what’s a moral theory
discourse constituted by a structured set of normative, coherent, and in principle justifiable assertions
- explains why an action is right or wrong or why a person or character is good or bad
- using moral theories is a normal, pervasive feature of the moral life
virtues
inner qualities and moral character that guide ones behaviour towards goodness
duty
the responsibilities and obligations that one owes to oneself and society
- keeping promises
utility
the principle of maximising overall happiness and welfare
- cost-benefit analysis
rights
fundamental privileges and entitlements
natural law
moral standards that govern human behaviour are sometimes objectively derived from the nature of human beings and the nature of the world
principles
the basic truths and standards that guide moral reasoning
- justice, fairness
capacities
the inherent abilities and potentialities that enable ethical behaviour
- empathy, critical thinking
Virtue ethics
- rightness of actions is based on whether an action would accord with the relevant virtues
- key concept: virtuous character
deontologism
rightness of actions is determined partly or entirely by their intrinsic nature
- key concept: duty
consequentualism
rightness of actions depends solely on their consequences or results
- key concepts: utility
key features of consequentialism
- Consequences determine morality
- outcomes are the only moral criterion - Impartiality
- every person’s well-being counts equally; no one’s happiness is more important - Aggregation
- we sum up harms and benefits across all affected - Flexibility
- no act is right or wrong in itself - context and outcomes decide - Forward-looking
- moral reasoning projects into the future: what will happen if we choose this?
Health contexts where consequences drive ethics
- resource allocation (ICU beds, ventilators, etc. who gets access when resources are scarce?)
- public health programs (vax, quarantines, harm-reduction)
- emergency triage (disaster medicine: prioritise those with highest survival probability)
- everyday clinical care (weighing risks vs benefits of treatments; balancing side effects against expected improvements)
limitations of consequentialism
Ends justify means
- can permit harmful acts (sacrificing one to save many)
Neglect of rights
- ignores duties like truth-telling, consent, or fairness
Measurement problem
- how do we compare outcomes (pain, dignity, life-years?)
Distribution issue
- maximising total good may overlook equity (benefits for some at expense of others)
what is utilitarianism
A consequentialist framework
- most influential form of consequentialism
Focuses specifically on happiness, well-being, or utility as the outcome measure
Jeremy Bentham
Utilitarianism
- nature has placed humankind under the governance of two sovereign masters, pain and pleasure
- everybody to count for one, nobody for more than one
- so it doesn’t matter how many followers you have on instagram, ur value to Bentham is 1 like anybody else
John Stuart Mill
Utilitarianism
- actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness
Utilitarianism
Morality = producing the greatest amount of happiness for the greatest number
Happiness / utility = pleasure, well-being, or preference satisfaction
Neutral across people: no ones happiness is worth more than anyone else’s
Aims for maximisation: adds up all benefits and harms, pick the action with the best balance
The greatest happiness principle
the right action is the one that produces the greatest overall balance of pleasure over pain
Central feature:
- maximisation: seek the option with the best net results
- aggregation: add together all people’s happiness
equality: everyone’s happiness counts the same
Health application: cost-effectiveness analysis in health care (QALYs)
Act utilitarianism
- evaluate each individual act by whether it maximises happiness
- no fixed rules: every case must be assessed on its own
- flexibility: lying, breaking promises, even harming someone could. be justified if it produces more overall benefit
- example in health care: breaking confidentiality if it saves a life
rule utilitarianism
An action is right if it follows a rule that would maximise happiness
- focuses on rules or practice, not individual acts
- rules shape long-term trust, stability, and predictability in society
Difference from act utilitarianism
Act: does this specific action maximise happiness right now?
Rule: would a general rule permitting this kind of action maximise happiness overall?
Applications of rule utilitarianism
- Confidentiality
- protect confidentiality except in narrowly defined cases - Informed consent
- always obtain informed consent before interventions - resources allocation protocols
- follow established triage frameworks during emergencies - Public health mandates
- important vax programs when evidence shows they maximise community protection
Act vs Rule utilitarianism
Focus:
- Act - each individual act
- Rule - general rules/practices
Decision basis:
- Act - immediate consequences
- Rule - longer-term outcome of following a rule
Flexibility:
- Act - highly flexible, no fixed rules
- Rule - more stable, promotes predictability
Risk:
- Act - justifies harmful acts if benefits are larger
- Rule - can entrench harmful rules if not updated
Health Example:
- Act - break confidentiality if it saves a life
- Rule - keep confidentiality as a rule to preserve trust
