Ethics and Law in Dental Hygiene

Chapter 02: Ethical Theory and Philosophy Beemsterboer: Ethics and Law in Dental Hygiene MULTIPLE CHOICE 1. Ethical decision making is a behavior and can be done well or done poorly. It is inherent and is not taught or learned. Both statements are true. Both statements are false. The first statement is true, the second statement is false. The first statement is false, the second statement is true. a. b. c. d. ANS: C Ethical decision making is something that can be done well or done poorly and it is something that can be taught and learned. Many problems are situations in which we can easily determine what to do, but in other situations determining what is the ethical action takes careful reflection. An introduction to the foundation of ethical theory can guide ethical decision making and assist in understanding the process by which such decisions are made. 2. Moral development is thought to be a process, because moral development has been shown to typically occur in progressive steps or stages. Both the statement and reason are correct and related. Both the statement and reason are correct but NOT related. The statement is correct, but the reason is NOT. The statement is NOT correct, but the reason is correct. NEITHER the statement NOR the reason is correct. a. b. c. d. e. ANS: A Just as each individual develops physically and intellectually, moral development also has been shown to typically occur in progressive steps or stages. Some researchers have related age, maturation of components of personality, and increased experience with moral development, whereas others have stressed that moral development has a cognitive component as well. 3. Which of the following is thought to be one of the strongest and most consistent correlates with development of moral judgment? Age Years of formal education Social status Income a. b. c. d. ANS: B Years of formal education is one of the strongest and most consistent correlates with development of moral judgment. It is even stronger than chronologic age. For many people moral development continues as long as the person is in a formal environment, but then plateaus upon leaving school. 4. Moral education programs seem to be most effective among which of the following members of society? Infants Children Adolescents Adults a. b. c. d. ANS: D Adults seemed to gain more from such programs than did younger children, most likely because a wider range of life experiences typically enriches a person’s awareness of the moral aspects of situations. A review of moral education programs revealed that almost half were effective in promoting moral development, especially if the program lasted longer than a few weeks and if the program involved the participants in discussions of controversial moral dilemmas. 5. The capacity for moral judgment is rigid, because a person’s cognitive moral development and his or her ability to employ what he or she understands peaks at a certain age. Both that statement and reason are correct and related. Both the statement and reason are correct but NOT related. The statement is correct, but the reason is NOT. The statement is NOT correct, but the reason is correct. NEITHER the statement NOR the reason is correct. a. b. c. d. e. ANS: E Findings suggest that the capacity for moral judgment is not as rigid as some have argued. Neither a person’s cognitive moral development nor his or her ability to employ what he or she understands in actual decisions is frozen at some specified age. Individuals can continue to learn, and research has supported the idea that adults make greater gains than children. 6. According to Piaget’s four-stage model of moral development, the egocentric stage is found in individuals of which of the following ages? 0-2 years old 2-7 years old 7-12 years old 12 years old and older a. b. c. d. ANS: B The egocentric stage is from ages 2 to 7 years old. Children in this age group are thought to bend rules and react instinctively to the environment. The amoral stage is from ages 0 to 2 years. The heteronomous stage is from ages 7 to 12 years. Children in this age group accept the moral authority of others. Persons 12 years old and older are thought to be autonomous and have a morality of self based on cooperation; rules and regulations become internalized. 7. According to Piaget, rules are tested and become internalized during which of the following stages of moral development? Amoral stage Egocentric stage Heteronomous stage Autonomous stage a. b. c. d. ANS: D Rules become internalized during the autonomous stage of moral development. The egocentric stage is characterized by bending rules and instinctive reaction to the environment. The heteronomous stage is typified by acceptance of the moral authority of others. Each stage in the process of cognitive moral development involves judgment skills that are more complex, comprehensive, and differentiated from the preceding stage. 8. Which of the following is the most basic stage of Kohlberg’s three-level model of moral development? Interpersonal concordance orientation Law and order orientation Punishment and obedience orientation Instrumental relativist orientation Social contract legalistic orientation a. b. c. d. e. ANS: C Kohlberg’s theory focuses primarily on cognitive processes. He defined six stages, of which punishment and obedience orientation is first. This stage is followed by Stage 2: instrumental relativist orientation, Stage 3: interpersonal concordance orientation, Stage 4: law and order orientation, Stage 5: social contract legalistic orientation, and Stage 6: universal ethical principle orientation. 9. Which of the following stages of Kohlberg’s three-level model of moral development is considered to be conventional reasoning, in which expectations of family and groups are maintained and where loyalty and conformity are considered important? a. Law and order orientation b. Instrumental relativist orientation c. Social contract legalistic orientation d. Universal ethical principle orientation e. Punishment and obedience orientation ANS: A Conventional reasoning involves interpersonal concordance orientation and law and order orientation. Preconventional reasoning involves punishment and obedience orientation and instrumental relativist orientation. Postconventional or principled reasoning involves social contract legalistic orientation and universal ethical principle orientation. 10. Which of the following theorists of cognitive moral development created the concept of the ethic of care? a. Lawrence Kohlberg b. Jean Piaget c. Carol Gilligan ANS: C Carol Gilligan worked with Lawrence Kohlberg but wrote that his model reflects a maleoriented perspective of morality. She stated that women tend to see morality in the context of a relationship that she called the ethic of care. She proposed that feminine moral reasoning is typically different from masculine moral reasoning. Gilligan believes that complete moral development occurs in the context of two moral orientations—a male justice orientation and a female ethic of care—and therefore that Kohlberg’s measurement of moral development only in a justice-oriented scoring system is biased toward the male. 11. Which of the following is an example where avoiding hurt becomes the moral guide governing all moral reasoning according to Gilligan’s model of moral development? a. Orientation to individual survival b. Goodness as self-sacrifice c. Morality of nonviolence ANS: C The morality of nonviolence is the highest level of moral development according to Gilligan. The most basic level of moral development is orientation to individual survival, which is surviving by being submissive to society. The intermediate level is goodness as self-sacrifice, in which being moral is first not hurting others with no thought of hurt to self. 12. People operate on their experiences to make sense of them. The experiences, as we make sense of them, change the basic conceptual structures by which people construct meanings. Both statements are true. Both statements are false. The first statement is true, the second statement is false. The first statement is false, the second statement is true. a. b. c. d. ANS: A This is the basic tenet of cognitive theory. Researchers studying the relation between moral judgment and behavior can see that many factors determine behavior. For example, studies link moral perception with actual, real-life behavior as well as moral judgment. 13. According to Rest and his co-workers, people who love to learn; seek challenges; and are reflective, set goals, take risks, and profit from stimulating and challenging environments are those who develop in which of the following characteristics? a. Longevity b. Advanced education c. Moral judgment d. High remuneration ANS: C Studies link moral perception with actual, real-life behavior as well as moral judgment. These characteristics are frequently found in professional students who are working hard to become excellent professionals. 14. The cognitive aspects of moral development are only part of the story, because incorporating the skill of differentiating right from wrong into life is a matter of building habits. Both the statement and reason are correct and related. Both the statement and reason are correct but NOT related. The statement is correct, but the reason is NOT. The statement is NOT correct, but the reason is correct. NEITHER the statement NOR the reason is correct. a. b. c. d. e. ANS: A One of the best ways to appreciate the value of a habit is to see how it operates in someone we admire. This is the fruition of development of habits such as carefully perceiving, carefully judging, and consistently acting in accordance with one’s moral judgments. 15. In the academic world, examining the different ways in which moral thinking can be done is called a study of humanity. moral or ethical theory. behavior. operant conditioning. reasoning. a. b. c. d. e. ANS: B An ethical or moral question is a question in which a person’s well-being or rights or duties are at issue or at stake. Because the meanings of “ethical” and “moral” are not carefully distinguished in a manner that is widely and consistently used, these terms often are treated as synonyms and used interchangeably. 16. Which of the following views of moral reasoning is predicated on the idea that the rightness or wrongness of any action is determined and justified by the consequences of the act being considered? a. Consequentialism b. Nonconsequentialism c. Virtue ethics d. Deontology ANS: A This type of thinking is always comparative because it aims at maximizing good consequences. Consequentialists consider the consequences of each important alternative course of action available to them in the situation before deciding the right action. Nonconsequentialism or deontology argues that some acts are right or wrong independent of their consequences. 17. You are at a party and notice that a friend has consumed more alcohol than usual and appears inebriated. At you watch her weave to her car, you wrestle with intervening, and many questions go through your mind. You wonder if she will be angry and resent it later on if you try to stop her but fear that she will not make it home safely if you do not. You wrestle whether or not to grab her keys and call a cab. This is an example of which of the following types of ethics? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics d. None of the above ANS: A You are weighing the potential outcomes or consequences of your decisions. Doing moral thinking in this way means considering all relevant consequences of potential actions in the situation, identifying and evaluating them in terms of benefit and harm in order to determine the action(s) that, compared with the alternatives, yield the best outcomes, before making a choice about which action to take. 18. John Stuart Mill was a proponent of utilitarianism, which states that an action should be judged to be moral on its capacity to provide the greatest good for the largest number of people. a. Both statements are true. b. Both statements are false. c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true. ANS: C John Stuart Mill was one of the most famous proponents of utilitarianism. Mill often is described as saying that an action should be judged to be moral on its capacity to provide the greatest good for the largest number of people. However, his teacher Jeremy Bentham said that, not Mill, and Bentham himself eventually repudiated the phrase because it misled people into thinking that, for a utilitarian, whatever benefited the majority was the right thing to do. Both men did teach that the moral action is the one that maximizes good and minimizes harm when the consequences for every affected person are considered. 19. Who was a proponent of utilitarianism? a. Immanuel Kant b. Plato c. John Stuart Mill d. Aristotle ANS: C John Stuart Mill was a proponent of utilitarianism, a version of the consequentialist approach to moral decision making who stressed that, in consequentialist reasoning, every person affected by an action should be considered. Immanuel Kant is credited for establishing one of the most detailed nonconsequentialist or deontological theories of ethical thinking. Plato and Aristotle articulated the Greek tradition of virtue ethics and emphasized that the cultivation of virtuous traits of character is the primary function of morality. 20. Adding fluoride to a community water system is a good example of the application of which of the following types of ethical reasoning? Consequentialism or utilitarian ethics Deontology or nonconsequentialism Virtue ethics None of the above a. b. c. d. ANS: A This is one of the best examples of utilitarianism in dentistry. The consequence is a benefit to society through caries reduction, provided at a relatively low cost and available to all members of a community regardless of social status or income, and with almost no possibility of causing harm. Nonconsequentialism would say that an action is right or wrong regardless of the consequences. 21. Which of the following ethical theories regards an action as right when it conforms to a principle or rule of conduct that meets a requirement of some overriding duty? Consequentialism Nonconsequentialism Virtue ethics Deontology a. b. c. d. ANS: B Deontologists or nonconsequentialists state that some actions are required by the rightness or wrongness of the action, regardless of the consequences of the action. Whereas consequentialists focus on the consequences of an act, deontologists argue that some acts are right or wrong independent of their consequences. 22. Immanuel Kant is associated with which of the following theories of ethical thinking? a. Virtue ethics b. Consequentialism c. Nonconsequentialism d. None of the above ANS: C Immanuel Kant is credited for establishing one of the most detailed nonconsequentialist or deontological theories of ethical thinking. Plato and Aristotle are associated with virtue ethics. John Stuart Mill is associated with consequentialism. 23. Which of the following ethical types of reasoning would be most likely to say that a physician should be honest in telling a cancer patient that he or she only has a short time to live, even if he or she knew the patient would live longer if he or she did not know the truth? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics ANS: B With this view, a professional’s duty to tell the truth to a patient is not founded on the consequences of telling the patient the truth, but on the belief either that an absolute duty exists never to lie or that the patient is entitled by reason of a fundamental right to receive the truth. 24. According to Immanuel Kant, the test for a universal law is whether an action is related to (a/an) overriding duty. moral compass. desirable outcome. benefit for the majority. a. b. c. d. ANS: A Kant held that the test of any rule of conduct is whether it can be a duty for all human beings to act on. That test is what tells us whether an action is directly related to an overriding duty. This school of thought has had a significant effect on biomedical ethics. 25. Immanuel Kant’s test for correct moral reasoning is called the categorical imperative, which means a designation of the reasoning according to four criteria. stable pattern of perceiving, thinking, and acting rightly. rule or standard of conduct that is binding for all human beings. consequence of an alternative course of action in a given situation. a. b. c. d. ANS: C This rule or standard of conduct is absolutely binding for all human beings under all circumstances in which the rule or standard applies. Sometimes Kant’s Categoric Imperative is compared with the golden rule. Kant did not develop the categorical imperative according to four criteria. Stable patterns of perceiving, thinking, and acting rightly are definitions of character, or virtue. Analysis of consequences is associated with consequentialist ethics, whereas Kant and his philosophies are associated with nonconsequentialism. 26. According to Kant, helping an elderly person cross the street is (a/an) a. categorical imperative. b. perfect duty. c. imperfect duty. d. moral obligation. e. universal law. ANS: C An imperfect duty is an obligation to help another person in need or to be compassionate. It is a matter of moral judgment that a person must carefully make to determine for whom and in which situations to fulfill this duty. A categorical imperative is a rule or standard of conduct that is absolutely binding for all human beings under all circumstances in which the rule or standard applies. 27. Some moral philosophers have advocated that correct moral thinking should be like solving a simple mathematical equation. Theories of moral development have been offered to help understand how easy making good moral decisions can be. Both statements are true. Both statements are false. The first statement is true, the second statement is false. The first statement is false, the second statement is true. a. b. c. d. ANS: B No moral philosopher has ever claimed that moral thinking is like solving a simple equation in mathematics. One reason theories have been offered is to help us understand how complex making good moral decisions can be and then to try to help us think about them more clearly. 28. Which of the following types of ethical philosophies is based upon good patterns of perceiving, thinking, and acting rightly? Consequentialist ethics Nonconsequentialist ethics Virtue ethics None of the above a. b. c. d. ANS: C If those patterns are perceiving, thinking, and acting rightly we call them virtues and we say the person has a “good character” or is a “good person.” Consequentialism refers to the kind of moral thinking that is predicated on the idea that the rightness or wrongness of any action is determined and justified by the consequences of the act being considered. Nonconsequentialist ethics argue that some acts are right or wrong independent of their consequences. 29. Which of the following is the focus of virtue ethics? a. Our perfect duties and our imperfect duties b. To reflect on what kind of person we ought to be c. The consequences of our actions d. Our duties and rights rather than the consequences of our actions ANS: B Rather than focusing first on consequences or nonconsequentialist factors such as duty or rights, philosophers of virtue ethics urge us to reflect on what kind of person we ought to be and not the ethical characteristics of the acts we ought to do. Perfect duties and imperfect duties are part of Immanuel Kant’s nonconsequentialist or deontological theories of ethical thinking rather than virtue ethics.