Bioethics 101 Lesson two

Subjective and Objective Questions Subjective: adj. Based or influenced by personal feelings, tastes, or opinions. What is your favorite ice cream flavor? Do you like to wear sneakers? Subjective questions usually relate to the speaker, are emotional, are modified by cultural bias. Objective: adj. A person or their judgments are NOT influenced by personal feelings or opinions in considering and representing facts. What is the capitol of Washington State? How many legs does an arachnid have? Objective questions require facts and evidence to answer and are often yes/no or right/wrong answers. On board, draw a continuum between 1-10 with “Purely Subjective (all opinion)” at 1 and “Purely Objective (all fact)” at 10. Ask students to write this down in their notes and include one of the example questions for each end. Ask students where they would put “Ethics” and “Science” on the continuum and draw two lines on their notes. Then, get a sticky note for each word and put it up on the board where they think Ethics and Science is most accurate on the continuum.

Is Science Objective? Yes! The facts of science are objective No! The process of science is done by humans in a social context. For example, people use their values to decide what science to fund how to conduct science responsibly (here let me do an experiment on your ear…uh, what?!) how to apply new discoveries and use them appropriately

Is Ethics Subjective? Yes! Ethical questions rely on people’s values to come to an answer…but that’s not all No! Reasoned judgment is also necessary to make an ethical decision, using evidence (facts!), logic, and bioethical analysis (oh, tell me more!) Ask students to look back at their continuum in their notes—do they still agree with where they put their line?

Skits! Let’s get real. Act out your given scenario. Say the thoughts of your character out loud, like we’re able to hear your thinking What code or standard is being honored (or not) in this skit? Scenarios: A: Parent respecting/not respecting the child’s after school activity choice. B: Parent helping/not helping child with homework. C: Parent being fair/not fair between siblings. D: Teacher correcting/not correcting behavior of student based on the school rules. E: Student standing up/not standing up when another person treats someone rudely. F: Picking teams for kickball for the most athletic team. G: Picking teams for kickball so everyone is included. After groups a and b present their skits, ask the question. Add, this bioethical principle is called Respect for Persons. Write on the poster (on the next slide): Respect for Persons emphasizes the inherent worth and dignity of each individual, and acknowledges a person’s right to make their own choices. It means not treating people as a means to an end. Continue with groups c and d (next next slide) and then groups e and f (and debrief with the next next next slide).

An action is right if it follows… The Principles

Principles: Respect for Persons Respect for Persons emphasizes the inherent worth and dignity of each individual, and acknowledges a person’s right to make their own choices. It means not treating people as a way to get what we want (“means to an end”). A: Parent respecting/not respecting the child’s after school activity choice.

Principles: Maximizing Benefits & Minimizing Harms Maximizing Benefits & Minimizing Harms asks how we can do the most good and the least amount of harm. It considers how one would directly help others and act in their best interest, while “doing no harm.” B: Parent helping/not helping child with homework.

Principles: Justice Justice considers how we can treat people fairly and equitably*. It involves the sharing of resources, risks and costs according to what is “due” to each person. Equality = everyone gets a shirt *Equity = everyone gets a shirt that fits C: Parent being fair/not fair between siblings.

An action is right if it follows… …certain fundamental Moral Rules

The Ethical Perspective DUTIES & RESPONSIBILITIES Actions are Right or Wrong: Are you motivated to always act on duty to your morals (the rules you live by)? Do you respect people every step of the way?   The German philosopher Immanuel Kant (1724-1804) was one of the developers of this perspective of ethics. He created these two rules that he considered unbreakable: One should act only in ways that would be acceptable if everyone else acted that same way. One should not treat persons as a means to an end only, where the outcome is the only concern. D: Teacher correcting/not correcting behavior of student based on the school rules.

An action is right if it matches… …a set of Virtues honored by a particular community

The Ethical Perspective VIRTUES If you develop your virtuous traits, such as honesty, trustworthiness, integrity, faithfulness, you are a virtuous person. What is ethical is what develops virtues in ourselves and our community. The challenge with this is that sometimes people don’t agree on the essential virtues. E: Student standing up/not standing up when another person treats someone rudely.

…good consequences outweigh bad consequences An action is right if … …good consequences outweigh bad consequences

The Ethical Perspective OUTCOMES It’s all about the consequences! Consequences support the well-being of everyone involved. Choose actions that produce the greatest overall benefits. The ends do justify the means (Do whatever you have to to get the “right” outcome) F: Picking teams for kickball for the most athletic team.

An action is right if it acknowledges… … the importance and value of interpersonal relationships

The Ethical Perspective CARE Focuses on the relationships and the power structures that influence a situation Asks questions like: What is not being said? How does the power (or lack of power) of different people and institutions influence actions? How can we value relationships? G: Picking teams for kickball so everyone is included.

Ethical Perspectives and Bioethical Principles help move ethics toward the “objective” end of the subjective-objective spectrum Pass out Perspectives and Principles cards to pairs or groups of three and revisit the Pandemic Flu scenario.

Now who would you save? Based on the Bioethical principle or perspective I assign your group, choose one or two people who would be your top priority to save. Respect for Persons—by respecting mother’s choice to forego vaccine, we are respecting her right to choose. Maximize Benefits/Minimize Harms—by wanting the highest number of people to benefit, we might choose to save the doctor in hopes that she could in turn save more lives. Justice—choosing to draw straws (or distribute vaccine without concerns about social status, age, or profession) would be the most ‘fair’ way to choose. Go back to the Approaches in Lesson One: Which principle is: Save the Youngest (Maximizing life span for the most people) Draw straws (justice) Save the Weakest (considers special needs…Respect for persons/Care) Save the Most Useful (benefits the most amount of people…Max. Benefits/Min. Harms) Respect Relationships (honors the dignity of people and their relationships…respect and care)

And now, What About Dennis? Read Case Study: Dennis’s Decision. What are the main ethical considerations of this case? Respect for Persons, specifically the autonomy of Dennis. Does he have the right to make choices based on his personal values and beliefs? Handout the Case Study and the Focus on the Principles handout. Read the case study aloud and have students work in groups for a short while to respond to the questions in each principle quadrant. Then lead a discussion that identifies the main ethical considerations/principles (raise the main principles as they come up in discussion) and identifies an ethical question, something like the one on the slide (raise the question as it comes up in discussion). Maximizing Benefits/Minimizing Harms. The doctors can “do good” by providing medical treatment. Should Dennis be allowed to reject life-saving medical treatment?