Theories and Principles
A Key concept: Commonsense Morality
 “Commonsense morality” is a key concept of moral
philosophy. Each person in society gets exposed to a
commonsense morality. This morality consists of a wide
variety of standards of conduct, duties, obligations,
values and principles that come from disparate sources,
such as parents, teachers, peers, religious leaders,
professionals, literature, music, the media, and so forth.
Ethicists call these standards a “commonsense morality”
because they are the norms that most people learn and
practice without any explicit theorizing or deeper analysis.
 Some of these commonsense morals include principles
like “do unto others as you would have them do unto you”,
“keep your promises”, “be fair”, “always do your best”, and
so on. Some of these commonsense values include
happiness, honesty, justice charity (or kind), courage,
integrity , community, love, knowledge, and freedom.
 After using moral theories to change commonsense
morality, we can then revise those theories so that they
cohere with this new database. This process of revising
commonsense morality in light of theory and vice versa
can continue indefinitely, and is known as the method of
wide reflective equilibrium. Most ethicists believe that
this method provides the best way of justifying moral
theories.
Different Kinds of Moral Theories
 Philosophers and theologians have defended a wide
variety of moral theories, each with its own particular
slant on morality:
 Some theories emphasize individual rights and dignity;
others emphasize the common good.
 Some theories are secular; others are religious.
 Some theories focus on obligations and duties; others
focus on virtues and character.
 Some theories establish moral ideals; others settle for
practical principles.
 Some theories assess consequences in judging actions;
others assess motives.
 Some theories are human-centered; others place human
beings in a larger ecological framework.
Different Theories
 In here, beyond the textbook, I want to provide brief
summaries of some of the most influential ones
nowadays in the west.
 1. divine command theory
 2. utilitarianism
 3. natural rights theory
 4. natural law theories
 5. social contract theory
 6. virtue approaches theory
 7. the ethics of care
 8. the deep ecology theory
The natural rights theory
 Like Kantianism, this theory emphasizes that importance of
individual rights and freedoms.
 According to this view, all people have natural rights to life,
liberty, and property, and everyone in morally permitted to
do anything they wish provided that their actions do not
violate the rights of other people.
Natural law theories
 Which hold that morality is founded on human nature: if
an action has a basis in our natural instincts, emotions,
or social relations, then it is right; if an action goes
against our natural instincts, emotions, or social relations,
then it is wrong.
 Natural law theories also maintain that we should strive
to produce or achieve natural goods and eliminate or
avoid natural evils.
 Natural goods include life, health, and happiness.
Social Contract Theory
 Social contract theorists propose that morality consists of
a set of rules that we agree are important to regulate
society. In justifying moral rules, social contract theorists
imagine people as existing in a state of nature prior to
the formation of society. In order to live well, people must
cooperate; and in order to cooperate, they need some
rules for conduct. These rules are the rules of morality,
politics, and the law.
The Ethics of Care
 A theory inspired by feminist approaches to morality,
rejects traditional approaches to ethics on the grounds
that they place too much emphasis on duties, rights, and
justice. Such traditional theories are too abstract,
legalistic, and uncaring, according to this view of feminist.
 The ethics of care holds that our main task in life is to
love and care for ourselves and other people. We should
cultivate loving and caring relationships in our conduct
instead of relying on abstract concepts and principles.
 In some ways, the ethics of care provides a modern
rendition of Jesus’ instruction to love your neighbor as
you love yourself.
The Deep Ecology Theory
 Which approach to morality is unlike all the other
approaches to ethics in that it is not human-centered.
 Human-centered moral theories frame important
questions about nature in terms of human interests,
rights, obligations, and so on.
The Deep Ecology Theory
 Deep ecologists hold that human-centered ethics cannot
adequately deal with moral issues involving other species,
the land, ecosystems, the atmosphere, and oceans, since
there are values in nature that are independent of human
interests or rights. Thus, an ecosystem is worth preserving
because it has intrinsic, moral value, not because we
happen to value it for its economic or social uses. Animals
have rights, according to this theory, because they also
have intrinsic moral worth and not mere instruments for the
promotion of human interests.
From many philosophers’ views
 Many philosophers who study applied ethics prefer to
work with general, ethical principles rather than moral
theories because one can use principles to support an
ethical decision or a social policy without defending an
entire moral theory.
 Another reason for employing general principles is that
they are easier to understand, to teach and learn than
moral theories.
 Finally, since principles are expressed in very general
terms, they can be applied to a variety of cases and
interpreted in different ways. This kind of flexibility allows
one to apply principles to diverse cases without ignoring
important details.
Some of these basic moral principles
are as follows:
 Non-malignance: Do not harm yourself or other people.
 Beneficence: Help yourself and other people.
 Autonomy: Allow rational individuals to make free,
informed choices.
 Justice: Treat people fairly; treat equals equally;
unequals unequally.
 Utility: Maximize the ratio of benefits to harms for all
people.
 Fidelity: Keep your promises and agreements.
 Honesty: Do not lie, defraud, deceive, or mislead.
 Privacy: Respect personal privacy and confidentiality.
The four Principles
 Autonomy
 Beneficence
 Non-maleficence
 Justice
1.Autonomy
 The principle of respecting the decisions made by those
capable of making decisions.
 It refers to an ability:
1)to reason and think about one’s own choices
2)to decide how to act
3)to act on that decision ,all without hindrance from other
people
 Autonomy is more than simply being free to do what one
wants to do. (animals)
 In respecting a person’s autonomy we recognize that they
are entitled to make decisions that affect their own lifes.
 In health care respecting people's autonomy has many
prima facie implications.
 It requires us to consult people and obtain their agreement
before we do things to them - hence the obligation to
obtain informed consent from patients before we do
things to try to help them.
 Medical confidentiality is another implication of
respecting people's autonomy.
 Respect for patients' autonomy prima facie requires us,
therefore, not to deceive patients, for example, about their
diagnosed illness unless they clearly wish to be deceived .
 Telling the truth about terminal cancer?
2.Beneficence and nonmaleficence
 Beneficence is the principle of doing ‘good’
In the medical context, this generally means improving the
welfare of patients.
 Non-maleficence involves ‘not harming patients’, or ‘above
all, do no harm’.
 There is often confusion about where non-maleficence
ends and beneficence begins.
 One way of looking at the two is to think of nonmaleficence as a duty towards all people, whereas
beneficence ,as we can’t help everyone, is a duty we
choose to discharge on specific people.
 Medical staff, by accepting a patient, have chosen to act
beneficently towards that patient.
 Similar to the principle of utility.
3.Justice
 The principle refers to the allocation or distribution of
resources amongst the population.
 It demands the fair treatment of ‘equals’ within the healthcare system.
 What is fair and equal distribution?
 Equality-Each person receives an equal share of the
resources available.
 Need-Each person receives resources appropriate to how
much that person needs.
 Desert-Each person receives resources according to how
much they deserve them (in terms of contribution, effort or
merit.)
 Desire-Each person gets what they want
What should we do when these principles
conflict?
 These principles should be viewed as guidelines for
conduct rather than hard and fast rules.
 We should follow these principles in our conduct but
exceptions can be made when they conflict with each
other or with other standards. When two principles
conflict we may decide to follow one principle instead of
another.
Moral Choices
 We make choices very waking moment of our lives.
Some of these choices are trivial or nor important; others
are profound or important. Some choices are informed
by personal preferences, tastes, or mere whimsy. Others
are based on standards of conduct.
 Standards of conduct can regulate our actions by
providing guidance for many of the choices we face in
living.
 But, It is not easy to follow standards of conduct all of the
time since they often conflict with each other or with our
personal interests.
 People often violate accepted ethical or moral standards
for personal gain, but we usually label such actions as
immoral and selfish and we disapprove of such conduct.
 People often must choose not between ethics (or morality)
and self-interest but between different moral, ethical, legal,
political, religious, or institutional obligations. In these
circumstances, the key question is not “should I do the
right thing?”, but “what is the right thing to do?” These
problematic choices are known as ethical (or moral)
dilemmas. Thus, an ethical dilemma is a situation in which
a person can choose between at least two different actions,
each of which seem to be well supported by some
standard of conduct. These choices may be between the
lesser of two evils or the greater or two goods. Sometimes
these choices involve two different ethical standards.
 For example, when ask to give our opinion of someone’s
cooking we may decide to be less than completely honest
in order to avoid harming that person.
 Since conflicts among various principles and standards can
arise, we must frequently exercise our judgment in
deciding how we should act. In order to exercise our
judgment, we need to understand the particular features of
a given situation. Thus, there is an important sense in
which ethics are situational: although some general ,
ethical principles should guide our conduct, we need to
base our decisions and actions on the facts and values
inherent in particular situations.
The Oath of Hippocrates
 You do solemnly swear, each by whatever he or she holds
most sacred .That you will be loyal to the Profession of
Medicine and just and generous to its members
That you will lead your lives and practice your art in
uprightness and honor ， That into whatsoever house you
shall enter, it shall be for the good of the sick to the utmost
of your power, your holding yourselves far aloof from
wrong, from corruption, from the tempting of others to vice
The Oath of Hypocrites
(continued)
 That you will exercise your art solely for the cure of your
patients, and will give no drug, perform no operation, for a
criminal purpose, even if solicited, far less suggest it
That whatsoever you shall see or hear of the lives of men
or women which is not fitting to be spoken, you will keep
inviolably
secret
These things do you swear. Let each bow the head in sign
of acquiescence And now, if you will be true to this, your
oath, may prosperity and good repute be ever yours; the
opposite, if you shall prove yourselves for sworn.