Biomedical Ethics and Healthcare Tech (12)

Biomedical Ethics & Healthcare Tech

Detect & explain potential ethical issues arising under any given factual scenario relating to:
(1) bioethics and related technological advancements; and
(2) healthcare technology, and
devise coherent moral arguments & recommendations (including normative theories and DDE, if relevant) in reaching
an overall, logical and nuanced stance on ethicality

State and explain Beauchamp & Childress’s 4 classical principles which guide decision-making in the context of
bioethics, and analyse their relevance in light of the different normative theories and DDE

Table of Contents
CLASSICAL PRINCIPLES OF BIOETHICS.....................................................................................................................................................1
4 PRINCIPLES WHICH GUIDE DECISION-MAKING IN THE CONTEXT OF BIOETHICS..........................................................................................................1
APPLICABLE MORAL VIRTUES.................................................................................................................................................................................................. 3
RELEVANCE OF NNL.........................................................................................................................................................................................3
BIOETHICS AND TECHNOLOGICAL ADVANCEMENTS...........................................................................................................................4
OUR EXPERIENCE OF NATURE (UNGER) – WE SHOULD KEEP DEVELOPING!!!...............................................................................................................7
THE PROMISE & PREDICAMENT (SANDEL) – AGAINST GENETIC ENHANCEMENT TAKEN TO THE EXTREME............................................................8
THE PREDICAMENT (SANDEL) – SHOULD WE ASPIRE TOWARDS ENHANCEMENT?.......................................................................................................9
THE WAY FORWARD................................................................................................................................................................................................................. 9
HEALTHCARE TECHNOLOGY......................................................................................................................................................................11
GROUP PRESENTATIONS MATERIAL......................................................................................................................................................11
DIFFERENTIAL TREATMENT BETWEEN VACCINATED AND UNVACCINATED INDIVIDUALS..............................................11
NNL + DDE............................................................................................................................................................................................................................ 11
(ACT) UTILITARIANISM.......................................................................................................................................................................................................... 12

Classical Principles of Bioethics

Bioethics is the study of the ethical issues emerging from advances in biology, medicine and technologies.
 Contemporary bioethicists make use of a variety of different views, including primarily utilitarianism and
Kantianism but also (NNL)
 more recently developed perspectives such as virtue theory and perspectives drawn from … the school of
thought known as the ethics of care.

Beauchamp & Childress (2008)

4 Principles which guide decision-making in the context of bioethics
(1) AUTONOMY of an individual when making decisions to receive biomedical
technologies/procedures/services
a. Opportunity to make informed decisions, understanding risks and benefits of the
technologies/procedures/services, likelihood of success, etc.
i. Free of coaxing or coercion
ii. Autonomy of thought [i.e. informed]
iii. Autonomy of intention [i.e. without controlling influences],

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iv. Autonomy of action [i.e. voluntary]

b. Moral basis of autonomy is defined differently under each normative theory
c. WHEN IS “NO AUTONOMY” JUSTIFIED? Clear-cut case of justified paternalism is seen in
the treatment of suicidal patients who are a clear and present danger to themselves.
d. Here, the duty of beneficence requires that the physician intervene on behalf of saving the patient's
life or placing the patient in a protective environment, in the belief that the patient is compromised
and cannot act in his own best interest at the moment

(2) NON-MALEFICENCE (act/omission) requires that the biomedical technologies/procedures/services do not

harm the individual involved (or others in society)
a. What can or cannot be permitted defined differently under each normative theory
b. Includes: Non-maleficence in commission/omission
c. 4th century BCE Hippocrates directed physicians “to help and do no harm” (Epidemics, 1780).
d. Implies that biomedical technologies/ procedures/ services providers should also be competent
enough to recognise harm and avoid harm
e. Interactions between the principle of NM with:
i. (1) Precautionary principle: The precautionary principle enables decision-makers to adopt
precautionary measures when scientific evidence about an environmental or human health
hazard is uncertain and the stakes are high
ii. (2) DDE
1. “Inevitable” harm?
2. Single action causing a good effect (vs. beneficence) and a bad effect (vs.
maleficence)?
a. NM acts as a threshold for treatment. If a treatment causes more harm
than good, then it should not be considered.
i. CF beneficence: where we consider all valid treatment options and
then rank them in order of preference.
b. NM is a constant in clinical practice. For example, if you see a patient
collapse in a corridor you have a duty to provide (or seek) medical attention
to prevent injury
i. beneficence as a response to a specific situation – such as
determining the best treatment for a patient..

(3) BENEFICENCE requires that the biomedical technologies/procedures/services be provided to each

individual with the intent of doing good to such individuals [and society at large?]
a. it ensures that healthcare professionals consider individual circumstances and remember that what is
good for one patient may not necessarily be great for another.
b. What is considered a “benefit” is defined differently under each normative theory
c. It is important to bear the patient’s expectations in mind when ranking treatments because when we
refer to doing “good” we are not simply referring to what is medically good for the patient, but also
what is acceptable to the human being we are treating.
i. E.g. doing good/dignity  NNL /kantian ethics
d. Implies that biomedical technologies/ procedures/ services providers should also be competent
enough to recognise benefit and provide benefit?
e. Is beneficence a ‘limited duty’ (cf. NM, which is a constant duty?), e.g. physician has duty to seek
the benefit of all patients, but physician may also choose whom to admit into his or her practice, and
does not have a strict duty to benefit strangers?
i. But what if two patients appeal for treatment at the same moment - how to resolve?
Urgency of need? First come first served?

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ii. Maybe give surgery to the one who has surgery as a higher ranking option/only option

(4) JUSTICE requires that burdens and benefits of new/experimental biomedical

technologies/procedures/services be dispensed ‘justly’
a. Considerations of ‘justice’ may include:
i. Whether the spirit of existing laws is upheld
1. But can ‘justice’ conflict with legislation?
ii. Fairness to all stakeholders, e.g.
1. Distribution of scarce resources: similar treatment of people with similar needs in
similar circumstances?
2. Competing needs
iii. Rights and obligations

Example scenario
A 52-year-old man collapses in the street complaining of severe acute pain in his right abdomen. A surgeon
happens to be passing and examines the man, suspecting that he is on the brink of rupturing his appendix. The
surgeon decides the best course of action is to remove the appendix in situ, using his trusty pen-knife.

From a beneficence perspective, successful removal of the appendix in situ would certainly improve the patient’s
life.

But from a non-maleficence perspective, potential harms to the patient:

 The environment is unlikely to be sterile (as is that manky pen-knife) and so the risk of infection is
extremely high
 The surgeon has no other clinical staff available or surgical equipment meaning that the chances of a
successful operation are already lower than in normal circumstances
 Assuming that the surgeon has performed an appendectomy before, they have almost certainly never done it
at the roadside – and so their experience is decontextualized and therefore not wholly appropriate
 Unless there isn’t a hospital around for miles, this is an incredibly disproportionate intervention.
Again this is a rather silly example but it is important to remember that before leaping to action, we need to consider
the implications and risks of intervening at all.

Applicable moral virtues

● Mortal virtues applicable to the biomedical space (e.g. compassion, trustworthiness, integrity) - going
beyond mere compliance with rules
● Each of these principles taken to its logical extreme may conflict with other norms, so each of the principles
would have to be ascribed the proper weight in any particular case, guided by the virtues

Relevance of NNL

Life BG
● Every aspect of vitality which puts a human being in good shape for self-determination
● Bodily & cerebral health, freedom from pain that betokens organic malfunctioning/injury
● Transmission of life by procreation of children: life-in-its-transmission
● E.g. “teamwork of surgeons and the whole network of supporting staff, ancillary services, medical schools,
etc … resuscitation of suicides” (Finnis, p. 86)
● PR: Must respect every BG

Sociability BG
● Forms of human community E.g. “teamwork of surgeons and the whole network of supporting staff,

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ancillary services, medical schools, etc

● Acting for the sake of one friend’s well-being

Practical Reasonableness (i.e. autonomy within reason) BG

● INTERNAL: one strives to bring one’s emotions and dispositions into the harmony of an inner peace of
mind that is not merely the product of drugs or indoctrination nor merely passive in its orientation
● EXTERNAL: one strives to make one’s actions (which are external in that they change states of affairs in
the world and often enough affect the relations between persons) authentic, that is to say, genuine
realisations of one’s own freely ordered evaluations, preferences, hopes, and self-determination
● 9 PRs: e.g.one must not choose to do an act which of itself does nothing but damages one/more of other
basic goods

Religion (Finnis, p. 89) BG

● “For, as there is the order of means to ends, and the pursuit of life, truth, play, and aesthetic experience in
some individually selected order of priorities and pattern of specialisation, and the order that can be brought
into human relations through collaboration, community, and friendship, and the order that is to be brought
into one’s character and activity through inner integrity and outer authenticity, so, finally, there arise such
questions as:
○ How are all these orders, which have their immediate origin in human initiative and pass away in
death, related to the lasting order of the whole cosmos and to the origin of that order?
○ Somehow subordination to something which makes that human freedom, human intelligence and
human mastery possible (not just 'originally' but from moment to moment) and which is free,
intelligent & sovereign in a way (and over a range) no human being can be

Bioethics and Technological Advancements

● Ethical issues relating to healthcare and biomedical sciences, in the context of technological advances
● Values of ancient traditions may be tested against new biomedical technologies/ procedures/ services

Examples
● End of Life Issues, Artificial Prolongation of Life (C&S, pp. 358 – 359)
○ Treatment of terminally ill patients; Advance Medical Directive Act
○ Balancing harms and benefits, and concerns about best interests of the patients
○ 'Best interests of the patient' = judgment concerning what'd achieve the patient's best interests
based on objective criteria, NOT the patient's subjective preferences
○ Cultural and religious differences
■ Western bioethics tend to valourise personal autonomy and interests in decision-making
(e.g. respect DNR do-not-resuscitate decision made by patients)
■ Other cultures place more emphasis on interdependence of interests amongst the patient,
family members and other affected persons
● Assisted Reproduction Techniques (C&S, p. 360)
○ IVF
■ Procedures involving egg donations are costly, time-consuming and risky for the female
■ Success rates of IVF are relatively low and procedure runs risks of miscarriages & multiple
births  against certain Christian beliefs – valuing life etc
■ IVF process inevitably results in discarding of embryos → ethical debates concerning status
of embryos and sanctity of life
○ Commercial surrogacy
■ Ethically questionable because of potential exploitation of surrogate mothers who may be
suffering from abject poverty, and under pressure to clear family debts

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■Also involved are agencies, intermediaries and brokers extracting financial gains from the
commercial deals with possible conflict of interest
● Genetic Disorders/Privacy of Genetic Information (C&S, pp. 361-363)
○ Genetic tests, gene therapy, genetic counselling; “wrongful” birth/life?; confidentiality of genetic
information
○ Genetic tests are conducted to identify patients at risk of developing genetic disorders
○ Mistakes in the use of technology CAN occur
■ Negligent failure of physicians to detect genetic disorders prior to birth can give rise to
legal claims for compensation by the disabled/deformed children aka wrongful life and/or
by their parents for the pain and suffering of childbirth and expenses for raising the child
aka wrongful birth
● Wrongful life claims are generally disallowed due to ethical and public policy
concerns - based on argument that child should not be considered as a
liability/detriment
○ Use of genetic info obtained - should it be treated as confidential? Does a patient have a right not to
disclose their genetic information?
■ General obligation of confidentiality owed by physicians to patients in respect of personal
info of the patient BUT such confidentiality obligations aren't absolute
■ Personal information MAY be disclosed in the public interest → avoid serious harms to
others
○ Wb respecting the dignity of disabled persons? kantian
● Genetic Enhancements (C&S, p. 364)
○ Designer babies and eugenics
■ Ability of parents to pre-select certain characteristics of their offspring → raise spectre of
designer babies & eugenics in the near future
■ Pre-selection of a child's characteristics can be thought to expand the autonomy of parents
in decision-making on reproduction
■ Savulescu: choosing NOT to enhance is wrong/neglectful
● Genetic enhancement is consistent with our rights to enhance people through
education and diet
● Enhancement is NOT different ethically from treating disease
● We should choose to be better
○ Michael Sandel: The Case Against Perfection
■ Enhancement and genetic engineering pose a threat to our capacity to act freely for
ourselves and by our own efforts
■ Fears that such tech would dissuade/deter parents from accepting their children as they
come and view them as objects of our design/products of our will/instruments of our
ambition (superficial things that make them take advantage of society’s problematic
preference for superficial biological features – and granting them more opportunities)
■ The drive to enhance human nature through genetic technologies is objectionable because it
represents a bid for mastery and dominion that fails to appreciate the gifted character of
human powers and achievements
● Stem Cells and Cloning (C&S, pp. 365 – 367)
○ Therapeutic/research cloning; reproductive cloning
○ 2 types of cloning:
■ #1 Therapeutic/research cloning - production of embryos by artificial means to harvest their
stem cells
● Stem cells & tissues that have been created through cloning process are implanted
into patient with aim of curing his/her illness

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● BUT human embryos will be destroyed in the process

● Doesn't result in creation of complete animal/human being
■ #2 Reproductive cloning - production of embryos by artificial means for purpose of creating
a viable cloned infant whether animal/human
● Takes nucleus of an adult cell and implants it into an egg where the nucleus has
been removed - somatic cell nuclear transfer
○ “Violation of things we rightfully hold dear”?
■ Disagreements centre on moral status of human embryos and when human life commences
■ Other arguments: reproductive cloning is an unnatural procedure going against design by
the Creator and it undermines intrinsic worth & dignity of humans
● Neuro-ethics (C&S, pp. 367 – 368)
○ Neuro-scientific methods to study the brain:
■ Neuroimaging/brain scanning methods - assess brain health and functions
■ Deep brain stimulation techniques to modify and improve brain functions
■ Use of brain-computer interface for patients to control external devices such as artificial
limbs solely by brain activity and to facilitate recovery of brain functions
○ Neuro-scientific techniques bring potential benefits to patients BUT some are invasive and may
entail side effects of a temporary/permanent nature
○ Neuroimaging techniques may be likened to mind-reading → raise privacy concerns over its use
○ Difficult issue of whether and to what extent neuro-pharmaceuticals may be used to enhance one's
mental performance
● Human organ transplants (C&S pp. 368-370)
○ Singapore Human Organ Transplant Act
○ Argued that the opt-out system [organ donation will occur automatically unless a specific request is
made before death for organs not to be taken] is justifiable as its onerous and inconvenient for
potential donors to make a conscious decision to donate
● Transhumanism (Nick Bostrom)
o Transhumanism is a philosophical and intellectual movement which advocates for the enhancement
of the human condition by developing and making widely available sophisticated technologies that
can greatly enhance longevity and cognition. It also predicts the inevitability of such technologies in
the future.
o Transhumanism advocates the well-being of all sentience, whether in artificial intellects, humans,
and non-human animals (including extraterrestrial species, if there are any). Racism, sexism,
speciesism, belligerent nationalism and religious intolerance are unacceptable.

look @ unger & sandel - see how to link to normative theories

e.g. sandal: should rein in impulse to control – NNL (PR)

e.g. having a sense of gratefulnmess - virtue ethics?

Our Experience of Nature (Unger) – we should keep developing!!!

Increasing human intelligence  outgrow frailties and increased power to control circumstances & impacts on us.
As a result of this growth in power, our experience of nature has fallen apart into four pieces, each marked by a
distinctive attitude toward the natural world and a characteristic contest of aspirations the idea that we are
something infinite imprisoned within something finite — from the vantage point of a question unaddressed in
my earlier work: our relation to nature. In asking what we should do with nature, we ask what we should do
with ourselves.

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● Delight of the gardener: we treat nature as a setting for escape from strife and striving into aesthetic
freedom
○ We worry about how much we can turn places into areas of recreation
○ as we increase in wealth and dexterity and as population growth levels off, we can turn more places
into gardens. Is not Japan (metropolitan), contrary to all expectation, the country with the largest
portion of its national territory covered by virgin forest?
● Responsibility of the steward: we view ourselves as trustees for future generations of a sinking fund of
non-renewable resources
○ Every disaster has been met by an ingenuous solution – time after time
○ Necessity, mother of invention, has never yet in modern history failed to elicit a scientific and
technological response to the scarcity of a resource, leaving us richer than we were before
○ BUT It is useful to be worried and therefore prudent. It is foolish to deny that no such event has yet
proved a match for ingenuity
● Infirmity of the mortal: only a small fraction of the world's population is now likely ever to be threatened
by the natural disasters that bedeviled our ancestors
○ There is one area of experience in which we continue to suffer as humanity always suffered until it
used mind to gain power over nature: our dealings with disease and death. Terrified and distracted,
doubting both our own powers and higher providence, we work to cure the illnesses that waste us,
and dream of undying life.
● Ambivalence (mixed feelings) of the titan: now that we need nature less, we face a conflict - able to
question effects of our actions on the animate & inanimate nature surrounding us
○ We wonder whether we should not sacrifice our self-centered desires for the sake of a more
inclusive fellow feeling. Yet we are not gods, only demigods, too strong to be indifferent, too weak
to forego exercising the prerogatives of our power over the forms of life

Nothing should prevent us from tinkering with our natural constitution, inscribed in genetic code, to avoid disease
and deformity. (EGOISM?)
 We should not, and to a large extent we cannot, suppress, in the name of delight, stewardship, or reverence,
the initiatives by which we strengthen our command over nature
 The place to stop is the point at which the present seeks to form human beings who will deliver a future
drawn in its own image. Let the dead bury the dead is what the future must say back, through our voices, to
the present. To let the future go free would show more than power. It would show wisdom.

Our societies and cultures make us who we are. However, there is always more is us -- in us, humanity, and in us,
individuals -- than there is or can be in them. They are finite. We, with respect to them, are infinite. We have no
greater interest than in so arranging society and culture that they leave the future open, and invite their own revision.

The Promise & predicament (Sandel) – against genetic enhancement taken to the extreme
sandal: should rein in impulse to control/manipulate nature – NNL (value BG? Respect life? PR)
 accepting of weaknesses, not defining ourselves by perceived weaknesses? (virtue ethics?)
 The promise is that we may soon be able to treat and prevent a host of debilitating diseases
● The predicament is that our newfound genetic knowledge: Manipulate our own nature and make
ourselves “better than well”, “reach beyond health”, above the norm
○ Enhance physical or cognitive capacities, e.g. stronger bodies/muscle enhancement, sharper
memories, happier moods, greater intelligence
● Reproductive technologies
○ Choose sex, height, and other genetic traits of children
○ E.g. California Cryobank – for-profit company that sells “ideal sperm”, genetically characterised
according to the sperm (sperm donors are college-educated, physically-attractive etc)

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■ LINK TO BUSINESS ETHICS

■ Turns childbearing into an extension of consumerism  children as commodity
■ Children will start to blame parents for genetic makeup  hurt and breakdown of society
(UTILITARIANISM BAD, NNL?, VIRTUE ETHICS?)
■ Or no freedom/autonomy for children? (NNL? Libertarian ethics?)
● But there are borderline cases – we need to decide as a society & debate: ARE THESE MEDICALLY
NECESSARY MANIPULATIONS? OR PURELY PREFERENTIAL?
● New era of genetic tech requires that we have a public debate about the meaning of health & the
limits of biotechnology

When science moves faster than moral understanding, as it does today, men and women struggle to articulate their
unease. In liberal societies they reach first for the language of autonomy, fairness, and individual rights. But this part
of our moral vocabulary is ill equipped to address the hardest questions posed by genetic engineering. The genomic
revolution has induced a kind of moral vertigo.
 SANDEL doES not think the main problem with enhancement and genetic engineering is that they
undermine effort and erode human agency. The deeper danger is that they represent a kind of hyperagency
—a Promethean aspiration to remake nature, including human nature, to serve our purposes and satisfy our
desires. The problem is not the drift to mechanism but the drive to mastery. And what the drive to mastery
misses and may even destroy is an appreciation of the gifted character of human powers and achievements.

The Predicament (Sandel) – should we aspire towards enhancement?

● The fundamental question towards enhancement is not (yet) how to ensure equal access, but whether we
should aspire to it in the first place
○ Examine the attitudes and dispositions that prompt the drive for enhancement
● The promise of mastery banishes our appreciation of life as a gift, and leaves us with nothing to affirm or
behold outside our own will
● Would the enhanced become dehumanised? The deeper danger is that enhancements represent a kind of
hyper-agency to remake human nature to serve our purposes and satisfy our desires
○ “To acknowledge the giftedness of life is to recognise that our talents and powers are not wholly our
own doing, despite the effort we expend to develop and to exercise them.”
○ “It is also to recognize that not everything in the world is open to whatever use we may desire or
devise.”
○ “Appreciating the gifted quality of life constrains the Promethean project and conduces to a certain
humility”
● Cultivation of natural gifts is not morally disturbing, but in fact intuitively celebrated: we admire/appreciate
human activity and achievement of those who manage, through striving, grit, and determination, to excel;
we also admire those who display natural gifts with grace and effortlessness
○ Cf. natural law 7BG
● “The drive for enhancement and mastery corrupts our accepting and transforming love and “openness to the
unbidden”. The demand for perfection animates the impulse to “rail against the given”.
● Dissolves virtues of humility, responsibility and solidarity (against virtue ethics)

The Way Forward

Sandel
From a religious standpoint the answer is clear: To believe that our talents and powers are wholly our own doing is
to misunderstand our place in creation, to confuse our role with God's. Religion is not the only source of reasons to
care about giftedness, however. The moral stakes can also be described in secular terms. If bioengineering made the
myth of the "self-made man" come true, it would be difficult to view our talents as gifts for which we are indebted,
rather than as achievements for which we are responsible. This would transform three key features of our moral
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landscape: humility, responsibility, and solidarity.

In a social world that prizes mastery and control, parenthood is a school for humility. That we care deeply about our
children and yet cannot choose the kind we want teaches parents to be open to the unbidden. Such openness is a
disposition worth affirming, not only within families but in the wider world as well. It teaches us to:
● Abide (accept) the unexpected
● Live with dissonance
● Rein in the impulse to control – NNL?
● Be aware that our talents and abilities are not wholly our own doing
● Have a sense of the contingency of our gifts

Unger
● “Nothing should prevent us from tinkering with our natural constitution, inscribed in genetic code, to avoid
disease and deformity. The place to stop is the point at which the present seeks to form human beings who
will deliver a future drawn in its own image. Let the dead bury the dead is what the future must say back,
through our voices, to the present. To let the future go free would show more than power. It would show
wisdom.”

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Healthcare Technology
Trends and Analysis

● Liability – AI predictive tools, chatbots, telemedicine

● Big data – Systematic biases?
● Privacy vs Productivity – IOT technology, systems integration, wearables
● Precision Medicine
○ Unravelling genetics – Do we want to know?
○ Ethics of stratification (dividing people) ? Cost? Subgroups?

Group Presentations Material

Differential Treatment between Vaccinated and Unvaccinated Individuals

Leisure Activities

● Moral actor: Singapore Government

NNL + DDE
○ Moral limit would be crossed if differential treatment violates BGs and/or PRs
BGs Application: Differential treatment for leisure Addressing counter-arguments
activities...

Life Safeguard bodily health of both vaccinated and unvaccinated individuals against COVID-19 virus

Possible vaccine injury (assuming measures nudge Foreseeable ‘bad side effect’
individuals towards vaccination)

Play Limited the range of options of play for unvaccinated
individuals (especially more social forms of play)
Sociability ● Limited opportunities for social interaction for
unvaccinated individuals
● Segregation between vaccinated and
unvaccinated individuals may undermine peace
and harmony amongst men
The BGs of play and sociability are not
completely destroyed and pursuit is not
entirely hindered
● Special groups of unvaccinated
individuals are exempted from
differentiated treatment
● Option of negative PET result

PR Subverting the Autonomy cannot be unfettered at the

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autonomy of unvaccinated individuals as “free expense of damaging others’ BG (some

agents” (in terms of choice of movement, vaccination, limitations may be reasonable
social interactions) opportunity cost of promoting 1 BG)

PR Application

Do not arbitrarily prioritise 1 BG over
another
Treat everyone equally (i.e. one must not
arbitrarily prefer amongst persons and
prevent others from realizing the 7BGs)
● 9 PRs are not algorithmic; some balancing is called for
● May require “prudential reasoning” to balance moral duties and
participation in human goods
● Overall, BG of life is prioritised with good reason over other BGs
in a time of pandemic where lives are at risk (worthwhile tradeoff,
not arbitrary preference amongst persons or values)

(Act) Utilitarianism

While intuition tells us that government rules should be analysed by rule utilitarianism, act utilitarianism would be
used here as it allows for a more rigorous contextual analysis of different moral agents with various idiosyncrasies
who may react to leisure-related restrictions in different ways (rather than an abstract consideration) and allow for
more efficient way to consider the government’s new measures without having to reframe rules to accommodate

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exceptions such that it conceptually resembles an act utilitarian analysis

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Choosing between Theories

● [CHOSEN] Act Utilitarianism: Government usually judged by the consequences of their actions in the exercise of their
mandate
● Virtue Ethics: Unclear whether there is an objective standard to determine moral limits & no practical guidance and
left to discern based on moral wisdom
● NNL + DDE: Unpersuasive as it does not offer a moral defence to utilitarianism, especially since intention is difficult
to be distinguished from foreseeability

Vaccinate or Test Regime (Corporate Context)

● Comparing Act and Rule Utilitarianism
○ Rule utilitarianism would be used here as we are analysing a rule placed by the government to
regulate access to the workplace. Since we are only looking at a specific context of businesses and
the current measures allow for no exceptions due to the strict government laws, an abstract
analysis would be more appropriate (as compared to a rigorous contextual analysis). Furthermore,
since this will be a rule that will be in place for the long run, a long-term approach of looking at rule
utilitarianism should be used
○ Rule: COVID-19 vaccination will be required for workers in selected sectors. Unvaccinated
persons will be required to undergo regular testing to detect infection early so as to prevent further
transmission within the community

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