Critical Analysis and Reasoning in

Disciplinary-Based Studies
DR. DANNY LEUNG
LECTURE 8
Model for moral decision making
Here is a 9-Step method for moral decision making. It is
revised from Professor Edwin Hui’s “12-step Approach to
Ethical Work-up of Clinical Cases”.
When you encounter a moral problem and you need to
decide what to do, you can apply this method.
There is no guarantee that the method will definitely give
you a perfect solution. But it should be more objective than
reliance on intuition ( 直覺 ). The final decision also
depends on the competence of the analyst (you). Hence, it
is always recommended that you seek confirmation from
more mature people.
Step 1: Identifying the ethical dilemma/issue.
What is the exact problem?
Who are the people at stake? How many parties are there?
How many positions are there?
Which moral principles, or moral values are in conflict?
Step 2: Examine each party’s perspective ( 看法 ):
Collect information from each party.
What is the reason for a party to have that position?
If there are arguments given, examine the arguments.
Consider the social and familial status, professional status,
educational background, or any other background
information relevant to the case.
Identify the party’s main values relevant to the case.
Step 3: Identify the social, cultural and institutional factors
relevant to your consideration.
For example, what is the common practice in society? In
different cultures, will the issue be dealt with differently?
How it will be dealt with in your present culture?
Is there any research showing people’s preference in your
society.
Are institutional factors, such as university policies and
allocation of resources, involved in the case? If yes, identify
them and consider them as well.
Step 4: Check whether there is any legal guide relevant to
the case?
For example, is there anyone breaking the law or
committing professional misconduct?
What does the law and code of professional conduct say?
What does the constitution (e.g. the Basic Law) say?
Step 5: Find out or assume missing information
Is there any missing information relevant to the case? If yes,
try to find out the answer.
If you cannot find out the answer, make reasonable
assumptions based on the information you obtain from
previous steps.
Step 6: Identify the human values and the corresponding
ethical principles/ theories involved.
The human values include, for instance, preservation of life,
promotion of well-being, removal of pain and suffering,
freedom, justice, fairness, equality, human dignity, quality of
life, truthfulness, trust, love, friendship, etc. If they are in
conflict, prioritize them.
The corresponding ethical principles/theories include, for
instance, utilitarianism, virtue-based ethics, deontology, the
principle of beneficence, non-maleficence, justice, and
autonomy etc.
Step 7: Prioritize competing values and guiding principles.
This is the most important step. Prioritize competing values
and make sure that they are justified.
Step 8: Make action plan
Make action plan according to your prioritization. Make sure
that all important and justified values are respected.
Your action plan should represent the best state of
equilibrium of all relevant factors, values and principles
considered.
Make sure that the action plan can solve the problem in
step 1.
Step 9: confirm your analysis and results with more mature
people.
Since your knowledge and perspective are limited, your
analysis and results might not be objective. Therefore, it is
preferable to discuss your analysis and results with more
mature and reliable people, to seek for confirmation.
Make sure that confidentiality ( 保密性 ) is secured.
Case 1: The helmet ( 頭盔 ) law
The helmet law requires motorcyclists to
wear a helmet when they are
motorcycling. Failure to do so will break
the law and will be penalized.
Pros: helmet can protect the head of a
motorcyclist when an accident happens. It
can effectively save the motorcyclist life.
Cons: violate the motorcyclists freedom. They should have
the freedom to choose whether they want to wear or not.
Step 1: Identifying the ethical dilemma/issue.
Values in conflict: the protection of motorcyclists’ life vs the
freedom to choose wearing a helmet
Ethical principles in conflict: the principle of beneficence (by
means of paternalism) vs the principle of autonomy
Step 2: Examine each party’s perspective
Main argument of the Pros: Head injuries can cause death.
Forcing motorcyclists to wear helmets can effectively reduce
head injuries. Hence, forcing motorcyclist to wear helmets
can effectively reduce the death rate in motorcycle
accidents.
Main argument of the Cons: People should have the right to
choose what they want to do in their private life as long as
they are not harming others. Wearing a helmet belongs to
one’s private life and not wearing it is not harming others.
Hence, motorcyclists can choose to wear helmets or not.
Examining the arguments:
For the Pros argument, (1) whether wearing a helmet can
effectively reduce death rate; (2) is it justified for the
government to intervene with people’s private life.
For the Cons argument, (1) whether not wearing a helmet is
not harming others; (2) Will the motorcyclist regret after an
accident happen; (3) is the freedom being violated an
important one?
Step 3: Identify the social, cultural and institutional factors
relevant to your consideration.
People are not absolutely free. They need to obey to traffic
lights and comply with safety measures.
The value of life is more than that of freedom in Chinese
society.
The Hong Kong traffic is packed. There are lots of
vehicles on highways.
Wearing a helmet might reduce medical cost.
Step 4: Check whether there is any legal guide relevant to
the case?
71% of countries in the world have mandatory ( 強逼性 )
helmet law. (WHO, 2018)
In the US, around 20 states require motorcyclists at all age
to wear helmet. Around 8 states require motorcyclists
below 17 to 20 to wear a helmet. (ValuePenguin, 2018)
In the EU and UK, the mandatory helmet law applies. (The
Daily Journalist, 2015)
In Japan, Singapore and Taiwan, the mandatory helmet law
applies.
Step 5: Find out the missing information.
What do HK people think about the helmet law?
Assumption: there is no strong objection to the mandatory
helmet law.
Step 6: Identify the human values and the corresponding
ethical principles/ theories involved.
Pros: Main value: Protection of life.
Corresponding ethical principle: The principle of
beneficence – Paternalism.
Secondary value: Harm to others (close relatives and
friends)
Corresponding ethical principle: the Principle of non-
maleficence - Harm Principle.
Cons: Freedom to choose wearing a helmet or not.
Corresponding ethical principle: The principle of autonomy
– the Harm Principle.
Step 7: Prioritize competing values and guiding principles.
Since life is the source of autonomy, protection of life can
override the freedom to choose wearing a helmet or not.
1. Protection of life – the principle of beneficence
(Paternalism)
2. The freedom to choose wearing a helmet or not – the
principle of autonomy (the Harm Principle)
3. Harmful feeling to others - the principle of non-
maleficence (the harm principle)
Step 8: Make action plan
Legislating the mandatory helmet law
To respect the motorcyclists’ of freedom, explain to them
the rationale of the legislation. Give sufficient time for the
motorcyclists to get ready for the enforcement of the law.
Case 2
One day, Milly and Jenny had a gathering at a pub.
Jenny found that Milly look unhappy.
Jenny: “Milly. You look quite unhappy. What upsets
you?”
Milly: “My boyfriend.”
Jenny: “Jack? Oh…what happened?”
Milly: “We had an argument. Jack thinks that drinking
alcohol is very harmful to the body. I think it’s ok if I don’t
drink too much. He thinks that alcohol is not different from
drugs. After drinking, people will become insane ( 失去理
智 ). But I think that it’s not different from…
a coke or fruit juice. I don’t drink often and I am not
addicted to it. Every time we have a bunch of colleagues
going to a pub together. It’s my important leisure and social
activity. I don’t want to quit it.”
Jenny: “Did he ask you to quit drinking.”
Milly: “Yes, a few times. And we had a few quarrels about
this. The problem is that…he thinks that, ‘Well Milly, you
choose to quarrel with me because of alcohol?” In his mind,
alcohol is the same as cocaine. But for me, asking me not to
drink is to infringe upon my personal freedom. I just drink a
bit occasionally. I am not addicted. I think he’s exaggerating
the issue.”
Jenny: “It seems that you two have different concepts of
alcohol.”
Milly: “Exactly.”
Jenny: “Do you know why he hates people drinking?”
Milly: “He said when he was young he had been bitten by a
drunk guy.”
Jenny: “I see. Do you love him?”
Milly: “Of course. I want to move forward with him. But this kind
of quarrel is really an obstacle.”
Jenny: “I have learned a model for ethical decision making from
the course CARDS. Let me use it to analyse your case.”
After talking to Milly, Jenny called Jack and tried to get more
information.
Jenny: “Hi, Jack. Are you free? Can we talk for a while?”
Jack: “Hi, Jenny. Sure. How are you?”
Jenny: “I am fine. I heard from Milly that you had a few quarrel
with her because of her drinking.”
Jack: “Yeah. You know that. I think she should quit”
Jenny: “Why? She said she wasn’t addicted and She didn’t
drink too much every time.”
Jack: “Now she is not yet addicted. But if she keeps on, she
will. And there is one thing I don’t like most….”
Jenny: “What is it? Do you mind telling me?”
Jack: “She actually asked me to go with her, with her
colleagues. And I did. But then I found that after drinking,
she set closer to her male colleagues, talking joyfully and I
just can’t bear this.”
Jenny: “Really…Have you talked to her about this?”
Jack: “Yeah, but she denied. Jenny. I know you are her good
friend. Please ask her to quit. Drinking is really bad for her
liver.”
Jenny: “Sure. I will. But Jack…If I am right, I think you quite
love her, right?”
Jack: “Yes. I want to marry her. But we have to solve this
problem first. I want her to be a healthy and happy woman.”
Jenny: “oh..I see.”
References
Hui, Edwin. “12-step Approach to Ethical Work-up of Clinical Cases” Lecture notes for medical
ethics. HKU, 2008.
Motorcycle Helmet Laws Around the World. The Daily Journalist, 2015.
thedailyjournalist.com/the-reviewer/motorcycle-helmet-laws-around-the-world/
Which States Have Motorcycle Helmet Laws? How Do They Impact Your Insurance?
ValuePenguin, 2018. https://www.valuepenguin.com/motorcycle-helmet-laws
Motorcycle helmet law and helmet standard. World Health Organization, 2018.
www.who.int/gho/road_safety/legislation/situation_trends_motorcycle_helmet/en/