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Medical Ethics
----------------------------------------------------------------Morality and Ethics
There
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are a variety of guides for conduct including:
Law
Statutes
Administrative regulations
Common law
Constitutional law
However, LAW does NOT equal Morality
Legal Standards are NOT the same as Moral Standards
For example:
Deciding whom to treat
Deciding how much to charge
Using drugs to increase submission
Denying drugs to those in pain
These questions involve moral issue but the law does not specify a particular course of
conduct.
LAW codifies customs, ideals, beliefs and moral values in society. LAW does not establish
moral criteria or standards.
OATHS and CODES
1. Pre- technological age, emphasis on cures- out of date
2. Generality- need interpretation
3. Do not anticipate changes in practice and organizational patterns and leave the
problem of how to resolve conflicts unanswered.
4. Do not acknowledge the underlying values
CODES
1. Conflict with one another and internally
2. Individual’s personal; moral beliefs may clash with professional codes
3. Do not cover all situations and dilemmas
4. Do not contain moral principles at all
There is the need for moral principles grounded in ethical theory.
PURPOSE of OATHS and CODES
1. Bind social groups together
2. Express aims and aspirations of the group
3. Promote integrity, dedication and principled behavior
CODES cannot take the place of Ethical Theory and Principle.
Impact of technology is to cause people to question Values and this is involved with
the Ethical Problems.
Professional Codes of Conduct and Common Sense are INSUFFICIENT.
Problem of Application of the Codes, variety of codes, vagueness of codes
Problem of Consistency, conflicting guidance in and between codes
Problem of Questionable Morality, on abortion, euthanasia, lies
Codes are more to do with etiquette, social and economic niceties and maintaining a
monopoly than with morality
Codes are not normative, ANACHRONISTIC and thus objectionable
NEED ETHICAL THEORY
AIM: To raise quality of HUMAN Life
ETHICAL RELATIVISM
1. does not allow for the resolution of conflicts
2. mistaken or confused sense of tolerance
3. can not explain social and moral reformers
4. makes all moral reflection irrelevant
5. goes against basic moral sensibilities, against our ordinary experiences
6. fact of cultural differences does not automatically imply there are no correct
principles
To equate or base Ethics on FEELINGS is unacceptable
1. Can’t resolve conflicts
2. Makes moral disagreements pointless
Therefore, ETHICAL THEORY and PRINCIPLES are NEEDED
Why aren’t people moral?
Why aren’t people more moral than they are?
Why don’t people act morally?
1. They lack knowledge-they do not know any better-IGNORANCE
2. They have erroneous beliefs- ERROR
Moral
Immoral
Ethical-act in accord with principle
Unethical-act against principle
Amoral
Non-moral
Non Ethical-act not related to principles
Many people believe that their problems must be solved with little or no suffering or
sacrifice or blame or guilt. Many want no responsibility for their actions. Many people
have not developed a moral maturity.
Moral DEVELOPMENT
Theories of John Dewey and Lawrence Kohlberg
Philosophical Theories Based Upon Principles and Utilizing Reason
Teleological Theories
Deontological Theories
Consequential
Non-Consequential
Egoism
Kantian- Categorical Imperative
Act Utilitarianism
Rawl's Theory of Justice
Rule Utilitarianism
Divine Command Theory
Situation Ethics
Natural Law Theory
A
theistic
B. non- theistic
Post Modernism-Relativism
Existentialism
Pragmatism
Feminism
There exist a number of ethical theories. This is indicative of the complexity of human
life itself. The most satisfactory theory is no more than a rough guide for action.
Competition between the theories can lead to improvement as with scientific theories.
It is better to have a theory and principles to guide one’s life than none at all.
ETHICAL THEORIES FUNCTION:
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Identify relevant factors in a situation
Provide a basis for deliberation
Provide guides for action
Actions will be based upon principles and are thus more defensible
Provide a perspective other than self-interest, conformity or social relativity,
encourage empathy and sympathy
6. Promote a consideration of consequences
7. Develop a sense of responsibility
8. Promote the virtue of moral courage
GOAL: An ethical theory that is rationally persuasive and defensible
The CHOICE of a theory is based upon individual judgment but need not be arbitrary.
Each person considers the advantages and disadvantages and the strengths and
weaknesses and chooses consistent with that person’s values.
The choice is:
Non-arbitrary
Slow
Methodical
Agonizing
Promoting courage
Each person is challenged to provide and apply a defensible standard for conduct in
specific instances requiring action.