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Chapter Two

Decision Making in Value Issues

Copyright ©2009 Delmar, Cengage Learning. All rights reserved.

“Am I Sure It Is My Job to Handle This?”

• Review the case – does the new person have an obligation?

• Decision making formats require you to ask yourself:– What are the facts?– What values are at stake?– What options are available to me?

• Evaluate options and select the best one


Examining Value Issues

• Consequence-oriented:– The right answer would maximize some good– Utilitarianism

• Duty-oriented:– Consequences are essentially irrelevant;

rightness or wrongness are inherent in the act itself

– Kantian ethics


Examining Value Issues (continued)

• Virtue ethics– Emphasis is not consequences nor

reasoning to a universal truth, but rather the character of the actor or the duty associated with the role

– Aretaic ethics

• Divine command ethics – Right answer in a finite set of rules set

forth by a divine or exemplary being


Consequence-Oriented Theories

• Utilitarianism– Jeremy Bentham, John Stuart Mill– No appeal to an absolute authority or

principle; the only test of rival solutions lies in the consequences

– The good resides in the promotion of happiness, or the greatest net increase of pleasure over pain


Utilitarianism

• Act utilitarianism:– “Pig philosophy” problem

• Equal consideration of interest

– “Hedonic calculus” problem

• Rule utilitarianism:– Right action conforms to a rule that has

been validated by the principle of utility


Consequence-Oriented Reasoning

1. Describe the problem

2. List solutions

3. Compare solutions with UTILITY

• Work the problem of Mr. Jimenez: case study: Act Utilitarianism


Criticisms of Utilitarianism

• Impossible to calculate all possible consequences

• Used to sanction unfairness

• Lack of sensitivity to special duties

• Lack of respect for persons


Criticisms of Utilitarianism (continued)

• May allow unacceptable intervention in private lives of individuals

• If followed, may recommend solutions that conflict with personal belief


Kantian Ethics

• Immanuel Kant (1724–1804)– Humans are rational beings– Morality is derived from rationality; our

obligations are grounded not in our nature or in circumstances but in pure reason

– Reason provides the guide to universal principles that can be applied to all people, at all times, in all situations


Kantian Ethics (continued)

• Categorical imperatives:– Universal application– Unconditionality– Demanding an action

• An action is either right or wrong; it cannot be both

• Example maxim for health care providers: “We must always treat others as ends and not as means only”


Duty-Oriented Reasoning

Describe problem List Solutions Compare Solutions with Principles

Possible findings

One Compliant Alternative

Several CompliantAlternatives

Compliant/ConflictingPrinciples

Correct AnswerSelect Among Choices

Rank Principles

Select Choice Work case study: Duty-Oriented Reasoning


Criticisms of Duty-Oriented Reasoning

• Exceptionless nature – too rigid for real life

• Morality not derived from reason alone

• Disregard of consequences

• Question of concern for nonhumans

• Multiple solutions of equal merit possible


Virtue Ethics

• Aretaic ethics: – Taken from Greek arete, which means

excellence or virtue

• Big question:– “Is it the action or the character of the

agent acting that is the heart of the matter?”


Virtue Ethics (continued)

• Virtue ethics: – Emphasis placed on heart of the moral

agent, not the particular action

• If an individual lives a life of good moral character and develops ethical habits – ethical response to a problem expected



• The question is not “what shall I do?” in a particular situation, but rather, “how shall I live?”



• Modern formulation of virtue ethics:– Each profession has set of virtues that

practitioners can adopt in practice – When personal habits, they come

forward when questions arise

• The question: “What would a good (fill in specialty) do in this situation?”


Reasoning with Virtue Ethics

1. Describe problem

2. List solutions

3. Compare solutions with professional traditions

4. Correct answer

• Review case study: Virtue Ethics: Saints and Sinners


Criticisms of Virtue Ethics

• Does not provide specific direction for problems

• New problems may require new solutions not covered by traditional practice

• Relying on tradition may not allow respect for individual choice or use of reason


Criticisms of Virtue Ethics (continued)

• Humans may attempt to respond to several different role demands at same time

• Results may not maximize happiness


Divine Command Ethics

• Big Idea:– Divine or exemplary being has set down

a finite set of rules by which one can gain guidance when making ethical decisions

• Specific reference to divine scripture such as the Ten Commandments


Divine Command Ethics (continued)

• General evaluation of actions based on a model of perfection

• WWJD – if you are Christian, what would Jesus do?

• In a similar fashion Muslims and Buddhists turn to the life and example of Muhammad and Siddhartha Gautama


Reasoning by Divine Command

1. Describe problem

2. List solutions

3. Find appropriate scriptural reference

4. Follow scriptural admonition


Criticisms of Divine Command Ethics

• Belief in divine or exemplary beings can be questioned by non-believers

• Scriptures do not cover all possible cases that require moral decisions

• Seeming exceptionless nature


Criticisms of Divine Command Ethics (continued)

• Euthyphro problem

• Recently several beheadings were justified in the name of God; they believed God told them to do this


Key Concepts

• Several theoretical positions for solving ethical dilemmas:– Consequence– Duty– Virtue– Divine command

• Review the illustrations for each position in the chapter and solve a problem using the system


Key Concepts (continued)

• Act utilitarianism: – Purest form of utilitarian reasoning,

each act evaluated for pleasure attained, pain avoided

• Rule utilitarianism:– Develops rules for action based on

previous validation by principle of utility



• Equal consideration of interest important concept to keep utilitarianism from becoming a purely self-serving form of reasoning



• Kant proposed duty-oriented system: morality based on rationality, not experience

• Consequences essentially irrelevant

• Universal truths create obligations for actions, binding for all people, for all times, in all situations



• The primary focus for virtue ethics is the heart of the moral agent

• Virtues can be formed as habits, which in times of question become our choice of action

• Even in virtue, the ancient Greeks counseled moderation and the golden mean



• Divine command ethics – Source of divine guidance or exemplary

being:• Ten Commandments (Christians and Jews)• Eight-Fold Path (Buddhists)

– Problem of nonbelievers – Euthyphro problem

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