Phil 309 exam 5 review - Discusses questions from Onora O’Neill, “Paternalism and Partial Autonomy” PDF

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Discusses questions from Onora O’Neill, “Paternalism and Partial Autonomy” and Holmes Rolston, “Feeding People versus Saving Nature”...

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What is paternalism? What is autonomy? What is informed consent? What is the potential conflict between paternalism and autonomy? Which concept – paternalism or autonomy – does utilitarianism – a results-orientated perspective – most naturally support (as being the more fundamental one in cases of conflict)? Same question for an action-orientated ethic. Why is autonomy especially problematic in medical contexts? What is hypothetical consent and why does O’Neill say about it? What O’Neill think is morally required of doctors when it comes to obtaining informed consent? Paternalism – acting like a parent on behalf of the benefactor. (i.e. government could act like this if we stop people from being self destructive – helmets, seat belts, etc.) Autonomy – set your own plan and agenda; your own ends and own means to those ends. Drives Kant’s theory. Informed Consent – An autonomous being can give informed consent; person must know enough to be informed and be able to consent, or at least to be able to say no to proposal. CONFLICT: The conflict is why should medical professionals feel the need to respect the autonomy of patients when why give patients a choice to make a bad choice? Why not just choose for them so it’s the correct choice? Paternalism can recommend override autonomy. O’Neill says this is not correct – the Kantian has to stand up and demand that informed consent be informed and true consent is given, even when a patient is compromised. Autonomy is a sliding scale; it is not a binary answer. Results-oriented perspective – more fundamental in cases of conflicts, if paternalism overall gives the better good, i.e. reduces negligence, self-destructive activities, etc., then utilitarianism would describe this as the appropriate course of action, despite treating the population like a child. The manner of the means is secondary as long as the outcome is favorable. Action-orientated perspective – results is just consequentialism. This utilizes Kantian ethics deontology – evaluate the action or the intention behind action, which is the raw unit of evaluation. Problematic: Autonomy is often compromised in medical ethics…but is autonomous enough. There’s the temptation to promote the patient’s good, which could work against the motivation to acquire real informed consent. The fundamental aspects are told, but not ALL the specifics – they have to be able to refuse. Hypothetical consent – what would the hypothetical, ideal person wants if they were fully autonomous? O’Neill says this is not enough. O’Neill says doctors must take it more seriously – it is a moral value that must be respected. A respectful autonomy should override utilitarian calculations on the issue. Actual consent about the fundamental aspects, the procedure, the proposal, etc.

What does Rolston say about the moral requirement to save people when it is within our power to do so? Is our duty to save people from starvation when it is within our power to do so always overriding of all other moral considerations such as saving nature? What is the connection between saving people, saving nature, and distributive justice? Why does Rolston think that our moral duty to save people does not always override or win out over our moral duty to save nature or other moral concerns? Moral requirements to save people when we can – it does not always override a moral duty to save nature. Feeding people does not always win. He argues that there are moral values apart from utilitarian/Kantian that show a need for respect for nature. Value is not always captured in the norm theories. These values CAN win out over the other calculations. Duty to save people is not always overriding of saving nature. Distributive justice is the justice of the distribution of valuable things in society (resources, jobs, etc.). Distributive justice, saving nature, and saving people are all functions of one another. Rolston’s arguments describe why this moral duty does not always override. People value many things besides preventing human tragedy. Not assessing what people should value, but looking realistically at what they do value. If there is unequal, unjust distribution of wealth…it’s not going to be able to alleviate all poverty anyway. If extinction of species is at stake, we should focus on nature. As alleviating human suffering is not really going to make THAT much of a difference. Basic problem – utilitarianism’s focus on feeling, eliminating suffering, promoting good feeling, etc. This misses an ecosystem which environmentalists want to say has intrinsic value. It’s not just the welfare of the animals, it’s the welfare of the entire thing as a biome. It misses the value of nature. Kantianism can miss the value of some piece of nature where there is no human dignity or autonomy at stake as well – it cannot give state of value to it if it is not there. If significant natural values are at stake, one ought not feed the people. It’s a Singer-esque opinion. Challenging the reflexive response that most people would think to feed people first given the choice, as how could saving an ecosystem outweight human suffering?...