Introduction to Ethics

Stephen Bartlett

Introduction to Ethics

“Are you ethical?” And, “where do you derive your ethics from?”

Two questions used on several occasions at the beginning of tutorials when I introduce ethics to healthcare students. Answers are not forthcoming. Tending to be along the lines of, and in no order: family, friends, school, religion, media and so on. I don’t expect students to be especially introspective. These questions are rarely ruminated on by any of us; the answers we may provide ourselves can be more dissatisfying than the questions. When I have tried to enquire more, I am met often with silence. It is unfair to expect more given that people are not generally occupied by what governs how they behave. However, introspection of the foundation of who we are but why we are is an important exercise.

What if I ask the same two questions but instead, I replace the words ethical and ethics with prejudiced and bias. So, the questions now read:

“Are you prejudiced?” And, “where do you derive your bias from?”

Neither word is strictly an antonym for ethical and ethics. However, looking them up in a thesaurus it would not be too much of a stretch to concur that behaviours attributed to prejudice and bias lean towards unethical conduct. I suspect, even the most reluctant student will be likely to refute accusations of being prejudicial and biased. Going so far as to provide more examples, by way of parallel, why they are not unethical moreover than why they are ethical.

Perhaps we take our behaviours for granted and don’t feel the same urge to defend behaviours that conform to societal norms, so there is no need to feel venerated. Instead, we feel challenged and undermined if we are held to account for thinking or acting in a way considered to be prejudiced and biased. Contrast this with the lengths people will not go to if asked: “Are you good?” And, if so, “how do you know? Prove it!” Sure, and here’s how with reputable citations, said by the most irreputable people.

It is as important to address where we derive our positive behaviours from as well as the less appealing aspects of our character. This helps us understand how and why we behave and what factors impact our behaviour. We need to explore where we derive our ethics, values and morals from. Doing so not only shapes us as people and healthcare professionals, it shapes the society we live in. Y’know… capital punishment.

So, come on, define ethics

Ethics are ingrained in every aspect of our daily lives. Some ethical conduct, although not unlawful is still enforceable in terms of codes and policies. At university, ethical behaviour determines interpersonal contact. At the time of writing, shaking hands has not been outlawed explicitly, but its inclusion in social, work and even family life it has become positively discouraged. Ethics, to achieve certain aims and outcomes must possess flexibility. Ethics are much more malleable than their legal counterparts. Despite this, ethical conduct is grounded in theory and subject to scrutiny. In many cases, centuries, if not millennia of scrutiny. Ethical theories, like fashion, come and go. Ethics are a form of governance related to acts and omissions. Whereas morals tend to relate to whether an act or omission is held to be right or wrong.

What’s this about ethical theory? Name them, name them all

Broadly speaking, it’s not possible. Morality is ever changing. Half-a-century ago, there are examples of conduct not vilified to the sententious standards of today: car seatbelts is a mild example, but I can think of many others, whereas, in the same period behaviour once considered unethical, corrupting public morals even, is no longer viewed in a similar vein.[1]

Ethical theory

Aristotle, building on the scholarly developments made by Socrates and Plato, emphasised the pursuit of eudaimonia; happiness obtained through possessing a high standard of character and virtuous behaviour, behaviour generally held to be and consistent with the traits of courage, justice, prudence and temperance.

The Golden Rule, found in all religions, refers to tolerated conduct felt by an individual. Acceptable behaviours are governed based on the same courtesy being extended to all individuals. Put loosely, if you don’t like it, you should not engage in the same act or omission that you are decrying.

In the centuries preceding the Enlightenment and covering the Renaissance, Christianity was the dominant influence in the development of natural law. The Age of Reason was in its infancy. It was the beginning of empiricism in relation to morality. Arguably, and more contemporary, natural law can be seen as the bedrock of current human rights legislation.

Immanuel Kant – regarded as the father of deontological ethics focusses on the individual engaging in an act or omission that determines the morality of the conduct. To Kant, there are no exceptions to lying, for example. Lying is wrong always. He based this belief on adherence to duty; a person is duty bound to behave in a certain way. If a person departs from this, it makes the act of lying morally acceptable. This, of course, would be a societal disaster and renders it impossible to engage in any conduct, as a person knows they are being lied to always and all the time. If it is one person’s duty not to lie, then the duty not to lie become universalised. Will and duty are the dominant aspects of Kantian ethics. Deontology can also be referred to as non-consequentialism.

Consequentialism or utilitarianism, on the other hand, derives from the principle that it is acceptable to engage in immoral or unethical conduct if the overall aim is to maximise or benefit the greatest number. The quantifiable maximum happiness within a group becomes the justification for the act. If more people in society benefit than not, the act or omission is considered ethical by consequential standards.

And, *clears throat, adjusts gaze to the floor* just for fun, which of these two ethical theories is the utility monster?

Notwithstanding the continuing appetite for deontology and utilitarianism, differing ethical theories developed in the 20th century. Ethical egoism find that people should do what’s in their own self-interest; overall this will benefit society. We will revisit this in more detail in chapter one.

[1] Cocks, Harry, ‘Conspiracy to corrupt public morals and the ‘unlawful’ status of homosexuality in Britain after 1967’ (Pt Routledge) (2016) 41(3) Social History 267-284.


CSB338 Ethics and the Law in Health Service Delivery Copyright © by Stephen Bartlett. All Rights Reserved.

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