health ethics
systematic reflection on values and norms guiding decisions that affect health
- what ought to be done
- aka bioethics
clinical ethics
patient-provider (compassionate AI) + intuitional decision making
- autonomy
- ex: informed consent for surgery, withdrawing life support
research ethics
knowledge production with/for humans
- ethics review board
- ex: placebo control in trials, genomic data sharing
health policy & public health ethics
population-level actions and policies
- health policy: legislatures, regulators, payers
- HP ex: insurance coverage decisions
- public health: collective benefit vs individual liberty
- PH ex: vax mandates, quarantine
why ethics in health - whats at stake?
high stakes - life, morbidity, quality of life
scarcity and trade offs - finite budgets, time, attention
uncertainty - incomplete evidence, evolving risks
pluralism - reasonable people value different goods
legitimacy and trust - reasons the public can accept
moral vs non-moral claims
moral - we should vax children to protect others
non-moral - vax rates are 85%
descriptive
what is
- facts, epidemiology
- non-moral claim
normative
what ought
- ethics, policy
- moral claim
differences between ethics and law
ethics: what ought we do
- deliberative, plural, evolving, contested
- can go beyond law
- may not be legally recognised
law: what must or must not be done?
- codified, precedent-based, enforceable, rigid but interpretable
- can lack ethical grounding
pyramid
ethics: (top) aspirational, flexible, evolving
policy: (middle) organisational or governmental rules and guidelines. More formal than ethics, less rigid than law
law: (bottom) precedent-based, minimum standard
common reasoning errors
- slippery slope - this is the claim that if we allow one thing, it will inevitable lead to a cascade of worse things
- appeal to authority - this is when someone justifies a claim by citing authority rather than reasoning
- conflating facts with values - misuse of descriptive facts to make normative judgments
- ad hominem - attacking the person instead of the argument
- false dichotomy - presenting only two options when more exist
- overgeneralisation - drawing sweeping moral conclusions from limited examples
autonomy
capacity to make informed voluntary decisions about ones own life and body
beneficence
acting to promote health and wellbeing
justice
fair distribution of benefits, risks, and burdens
efficiency
maximising outcomes with limited resources
immediate burdens
costs, risks, restrictions, inconvenience
long-term benefits
prevention, sustainability, intergenerational health
