Topic 3: ETHICAL
DECISION
MAKING
Dr. Salim Mohamed
Universiti Malaya
Ethical
deliberation
..Is the process in which everyone
concerned by the decision is
considered a valid moral agent,
obliged to give reasons for their
own points of view, and to listen to
the reasons of others.
A moral agent..
• is a person who has the ability to discern right from
wrong and to be held accountable for his or her own
actions.
• Moral agents have a moral responsibility not to cause
unjustified harm.
Nature of Persons
• 'What does it really mean to be a person?' For instance,
is a person a person simply because he or she is human,
or is more required?
• Specifically, we're going to take a look at how the terms
'moral agency,’ and 'moral agent' fit into the nature of
persons debate.
Autonomy
autonomy is required for
personhood. In other words,
personhood takes independence. It
requires the ability to steer the
course of one's own existence –
Immanuel Kant
what constitutes autonomy and independence?
For instance, by no stretch of the imagination is a newborn baby
either autonomous or independent. Does this mean a baby is not a
person? If so, when does it become a person?
Taking it a step further, what about someone who suffers with
Amyotrophic lateral sclerosis (Lou Gehrig's disease)? Having lost
the ability to move or speak, is someone with this disease no
longer a person?
Autonomy
• Autonomy- individual capacity for self-
determination, independent decisions,
actions, and evaluations.
• In Kantian approach – autonomy is an
ability of deliberated self-legislation
• In Utilitarian approach – autonomy is
associated with one’s ability to follow one’s
preferences
Autonomy and responsibility
• Responsibility is one’s awareness of one’s obligation to make decisions and
to act appropriately on the basis of certain commitments (for example,
towards an external authority , oneself, one’s status, engagements, or
agreements, respected others, accepted principles and rules.
Different aspects of responsibility:
• Spontaneously obtained status or commitments (e.g. responsibility of
parents)
• Consciously accepted status or commitments (responsibility of an officer,
professional, self-committed person.
• Legal responsibility
In ethics, the notions of autonomy and responsibility are
mutually related. Responsibility manifests autonomy; there is
no autonomy without responsibility, beyond responsibility
autonomy turns arbitrarily, which means that the person in
his/her decisions does not take into consideration the interests
of others.
Autonomy and responsibilities
q Responsibility for consequences of freely taken decisions
• If individuals are autonomous and if they decide in all freedom,
they have to take responsibility for the consequences of theses
decisions. An example is engagement in risky behaviors.
q Responsibility to avoid infringement of another person’s
autonomy
• A limit to the autonomy of an individual is the autonomy of other
individuals. We cannot argue that as autonomous persons we have
the right to limit the autonomy of other persons. If we want or free
choices, and thus our values, to be respected, we are obliged to
give the same respect to the free choices, and thus values., of
others. An example is the debate on smoking; we are free to decide
to smoke and endanger our own health, but we cannot endanger
the health of others.
Autonomy and consent
Purpose of the principle of consent:
• It asserts individual autonomy
• It protects his/her status as human being
• It prevents coercion and deception
• It supports the process of rational decision-making
• It educates people at large
article 1 of the Universal Declaration of Human Rights 1948
holds that all human beings are born free and equal in dignity
and rights . Consent therefore expresses respect for dignity
and rights of each human being.
Relation between
autonomy and consent?
• Autonomy may be defined as self rule
and refers to the right of persons to
make authentic choices about what they
should do and what shall be done to
them.
• Autonomous persons can only make
decisions and take responsibility for the
decisions if they can consent to
interventions that affect their lives.
Criteria for capacity to consent
• The ability to understand given information
• The ability to appreciate the nature of the situation
• The ability to assess the relevant facts
• The ability to exercise choice
• The ability to use understood information for realistic
and reasonable decisions
• The ability to appreciate the consequences of giving or
refusing consent.
Examples of person not able to
consent
• Neonates
• Children
• Confused elderly patients
• Patients with learning difficulties
• Mentally ill patients
• Unconscious patients
Moral Agency
• personhood requires moral agency,
the capacity to make moral decisions based on the
perception of right and wrong.
• For instance, a 7-year-old who bites her little brother, then lies about
it to escape punishment, is exhibiting the traits of a moral agent. She
knows what she did is wrong. Therefore, she makes it into the
personhood club. However, a puppy who bites and excitedly tears up
every shoe in sight does not. At first glance, this whole thing might
seem cut and dry.
• However, what about the severely and profoundly mentally
handicapped man who bites his nurse every time she tries to feed
him? Based on all observation, he has no concept that his biting is
hurtful and wrong. Does this mean he's not a person? Just like the
autonomy argument, the requirement of moral agency often gives
rise to more questions than answers.
Ethical deliberation- practical decision
• The process of thinking that produces a practical decision is known as
deliberation.
• At the start of a piece of deliberation, a person is undecided as to which
of several courses of action to take.
• Where the selecting or non-selecting of one of those courses of action is
seen as depending on moral considerations, the deliberation is
ethical/moral deliberation
Ethical deliberation can be viewed as involving the following elements:
• • moral principles
• • an appreciation of the situation
• • a review of possible courses of action
• • application of the principles
• • decision (selection of one of the practical possibilities).
What is Ethical Reasoning?
• Most human behaviour has consequences for the
welfare of others, even for society as a whole.
• Individuals are able to act in such as way as to enhance
or decrease the quality of the lives of others, and
generally know the difference between helping and
harming.
• Ethical reasoning holds two roles in life:
• Highlighting acts that enhance the well-being
of other people.
Ethical reasoning is a type of
• Highlighting acts that harm the well-being of critical thinking that uses ethical
other people. principles and frameworks. It is a
process of identifying ethical
• When an act enhances the well-being of others, it is issues and weighing multiple
worthy of praise from others, when an act harms or perspectives to make informed
decreases the well-being of others, it is worthy of decisions. Ethical reasoning is not
about knowing right from wrong,
criticism.
but being able to think about and
respond to a problem fairly, justly
and responsibly.
• Ethical reasoning pertains to the right and wrong of
human conduct. Each person has standards that are
defined by their personal values which come into play
when the person faces certain dilemmas or decisions.
• Ethical reasoning is the ability to identify, assess, and
develop ethical arguments from a variety of ethical
positions.
• Ethical questions concern judgments of right and
wrong, good and bad, as well as matters of justice,
fairness, virtue, and social responsibility
Methods in ethical reasoning
ETHICAL STATEMENT
Ethical statements are propositions of the form that
such and such is good or bad, right or wrong,
obligatory or non-obligatory
Ethics attempt to determine why individuals or
groups make statements about what is good, right,
or obligatory.(justifying an action)
Furthermore, ethics is concerned with prescriptive
statements, which attempt to transcend relative
cultural and individual positions.
On the other hand..
• Science is the discipline that attempts to
make descriptive statements about the
nature of reality through analysis of
facts and experience.
• Science and its derivative technologies
attempt to describe through an empirical
methodology, facts and relationships
among facts, and the laws of nature that
govern the universe.
Descriptive vs prescriptive
statement
• Descriptive statement: establishes definition/identity
• Prescriptive statement: indicates how things should be
• For example, a descriptive statement could be, “The U.S.
federal government is $250 million in debt,” and;
• a prescriptive statement is, “The U.S. Federal
government should not be able to incur such debt,” or
“The U.S. Federal government should declare
bankruptcy.”
Why need ethics?
• It is generally accepted that science cannot deduce
prescriptive statements from facts.
• Although a description of certain facts may suggest an
ethical position, one cannot, through a description of the
facts alone deduce an ethical conclusion.
• An ethical system such as utilitarianism may provide the
minor premise needed for ethical reasoning.
• For instance, if one concludes that option A will create the
greatest happiness, by applying the utilitarian maxim
that one should choose the option that creates the greatest
happiness, one can conclude that option A is the optimal
solution.
• Ethics is concerned with the ends that should be chosen by people.
• Science is extremely important in most environmental ethical
discussions, because once a particular goal is chosen, science can help
evaluate various means that are available to achieve the goal.
• Science can also analyse which ends are possible.
• If a society determines that it is good to build a nuclear power plant,
science can analyse what structures or what types of institutions
most effectively and safely achieve the type of power plant desired
by the community.
• Science can also help determine what environmental impacts the
community should expect from the power plant.
• however, science cannot fully determine whether the power plant
should be built, precisely because no amount of descriptive analysis
can logically certify a prescriptive course of action. Agree??
Ethical dilemma?
• a situation in which a difficult choice has to be made
between two or more alternatives, especially equally
undesirable ones.
• By definition, an ethical dilemma involves the need to
choose from among two or more morally acceptable
options or between equally unacceptable courses of
action, when one choice prevents selection of the other
(Ong et al., 2012)
Will help each of us identify
and understand the ethical
challenges we face,
Good Evaluate the facts and try to
ethical fit it alongside our shared
deliberation norms, and
Provide the basis for acting
ethically.
Four (4) Main
Steps Toward
Ethical Decision-
Making
Identify and state the
problem.
Gather as much information as possible.
Outline the facts, separating out bias,
innuendos, assumptions, hypotheses or
suspicions.
• There are several questions you can ask yourself:
• What is the issue? Are there underlying issues? Does this
situation make you uncomfortable? Why?
• Identify relevant players/parties.
•Who is affected by the decision? Individual? Small
groups? An organization? What are the
consequences for the affected parties (including
yourself)? Do any laws/professional codes exist
that should be considered?
•Generate potential courses of action/possible
options to the problem.
•Brainstorm as many possible courses of action as
possible and come out with two main options or
possible decisions.
Test your options.
• HARM Test: Does this option do less harm than
the alternatives (show how one option carries
more benefit and less harm than the other)?
• FAITH Test: What would religion think about my
decision (support your chosen option based
on various religious point of view) ?
• PROFESSIONAL Test: What would my
profession’s ethics committee say about this
option? (what are
laws/regulation/policy/guideline that can
support the option/decision)
• PUBLICITY Test: Would I want this option to be
published in the newspaper with my name?
Sample of ethical dilemma
• An institution of higher learning has built a new
multi-storey building to be used as chemical
laboratory for teaching and research purposes.
However, the building is not well designed and
Central constructed giving rise to problems such as poor
problem ventilation and low water pressure (as well as
frequent disruption of water supply). It is
estimated that millions of dollar is required to rectify
these problems. The institute of higher learning also
plans to purchase a piece of instrument considered
to be very useful for both teaching and research,
costing about the same amount.
2. Purchase
teaching and
research 1. Rectify the
instruments building
Group members
Title
Precise Similar case-
introduction
2. Faith test
1. Harm test
3. Publicity
test 4.
Professional
test
Short
conclusion/
summary
References:
Acknowledgement APA format
List what are the specific
aspects of each option that
Harm test can affect the parties
involved.
+ve sign:
benefits
-ve sign:
harm
References
• http://ethics.iit.edu/index1.php/Programs/Ethics%20Across%20the%
20Curriculum/A%20Format%20for%20Ethical%20Decision%20Maki
ng
• https://www.ncbi.nlm.nih.gov/pubmed/22252176
• Ong, W. Y., Yee, C. M., & Lee, A. (2012). Ethical dilemmas in the care
of cancer patients near the end of life. Singapore medical journal,
53(1), 11-16.
