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This is the complete lecture note for MDH202 Multidisciplinary Healthcare I. You can read it online below, open it in the full viewer, or download the PDF for offline study. It pairs with the course's video lectures, so you can read and watch together.
Course code: MDH 202 Course title: Multidisciplinary Healthcare I Course credit load: 2 Units Series 1: Foundations of Moral Philosophy • Part 1.1: What is Moral Philosophy? o Sub Part 1.1.1: Definition, scope, and importance of ethics o Sub Part 1.1.2: Metaethics: the nature of moral claims o Sub Part 1.1.3: Normative ethics versus descriptive ethics • Part 1.2: Major Ethical Theories o Sub Part 1.2.1: Consequentialism and utilitarianism o Sub Part 1.2.2: Deontological ethics o Sub Part 1.2.3: Virtue ethics and care ethics • Part 1.3: Moral Reasoning in Practice o Sub Part 1.3.1: Applying ethical theories to real situations o Sub Part 1.3.2: Moral conflict, dilemmas, and their resolution o Sub Part 1.3.3: The role of moral intuition alongside theory • Part 1.4: Ethics in African and Nigerian Philosophical Tradition o Sub Part 1.4.1: African communitarian ethics and Ubuntu o Sub Part 1.4.2: Moral philosophy in Nigerian cultural context o Sub Part 1.4.3: Integrating African and Western ethical frameworks in medicine
Introduction Every decision a clinician makes carries an ethical dimension, from the most routine to the most consequential. Deciding how much time to spend with a patient, what to say about a difficult prognosis, whether to continue or withdraw treatment, and how to allocate a scarce resource among competing needs are all ethical acts, whether or not the clinician recognises them as such. The clinician who has studied moral philosophy approaches these decisions with a richer set of tools and a greater capacity to reason through them clearly and defensibly. The clinician who has not is not avoiding ethics; they are practising it unreflectively. This Series introduces the intellectual foundations of moral philosophy and their relevance to medicine. It begins with the nature of ethics as a discipline, examines the major theoretical frameworks that philosophers have developed for thinking about right and wrong, explores how these frameworks are applied to practical moral problems, and concludes with an examination of African and specifically Nigerian philosophical traditions that offer perspectives on morality and community that are essential for any clinician working in the Nigerian context. Series Learning Outcomes Upon completing this Series, you should be able to: • SLO 1.1 define moral philosophy, distinguish between metaethics and normative ethics, and explain why ethical reasoning matters for clinical practice, • SLO 1.2 describe the major ethical theories including consequentialism, deontology, virtue ethics, and care ethics, and apply each to a clinical example, • SLO 1.3 explain how to apply ethical theories to practical dilemmas, describe strategies for resolving moral conflict, and explain the role of moral intuition alongside theoretical reasoning, and • SLO 1.4 explain African communitarian ethics and Ubuntu, describe the moral dimensions of Nigerian cultural context, and discuss how African and Western ethical frameworks can be integrated in medical practice.
1.1 What is Moral Philosophy? 1.1.1 Definition, scope, and importance of ethics Ethics, or moral philosophy, is the branch of philosophy concerned with questions about what is right and wrong, what we ought to do, and what kind of persons and communities we should strive to be. These questions are not abstract puzzles confined to university seminar rooms; they arise in clinical medicine with urgent regularity. Should a patient be told a diagnosis that may cause them severe distress? Should a limited supply of blood be allocated to the patient who arrived first or to the one most likely to survive? Should a clinician follow institutional policy when they believe it will harm a specific patient? Each of these questions requires ethical reasoning, and the quality of that reasoning matters for the patient who will be affected by the decision. The scope of ethics is broader than the scope of any single professional code of conduct. A code of conduct tells a clinician what the profession has decided they must or must not do; ethics asks why those rules exist, whether they are justified, what should be done when they conflict, and how to handle situations the code does not cover. This means that studying ethics is not redundant for a clinician who already knows their professional obligations; it provides the deeper understanding of why those obligations exist and the reasoning capacity to navigate the inevitable situations where professional guidance runs out. It also builds the habit of transparent justification, which protects both the patient and the clinician when difficult decisions are made. Fill in the blank: Ethics is the branch of philosophy concerned with questions about what is right and wrong and what we ought to do; it provides the ________ capacity to navigate clinical situations where professional codes and guidelines do not give clear answers. 1.1.2 Metaethics: the nature of moral claims Metaethics does not ask what is right or wrong; it asks what we mean when we say something is right or wrong, and whether moral claims can be true or false in the way that factual claims can. Moral realists hold that moral facts exist independently of human belief: the claim that causing unnecessary suffering is wrong is true in the same objective sense as the claim that the earth
orbits the sun. Anti-realists disagree; some hold that moral claims express emotional attitudes rather than facts (emotivism), others that they vary across cultures without any universal standard (moral relativism), and others that they are neither true nor false but are expressions of practical commitments. These metaethical positions have practical implications for medicine. If moral relativism is correct, then there is no basis on which a biomedical clinician can say that female genital mutilation, child marriage, or the denial of healthcare to women on cultural grounds is wrong; it is simply different. Most medical ethicists reject this conclusion, arguing that there are at least some moral claims, particularly those concerning serious harm to persons, that hold across cultures even if their application requires sensitivity to cultural context. Understanding the metaethical debate helps a clinician recognise why ethical disagreements sometimes seem irresolvable: the disputants may be disagreeing not only about what is right but about the nature of rightness itself. Fill in the blank: Moral ________ is the metaethical view that moral claims vary across cultures without any universal standard, implying that practices causing serious harm cannot be objectively condemned across cultural boundaries. 1.1.3 Normative ethics versus descriptive ethics Normative ethics is the branch of ethics concerned with establishing standards or norms for how people ought to behave. It produces theories and principles that guide moral decision-making, such as the claim that we ought to maximise wellbeing, or that we ought to respect persons as ends in themselves. Descriptive ethics, by contrast, is an empirical study of how people actually do behave morally and what moral beliefs different individuals and cultures actually hold; it is a branch of social science rather than of philosophy. The distinction matters because the fact that people in a particular community believe something is right does not make it normatively right; the is does not automatically become an ought. Applied ethics is the application of normative ethical theory to specific domains of human practice such as medicine, business, law, and environmental policy. Bioethics is the most relevant applied ethics for medical students; it applies normative ethical reasoning to the specific
situations arising in healthcare, including the permissibility of different kinds of treatment, the rights and obligations of patients and clinicians, and the ethical governance of research. Understanding the distinction between normative and descriptive ethics protects the clinician from a common error: assuming that because a practice is widespread or culturally accepted it must therefore be ethically acceptable, when in fact its ethical status requires independent evaluation. Fill in the blank: ________ ethics is the empirical study of how people actually behave morally and what beliefs they hold; it describes moral behaviour without establishing whether those behaviours are right or wrong. Figure 1.1: The structure of moral philosophy Pilot questions 1.1 1. Define ethics and explain why a clinician who knows their professional code still needs to study moral philosophy.
2. Explain the difference between moral realism and moral relativism and describe the practical implication of each for medical practice. 3. Distinguish between normative and descriptive ethics and explain why the distinction matters in clinical practice. 4. What is applied ethics and what does bioethics add to general moral philosophy? 1.2 Major Ethical Theories 1.2.1 Consequentialism and utilitarianism Consequentialism is the family of ethical theories that hold that the moral rightness of an action is determined entirely by its consequences. An action is right if and only if it produces better consequences than any available alternative. The most influential consequentialist theory is utilitarianism, developed by Jeremy Bentham in the eighteenth century and refined by John Stuart Mill in the nineteenth. Classical utilitarianism holds that we ought always to act so as to produce the greatest happiness for the greatest number, where happiness is understood as pleasure and the absence of pain. Modern versions have refined this to speak of welfare, preference satisfaction, or wellbeing rather than pleasure, but the core structure remains:
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