the role of
culture)
Termination of services (helpfulness,
get feedback, don’t coerce, be vigilant)

Respect informed refusal (respect

client’s rights)
Principle of Human Dignity/Autonomy
In a prima facie sense, we ought
always to respect the autonomy of
the patient.

Such respect is not simply a matter

of attitude, but a way of acting to
recognize and even promote the
autonomous actions of the patient.

The autonomous person may freely

choose values, loyalties or systems
of religious belief that limit other
freedoms of that person.
Principle of Human Dignity/Autonomy
For example, Jehovah's Witnesses
have a belief that it is wrong to
accept a blood transfusion.

Therefore, in a life-threatening
situation where a blood transfusion
is required to save the life of the
patient, the patient must be so
informed.

The consequences of refusing a

blood transfusion must be made
clear to the patient at risk of dying
from blood loss.
 Principle of Human Dignity/Autonomy

Desiring to "benefit" the patient, the physician may

strongly want to provide a blood transfusion, believing
it to be a clear "medical benefit."
When properly and compassionately informed, the
patient is then free to choose whether to accept the
blood transfusion in keeping with a strong desire to
live, or whether to refuse the blood transfusion in
giving a greater priority to his or her religious
convictions about the wrongness of blood transfusions,
even to the point of accepting death as a predictable
outcome.
This communication process must be compassionate
and respectful of the patient’s unique values, even if
they differ from the standard goals of biomedicine.
 Principle of Human Dignity/Autonomy

In analyzing the above case, the physician had a

prima facie duty to respect the autonomous
choice of the patient, as well as a prima facie
duty to avoid harm and to provide a medical
benefit.
In this case, informed by community practice
and the provisions of the law for the free
exercise of one's religion, the physician gave
greater priority to the respect for patient
autonomy than to other duties.
However, some ethicists claim that in respecting
the patient’s choice not to receive blood, the
principle of non-maleficence also applies and
must be interpreted considering the patient’s
belief system about the nature of harms, in this
case a spiritual harm.
 Principle
By contrast, in of
an Human
emergency,Dignity/Autonomy
if the patient in
question happens to be a ten year old child, and
the parents refuse permission for a life saving
blood transfusion, in the State of Washington and
other states as well, there is legal precedence for
overriding the parent's wishes by appealing to the
Juvenile Court Judge who is authorized by the
state to protect the lives of its citizens,
particularly minors, until they reach the age of
majority and can make such choices
independently.

Thus, in the case of the vulnerable minor child,

the principle of avoiding the harm of death, and
the principle of providing a medical benefit that
can restore the child to health and life, would be
given precedence over the autonomy of the
child's parents as surrogate decision makers
Right to Privacy/Confidentiality

A person A person
should have should have
the right to the power
control what to decide
others know what
about his or information
her private about self
life to share
 Principle of Nonmaleficence

Primum non nocere (first do no

harm)
Includes acts of commission
and omission
Associated with the
Hippocratic oath
Includes avoiding preventable
risks
Principle of Nonmaleficence
The principle of nonmaleficence
requires of us that we not intentionally
create a harm or injury to the patient,
either through acts of commission or
omission.

In common language, we consider it

negligent if one imposes a careless or
unreasonable risk of harm upon
another.

Providing a proper standard of care

that avoids or minimizes the risk of
harm is supported not only by our
commonly held moral convictions, but
by the laws of society as well.
Principle of Nonmaleficence

Medical mistakes may occur

This principle articulates a

fundamental commitment on the
part of health care professionals to
protect their patients from harm.
Principle of Nonmaleficence
While caring for patients, there are situations in
which some type of harm seems inevitable, and
we are usually morally bound to choose the lesser
of the two evils, although the lesser of evils may
be determined by the circumstances.

For example, most would be willing to experience

some pain if the procedure in question would
prolong life.

However, in other cases, such as the case of a

patient dying of painful intestinal carcinoma, the
patient might choose to forego CPR in the event
of a cardiac or respiratory arrest, or the patient
might choose to forego life-sustaining technology
such as dialysis or a respirator.
 Principle of Nonmaleficence
The reason for such a choice is
based on the belief of the
patient that prolonged living
with a painful and debilitating
condition is worse than death, a
greater harm.
It is also important to note in
this case that this determination
was made by the patient, who
alone is the authority on the
interpretation of the "greater"
or "lesser" harm for the self.
Principle of Nonmaleficence
There is another category of cases
that is confusing since a single action
may have two effects, one that is
considered a good effect, the other a
bad effect.

How does our duty to the principle of

nonmaleficence direct us in such
cases?

The formal name for the principle

governing this category of cases is
usually called the Principle of Double
effect.
 Principle of Nonmaleficence
A typical example might be the question as
to how to best treat a pregnant woman
newly diagnosed with cancer of the uterus.

The usual treatment, removal of the uterus

is considered a life saving treatment.

However, this procedure would result in the

death of the fetus.

What action is morally allowable, or, what

is our duty?
 Principle of Nonmaleficence
It is argued in this case that the
woman has the right to self-defense,
and the action of the hysterectomy is
aimed at defending and preserving her
life.
The foreseeable unintended
consequence (though undesired) is the
death of the fetus.

There are four conditions that usually

apply to the principle of double effect.
 Non-maleficence: Practical Suggestions
Money (accept fiduciary responsibility,
beware of bribes/gifts)

Prestige (appreciate the danger/reasons

of seeking prestige)

Power (intoxicating, slippery slope,

exploitation)
Misuse of work (public corrections,
respond immediately, be vigilant, apply
appropriate measures)
Plan for illness, incapacity, retirement,
death
 Non-maleficence: Practical Suggestions

Vigilance (anticipate/prevent/minimize harm,

repair damage)

Coercion (resist coercion to comply with

unethical or unlawful practices – overt/subtle)
Roles (communicate clearly your role, negotiate
secondary roles, blurred roles undermine
effectiveness and creates conflicts)

Sex (attraction is not unusual)

Principle of Beneficence
Responsibility to do good

The act of being kind

Provides care that is in the best interest of

the client

Includes the duty to help society including

pro bono work
Principle of Beneficence
Best Interest:

The condition of the client (physical,

psychological, and social implications) which
requires the procedure or treatment

The nature of and reason for the procedure or

treatment proposed

Alternative courses of treatment, nature and

degree of risk views of the carers
Beneficence: Practical Suggestions

Establish win-win solutions (collaboration,

seek opportunities to build trust, assist
colleagues/client who are struggling)

Clarify expectations (seek agreement,

make implicit expectations explicit, use
initiative/be proactive, ensure subordinate
understand performance expectations)

Communicate clearly (take time, never

assume/take for granted others
understand, listen carefully, confront
misunderstandings)
Principle of Beneficence
The ordinary meaning of this principle is that
health care providers have a duty to be of a
benefit to the patient, as well as to take positive
steps to prevent and to remove harm from the
patient.

These duties are viewed as rational and self-

evident and are widely accepted as the proper
goals of medicine.

This principle is at the very heart of health care

implying that a suffering supplicant (the patient)
can enter a relationship with one whom society
has licensed as competent to provide medical
care, trusting that the physician’s chief objective
is to help.
Principle of Beneficence

The goal of providing benefit can be

applied both to individual patients, and to
the good of society.

For example, the good health of a

particular patient is an appropriate goal of
medicine, and the prevention of disease
through research and the employment of
vaccines is the same goal expanded to the
population at large.
Principle of Beneficence
It is sometimes held that nonmaleficence is a constant
duty, that is, one ought never to harm another
individual, whereas beneficence is a limited duty.

A physician has a duty to seek the benefit of any or all

her patients, however, a physician may also choose
whom to admit into his or her practice and does not have
a strict duty to benefit patients not acknowledged in the
panel.

This duty becomes complex if two patients appeal for

treatment at the same moment.

Some criteria of urgency of need might be used, or some

principle of first come first served, to decide who should
be helped now.
Principle of Beneficence
One clear example exists in health care where
the principle of beneficence is given priority over
the principle of respect for patient autonomy.

This example comes from Emergency Medicine.

When the patient is incapacitated by the grave

nature of accident or illness, we presume that
the reasonable person would want to be treated
aggressively, and we rush to provide beneficent
intervention by stemming the bleeding, mending
the broken or suturing the wounded.
Principle of Beneficence
In this culture, when the physician acts from a
benevolent spirit in providing beneficent treatment that
in the physician's opinion is in the best interests of the
patient, without consulting the patient, or by overriding
the patient's wishes, it is "paternalistic."

The most clear-cut case of justified paternalism is seen

in the treatment of suicidal patients who are a clear and
present danger to themselves.

Here, the duty of beneficence requires that the physician

intervene on behalf of saving the patient's life or placing
the patient in a protective environment, in the belief that
the patient is compromised and cannot act in his own
best interest now.

As always, the facts of the case are extremely important

to make a judgment that the autonomy of the patient is
compromised.
Principle of Informed Consent
Respect client’s right to autonomy, dignity and self-
determination

Conceptualize informed consent as a process and not an

event

Ensure clients have full understanding of services and

that they are emotionally and intellectually competent

Obtain in both verbal and written form when possible

If you do something without your client’s consent, you

are liable for the damages and intended consequences

The exception is in emergency cases (Emergency

Privilege)
 Principle of Informed Consent

Your first duty is to act in the best interest of your

client: you must ensure that your client is aware of any
material risks and reasonable alternatives
This also includes informed refusal respecting the
client’s autonomy

The professional principles are non-hierarchal (no one

principle trumps another principle)
Consent may not required in emergency (to save
patient’s life, tom prevent serious damage, incapable of
consenting
Proxy consent (spouse, guardian, carer, depending on
the law)
 Ethics and Law
Two types of civil
actions
• lack of informed consent (a
communication process that
refers to a state of mind -
understanding the
information provided to
make an informed choice)
• violation of fiduciary
duties/standard of care (the
 The Litigation Process
There are
essentially three
distinct phases
to the litigation
process:
• initiation
• pre-trial
• trial and post-trial.
The Litigation Process

The possibility that the parties will

reach an agreement about the legal
claims before or during trial, known as
a settlement, means that most initiated
claims do not go through all three
phases.
An understanding of the litigation
process and its accompanying
vocabulary can be helpful in providing
a fuller understanding of the
intersection of law, clinical ethics, and
risk management.
The Litigation Process: Initiation Phase
A lawsuit will begin when the plaintiff (an allegedly
injured patient) files a complaint (claim) with the
court. The plaintiff is obligated to legally notify
(serve) the defendant(s) (e.g., the health care
provider) with a summons and the complaint on the
defendant.

Medical malpractice lawsuits frequently include

more than one defendant and may be made against
more than one provider, institution, and
manufacturer of medical equipment and/or
pharmaceutical companies.

In the complaint, the plaintiff presents the facts

that are the basis for the lawsuit. The defendant is
required to file an answer (written response) with
the court, and to also provide the plaintiff with a
copy within a specified period.
The Litigation Process: Pre-Trial Phase
After filing a lawsuit and before trial, both sides (plaintiff
and defendant) gather information using various methods
known as discovery.

Discovery methods used may include interrogatories,

which are written questions that the opposing side must
answer under oath.

Requests for production require the opposing side to

provide documents to the other side.

Requests for admissions require the opposing side to state

that some facts are true before trial.

Witnesses can be required to answer questions in person

under oath, known as a deposition, and may also be
required to bring documents to the deposition.
 The Litigation Process: Pre-Trial Phase

Although the information collected during

discovery prepares the parties for trial, it
also can be used as a basis for settlement.
Indeed, most civil lawsuits, including
actions against health care providers, are
settled and never go to trial before a judge
or jury.
Some cases are resolved by summary
judgment, in which the court decides in
favor of one party based on information
derived during the discovery process.
To encourage the parties to find a
resolution to a health care dispute before
trial, a few states require the parties to
submit to mediation.
 The Litigation Process: Trail and Post-Trial Phase
Cases involving injuries in health care are typically decided by
a jury.
However, cases involving federal health care facilities (and
their employees), such as the Veterans Health Administration,
are decided by a judge.

A trial in front of a jury will involve the following, in this order:

• jury selection
• opening statements by both parties
• plaintiff’s trial testimony
• defendant’s trial testimony; closing arguments
• jury instructions (argued by legal counsel to the judge, determined by the
judge, and designed to guide the jury in decision-making)
• jury deliberation
• verdict
• Even after a jury verdict, there may be post-trial motions to the judge which
could alter the outcome of the case.
 Building Character :The Virtues
Virtue is an enduring quality of character (good habits worth
having) through which one can act in a praiseworthy way
and to live a morally good life

What makes a person good

What kind of person should one be aiming to be

Cannot be taught but caught

Acquired through practice

Conveyed through example, directed practice, stories

Types of Virtues

Intellectual (acquired through

learning, speculative or practical,
associated with instruction)

Moral (acquired through repetitive

practice, associated with education)
 The Cardinal Virtues
Prudence • Habit of recognizing the good
(Wisdom, ends and choosing morally
Good licit means to achieve them
Judgment)
Justice
(Fairness, • Habit of giving to others what
Responsibilit are due to them
y)
Temperance
(Discipline, • Habit of moderating the
Self emotions of enjoyment
Mastery)
• Habit of moderating emotions
Fortitude of fear to achieve a rational
(Courage) good
 Prudence: Characteristics
An intellectual virtue geared toward truth

Most important of all the human virtues

Informs , guides and regulates the other virtues

Points out the golden mean and proper means to

achieve the goal

Takes counsel carefully, judges correctly, and directs

 Prudent Decisions and Knowledge

Prudent decisions, when realized, shape

one’s free actions fed from two sources:
universal principles and the singulars
Universal principles concerns the most
general and fundamental naturally
apprehended principles
Prudence involves the application of the
principles to a specific situation
For example, to do good and avoid evil is
understood by all regardless of their faith
or moral background
Aspects of Prudence
Optimization of the past (memory, reason)

Diagnosis of the present (circumspection)

Foreseeing the future (creative imagination)

Decision and implementation (swift action)

 Memory and Reason

Recollection of the truth of real things

Requires docility (seeking advice, open-

mindedness)

There is no more insidious way for error

through falsification of the memory through
biases and prejudices

Reason is the readiness to infer one thing

from another which points out the causal
link among events
 Foresight and Decision
Foresight balances excessive caution and
recklessness

It does not expect certainty nor false certainty

Decision involves agility and shrewdness

avoiding pitfalls of injustice, cowardice or
intemperance
It must be done and not allowed to fall into the
pit of futility
Beware of casuistry (ethical decisions made in
individual cases) which can end up a being
morally rigorous systems of rules
 False Prudence
Reflects the cunning person (neither
face things squarely nor act
straightforwardly)who employs
insidiousness, guile and craftiness

Seeks only one’s good and not that

based on truth

Has its roots in covetousness

(immoderate straining for all
possessions to assure one’s own
importance and status)
 Acts of Imprudence
One who does not take the past into consideration, acts
rashly

One who does not consult others is ill-advised

One who does not pay attention to details, acts

inconsiderately

One who does not have an understanding of the present

acts superficially

One who does not draw conclusions from the past and the
present, acts without reflection

One who always wants to be sure, even if it means having

to employ illicit means, usually ends up committing fraud

One who out of apprehension is afraid of the future,

avoids accepting the risks involved
 Justice
Perfects relationships (virtue of otherness)

Move beyond self-centeredness (obligations)

Give to each what is his due

Establishes a world of peace

Orders and regulates relationships/duties

Fundamental principle of community

Not opposed to mercy

Does not assign things (secondary acts)

Fulfills and respects rights (not create rights)

Main concern is “rights”

 Types of Justice
Distributive (between
community and
individual)
Commutative (between
individuals)
General/Legal/Social
(between individual
and community)
Distributive Justice
Relation of community to member

Applies chiefly to the State

Violated by favoritism, nepotism and

partiality

Exists between superior and subordinate

 Commutative Justice

Justice in the strictest

sense
Between equals

Basis of contracts
Relates to obligations and
restitution
 General or Legal Justice

Relation of members to
community
Each contribute proper share
Contributive as opposed to
retributive justice
Entails social justice
Basis of the law (just vs. unjust
laws)
Justice, Gratitude and
Humility
Just persons are first and foremost grateful
persons

They recognize their essential equality with

others

They observe, when they receive something

from others, an inequality exists, and they try
to repay

Humble persons willingly accept who they are

and easily see what they owe to others
 (Sincerity)
The just persons recognize their own equality
with others and will that equality (golden
rule)

They also recognize that they have a moral

debt to express themselves truthfully

To lie to another is to will a relation of

inequality between equals

Unjust persons, convinced of their superiority

over others, consistently and willingly lie to
deceive, mislead and manipulate others
 Justice and Truth (Sincerity)
To lie to others is to exercise a kind of lordship or
dominion over them

Habitual liars practice justice only if it suits their

agendas

They divide themselves in two (what is in their

mind and what they say – a definition of a lie) and
so does not live integrity (harmony between the
various elements of the self)

A divided self leads to a state of mental illness in

which one believes in one’s own lies
 Unjust Persons
Blind to the many things that they have received
from others

Think that they are entitled to things they have

received

The thoroughly unjust persons are convinced of

their natural superiority over others whom they
see as means to their personal ends

Lack humility and deny rights to others except

themselves
Some Manifestations of Justice: The Golden Rule

All of us would like a word of encouragement

when things have not gone well, and would
appreciate understanding from others when,
once again, despite our best intentions, we
made a mistake

We prefer others to have more regard to our

positive deeds than our shortcomings

We are glad to have a cordial atmosphere at

our place of work or on coming home
Some Manifestations of Justice: The Golden Rule

We like to be stretched at work, but to be asked

nevertheless, with courtesy and in a kindly
fashion to do the work that is required of us

We do not like anyone to speak badly of us behind

our backs, and if someone does, we would be
grateful to have another defend us in our absence

We would like others to be concerned about us

when we are ill

We would like not to be adverse to receiving

corrections when we do something badly, instead
of having our blunder gossiped about with
someone else
 Principle of Justice
Obligation to act fairly

Calls for professionals to recognize the dignity of all people

and to avoid bias

Make available services at reasonable costs

Includes fidelity or faithfulness to promises made and to the

truth, including therapeutic privilege (withholding information
that may be detrimental)

To each person: an equal share; according to need, effort,

contribution, merit, free market exchanges

Abiding by agreements in a manner true to their purpose and

working sincerely and cooperatively through negotiations and
implementations to attain agreed objectives
Principle of care
Justice in health Justice
is usually defined
as a form of fairness, or as Aristotle once
said, "giving to each that which is his
due." This implies the fair distribution of
goods in society and requires that we
look at the role of entitlement. The
question of distributive justice also
seems to hinge on the fact that some
goods and services are in short supply,
there is not enough to go around, thus
some fair means of allocating scarce
resources must be determined.
It is generally held that persons who are
equals should qualify for equal
treatment. This is borne out in the
application of Medicare, which is
available to all persons over the age of
65 years. This category of persons is
equal with respect to this one factor,
their age, but the criteria chosen says
nothing about need or other noteworthy
factors about the persons in this
category.
 Principle of Justice
John Rawls (1999) and others claim that many of
the inequalities we experience are a result of a
"natural lottery" or a "social lottery" for which the
affected individual is not to blame, therefore,
society ought to help even the playing field by
providing resources to help overcome the
disadvantaged situation.

One of the most controversial issues in modern

health care is the question pertaining to "who has
the right to health care?"

Perhaps as a society we want to be beneficent and

fair and provide some decent minimum level of
health care for all citizens, regardless of ability to
pay.
 Principle of Justice
Medicaid is also a program that is designed to help fund
health care for those at the poverty level.

Yet, in times of recession, thousands of families below the

poverty level have been purged from the Medicaid rolls as a
cost saving maneuver.

The principle of justice is a strong motivation toward the

reform of our health care system so that the needs of the
entire population are considered.

The demands of the principle of justice must apply at the

bedside of individual patients but also systemically in the
laws and policies of society that govern the access of a
population to health care.

Much work remains to be done in this arena.

 Living Justice: Practical Suggestions

Credit (give credit to others, never

take credits from others, give
measured credit to those who don’t
make significant contribution)
Performance (provide and clarify
criteria for evaluation, offer critical
feedback)
Treat people equitable, not equally
(seek to further best interests of each
individual according to contribution,
needs, and circumstances
Living Justice: Practical Suggestions

Complicity (use prudence in addressing

injustices)

Gate-keeping (ethical obligation to protect

public from potentially harmful professionals,
rigorous screening/credentialing efforts, not
allowing advocacy/support to influence honest
assessment of a person’s moral
character/psychological fitness)
 Fortitude: Some
Considerations
People are made to be happy.
But they are weak and
vulnerable. There are obstacles
to obtaining the good. Fortitude
helps them to attain the good in
spite of those obstacles
Fortitude strengthens the will
enabling one to continue the
pursuit of difficult goods even in
the face of the greatest dangers
to bodily life
 Fortitude
Resist (bear difficulties well –
patience)

Attack (confront difficulties –

perseverance)

Regulates aggression, fear, power

 Temperance
Regulates the sensible
appetite
Moderates excessive
indulgence (food, drink,
sex)
Helps bring desires under
reason
 Components of
Virtues
Integral
Elements that are
necessary for the
proper operations in
order to perfect or
Potential
Subjective complete
Secondary virtues
Kinds or that are
species that connected and
are related to subordinated to
the virtue or
genus VL the virtue and
share something
 Components of
Prudence
Integral
 Memory, Docility,
Reasoning,
 Circumspection,
Caution, Shrewdness,
Subjective Foresight, Potential
Self-direction) (Command and Execut
Understanding
Good counsel
Personal Judging according to
(domestic) principles in
Political ordinary matters

VL
(public affairs: Judging according to
military, higher principles in
legislative, exceptional or more
 Components of
Justice
Integral
 Doing Good: Recognizing the
rights of others
Subjective  Avoiding Evil: Declining to
harm others
Legal,
General or Potential
Social Justice Religion, Piety,
(what the Respect,
individual Politeness,
owe the Gratitude,
community) Truthfulness,

VL
Commutative Sincerity,
(between Friendliness,
equals) Liberality,
 Components of
Fortitude
Integral
 Magnanimity,
Magnificence,
Munificence,
Subjective Patience,
Potential
Perseverance
Same as the Integral
No Subjective
Components Component

VL
 Components of
Temperance
Integral
Shame, Decorum,
Propriety (honesty, things
well-done, calmness,
Subjective inclination to what is
honorable Potential
Abstinence, Continence,
Sobriety, Kindness, Meekness,
Chastity, Clemency, Humility,
Modesty Diligence

VL
 The Golden Mean of the
Virtues
Virtues: The Golden Mean
 Authorita
tive
 Courage
Vices: Deficit Vices: Excess
 Truthfuln
Permissive ess Authoritar
Cowardice  Magnani
ianism
Apathy mity Foolhardin
ess
Modesty  Tempera
Understatem nce Aggressiv
ent  Honesty eness
Small-  Friendlin Bashfulne
Mindedness ss
ess

VL
Insensitivity  Modesty Boastfulne
ss
Secrecy
Vulgarity
Quarrelsome Moral Freedom
ness Self-
 Ethical Decision-Making:
Human Acts

An act of free will

Preceded by knowledge

A person is morally responsible for

his or her actions

Imputable vs. Non-imputable acts

 Factors Affecting an Act’s Voluntary Character

Force or violence

Ignorance

Strong passions or emotions

Intellectual Fear

Habits

Mental Illness
Other Factors (e.g., sociological
Sources of Morality: The Triple Font Theory

Moral Object

Personal or
Subjective Intention

Circumstances
 Sources of Morality: The Moral Object

Moral Object

Primary determinant

Different from a ‘neutral’ description

The action chosen to achieve the aim with
regards to its morality
Not simply the physical action

Some acts are intrinsically evil

 Sources Of Morality: Intention

Subjective or Personal
Intention
• The aim of performing an
action evaluated in moral
terms
• Not a matter of having an
internal feeling or
impression or following a
desire
Sources of Morality: Circumstances
Circumstances (include relevant
aspects of the situation including the
socio-culture context where the action
takes place and the consequent
circumstances/consequences)

Who, What, Where, By What Aids, Why,

How, When

Aggravating vs. Specifying/Attenuating

 Cases
To salvage my reputation from a
blackmailer’s threats, and since I am a
respected member of the community, with a
wife and several children, employing several
hundred employees whose welfare depends
on my continued well-being, I murder the
blackmailer.
I give a large amount of money to a group of
starving people in desperate circumstances
who need some assistance if they are not
otherwise to engage in robbing and looting a
group of stores near me, but I do so precisely
in order that I will win their votes for a
certain politician to whom I owe a political
debt.
 Case
I am a commercial pilot,
flying a Lockheed 1011 from
Trinidad to Jamaica. This is
part of my job which I need
to support my family, but I
am doing so in defiance of a
red light on the flight panel
that tells me that something
 Analysis of Consequences:
Principle of Double Effect (PDE)
An action with at least one good effect and with one or
more evil effects may legitimately be performed, given the
fulfillment of the following four conditions:

(1) The action itself must be morally good or at least

morally indifferent

(2)The good effect must not be obtained through or by

means of the evil effect

(3)The evil effect must not be intended but rather only

tolerated

(4)There must be sufficiently serious reason to justify

allowing the evil effect
 Some Preliminary
Questions
What is the action in question?

What is (are) the good effect (s)?

What is (are) the evil effect (s)?

 PDE: Some Considerations
What is directly done must not be
an intrinsically wrong action

The agent’s intention must be

confined to the good effect

Every reasonable precaution must

be taken to avoid the bad effect
There must be a reasonable
proportion between the good aimed
at and the harm permitted
 PDE: Some Considerations
There is no better acceptable alternative

There is a just cause for this action

The bad effects are proportionate to the necessity of the

action

Reasonable means should be employed to minimize

negative secondary effects

Monitoring and evaluating the situation should be done

on a timely basis

Steps should be taken to find some alternative that

avoids actions with double effect in the future
 Cases
A man rushes into a burning building, having
seen that there is a child stranded near a
third-floor window. He succeeds in saving the
child but loses his own life in the process. Is
he justified in doing this?
I am a military commander, in charge of field
operations in each area in time of war. There
is an enemy ammunition dump located in my
sector. I know that if I order it bombed, a
great source of danger to my men will be
removed; on the other hand, several people in
the area (enemy soldiers but also some
civilians) will be killed. May I order the
 Cases
I am a physician,
specializing in OB-GYN. One
of my patients has a
cancerous uterus and is
pregnant. She also has eight
children and no husband. In
surgery, I remove the uterus
and child, destroying both.
 Cases
I am a political activist, of a quite radical bent. I
am profoundly disturbed by certain activities of
my government, which I feel are seriously
injuring people in other lands. But no one seems
to be paying any attention to this. To dramatize
my cause, having first alerted the local TV and
radio stations, I go to the Capital Building, pour
gasoline all over my clothes, and set myself on
fire in protest. I know that I will be gravely
injured or possibly killed. My protest, and
therefore my cause, certainly does receive all
sorts of publicity. But I end up in the emergency
room of the local hospital with third-degree
burns over sixty percent of my body. Was I
 Analysis of Corruption: Formal
Cooperation

Occurs when a person explicitly approves of another’s action

or shares the principal agent’s intention, either for its own
sake or as a means to some other goal.
Make a person fully responsible for whatever is done during an
action

Occurs not only when one helps another do evil but also joins
in the other’s evil intention

“I intend to take part in another’s evil act. Since I intend evil,

my action is evil.”

Involves guilt and complete voluntariness

Always wrong and cannot be justified under any circumstances

Analysis of Corruption: Material
Cooperation
Occurs when without approving another’s
wrongdoing, one helps the other perform his
immoral act by an action of one’s own that is
not of its immoral nature because of a real
necessity

“I do not intend to take part in another’s evil

act, but I knowingly aid that evil act by some
act of my own which is not itself evil.”

“They use my act as a means to do their evil,

but I do not use their evil act as a means to do
anything.”
Material Cooperation: Some Factors
The amount of evil that others will be enabled to do
by my cooperation

The amount of evil that will happen to one if I

refuse to cooperate
The closeness with which my cooperative act
relates to the evil act of the principal agent (must
be proportionate to the causal proximity)
Greater reason is required for indispensable
cooperation

If the agent does not will the whole operation

If the agent’s part in that operation is not

intrinsically wrong

If there is something important at stake

 Analysis of Corruption: Material Cooperation

The first responsibility is to avoid, if possible,

material cooperation
In some situations, the principal agent might even
be persuaded to switch to an acceptable or less
grave course of action

There are no viable alternative to cooperation

There is proportionate serious reason for the

cooperation

Measures must be taken to avoid

misunderstanding

Timely review necessary to check whether

alternatives are possible
 Cases
Suppose there are two bank robbers,
one of who actually sticks up the
teller and the other of whom drives
the get-away car. Is the driver guilty
of robbery?
Two people kidnap a child. I am not
one of the two, in fact, I am many
miles away when the kidnapping
takes place. However, I lend my car
to the kidnappers, knowing full well
what use they plan to make of it. Am
 Cases
A bank manager, under the
threat of a robber’s gun,
opens the safe and enables
the robber access to the
money, which the thief could
not get without the
manager’s help. Is the bank
manager guilty of robbery?
 Cases
A discussion arose in one of the meetings of the members of a
construction co-operative. Peter, an upright and integral man,
said that it was necessary to offer an amount of money to a
public official so as to be able to obtain a construction license
on time. Another member, Henry, thought that this is illicit
since it involves fostering corruption in public offices. He
claimed that it would therefore be better to wait a bit more till
the license could be obtained, even if this meant some
grievous economic losses. Peter explained that it is not the
same to give illicit money as it is to receive it and that if the
co-operative decides to give that compensation, it could not be
imputed on the members of the co-operative. The ones who
must be blamed for this mess are the city officials themselves
who do not correct the slowness in attending to public
services. And, therefore, citizens are forced to behave in such
a manner. After deliberations, the members of the co-
operative decided to follow Peter’s suggestion. Peter went to
an expert in ethics, Marco, and asked if what he suggested in
the meeting was licit. After some discussion the expert
concluded that Peter had acted in a moral manner.
 Cases
I am an assistant manager of a food
processing plant; part of whose
sales are to a developing country. I
know that a certain product which
my company sells is bad for the
health of the people in that country.
Specifically, I know that if I approve
of a certain shipment, several
pregnant women are going to suffer
very dire consequences during their
pregnancies. I also know of course,
that if I do not approve this
Analysis of Conflicts: Rights vs. Duties

A right is the reverse side of a duty (and vice

versa)

Duty is the moral obligation to do or omit

something

No real conflict (in theory)

Stronger right or duty prevails (weaker ceases to

be a right or duty)
 Conflict Situations
One person may claim the moral power to
do a certain thing, and another may claim
the moral power to prevent him

Two persons claim the same thing

The actual existent right is determined by

an examination of each claim in the light of
the norms derived from the relative
components of a right
Conflicts of Professional
Interest
Situations where personal or financial
considerations compromise judgment in any
professional activity or where the situation may
appear to provide the potential for professional
judgment to be compromised

Situations in which the private interests and the

official responsibilities of a person in in a position
of trust are in conflict, or when someone who
ought to be serving people has competing
interests

Arises when one has interests that compete

personally or professionally with the duty to
serve his/her firm with loyalty (fiduciary duty)
Conflicts of Interest: Some
Examples
A person responsible for purchases
having an interest in some supplier,
either directly or through a close
relative

An official of a governmental institution

with interest in a firm that offers
goods or services to such institutions

Working for a competitor or taking on

any outside employment in which the
interests of one job contradict those of
another
Conflicts of Interest: Some
Examples

A director of a large company who, as a

member of the board of directors, has
voted on whether to buy a small firm (in
which he is one of the owner) for a
certain price

Auditing and providing consultancy

services to the same company (impedes
auditing with independence and
impartiality)