This is also known as the consequentialist approach since the outcomes determine the morality of the intervention. This approach could lead to harm to some individuals while the net outcome is maximum benefit. This approach is usually guided by the calculated benefits or harms for an action or intervention based on evidence.
A few examples of utilitarian approach in medical care include setting a target by hospitals for resuscitation of premature newborns gestational age or treatment of burns patients degree of injury based on the availability of time and resources.
There are two variants of utilitarianism: Act utilitarianism and rule utilitarianism. Act utilitarianism deals with decisions undertaken for each individual case analyzing the benefits and harms promoting overall better consequences. This method would lead to enormous wastage of time and energy in decision-making and are prone to bias.
In rule utilitarianism, no prediction or calculation of benefits or harms is performed. These decisions are guided by preformed rules based on evidence and hence provide better guidance than act utilitarianism in decision-making. These ethical issues can be accommodated when dealing with patients who are competent to play a role in decision-making, while posing moral dilemmas in patients who are incompetent, e.
In the above scenario, dilemmas can be dealt ethically and legally if the patients had made advance decision directives about their life similar to decisions on wealth. In contrast to the utilitarian concept, deontology is ethics of duty where the morality of an action depends on the nature of the action, i.
This concept was introduced by a philosopher, Immanuel Kant and hence widely referred as Kantian deontology. The decisions of deontology may be appropriate for an individual but does not necessarily produce a good outcome for the society. The doctor-patient interaction or relationship is by nature, deontological since medical teaching practices inculcate this tradition, and when this deontological practice is breached, the context of medical negligence arises.
This tradition drives clinicians to do good to patients, strengthening the doctor-patient bond. The deontological ideologists doctors and other medical staffs are usually driven to utilitarian approach by public health professionals, hospital managers, and politicians utilitarian ideologists. From a utilitarian perspective, health care system resources, energy, money, and time are finite and are to be appropriately accommodated to achieve the best heath care for the society. What about consequences?
Kant is not a Utilitarian He believes that there are many actions which we ought not perform, even if they have good consequences. Some actions may, for instance, accidentally benefit a lot of people -- it doesn't make any sense to say that their actions were morally good. Lucky, perhaps. But we would not want to say that right actions are right in virtue of being lucky, right?
Moral worth only comes when you do something because you know that it is your duty and you would do it regardless of whether you liked it. Imagine two people out together drinking at a bar late one night, and each of them decides to drive home very drunk. They drive in different directions through the middle of nowhere. One of them encounters no one on the road, and so gets home without incident regardless of totally reckless driving.
The other drunk is not so lucky and encounters someone walking at night, and kills the pedestrian with the car. Kant would argue that based on these actions both drunks are equally bad, and the fact that one person got lucky does not make them any better than the other drunk. After all, they both made the same choices, and nothing within either one's control had anything to do with the difference in their actions. The same reasoning applies to people who act for the right reasons.
If both people act for the right reasons, then both are morally worthy, even if the actions of one of them happen to lead to bad consequences by bad luck. Imagine that he gives to a charity and he intends to save hundreds of starving children in a remote village. The food arrives in the village but a group of rebels finds out that they have food, and they come to steal the food and end up killing all the children in the village and the adults too.
The intended consequence of feeding starving children was good, and the actual consequences were bad. Kant is not saying that we should look at the intended consequences in order to make a moral evaluation.
Kant is claiming that regardless of intended or actual consequences, moral worth is properly assessed by looking at the motivation of the action, which may be selfish even if the intended consequences are good.
One might think Kant is claiming that if one of my intentions is to make myself happy, that my action is not worthy. This is a mistake. The consequence of making myself happy is a good consequence, even according to Kant. Kant clearly thinks that people being happy is a good thing. There is nothing wrong with doing something with an intended consequence of making yourself happy, that is not selfishness. You can get moral worth doing things that you enjoy, but the reason you are doing them cannot be that you enjoy them, the reason must be that they are required by duty.
Also, there is a tendency to think that Kant says it is always wrong to do something that just causes your own happiness, like buying an ice cream cone. This is not the case. Kant thinks that you ought to do things to make yourself happy as long as you make sure that they are not immoral i. Getting ice cream is not immoral, and so you can go ahead and do it.
Doing it will not make you a morally worthy person, but it won't make you a bad person either. Many actions which are permissible but not required by duty are neutral in this way.
It is fine if they enjoy doing it, but it must be the case that they would do it even if they did not enjoy it. The overall theme is that to be a good person you must be good for goodness sake. His argument for this is summarized by James Rachels as follows:. After all, it is not as though people would stop believing each other simply because it is known that people lie when doing so will save lives. For one thing, that situation rarely comes up—people could still be telling the truth almost all of the time.
Even the taking of human life could be justified under certain circumstances. Take self-defense, for example. Maxims and the universal laws that result from them can be specified in a way that reflects all of the relevant features of the situation. Consider the case of the Inquiring Murderer as described in the text. Suppose that you are in that situation and you lie to the murderer.
This maxim seems to pass the test of the categorical imperative. Procedure for determining whether a proposed action violates CI I am to do x in circumstances y in order to bring about z. I am to lie on a loan application when I am in severe financial difficulty and there is no other way to obtain funds, in order to ease the strain on my finances. Everyone always does x in circumstances y in order to bring about z.
Everyone always lies on a loan application when he is in severe financial difficulty and there is no other way to obtain funds, in order to ease the strain on his finances. Note: assume that after the adjustment to equilibrium the new law is common knowledge -- everyone knows that it is true, everyone knows that everyone knows, etc. One criticism that Kant faced among his contemporaries was for his stance on lying, since he said that we always have a duty to be truthful to others Metaphysics of Mora ls Suppose that your friend is being pursued by someone who intends to kill him.
Your friend comes to your house and asks to hide. Suppose your friend hears the killer knocking at the door and decides to flee out the back without your knowing. You lie and tell the killer that your friend is not here, and the killer leaves. Because of this, your friend and the killer bump into each other, and your friend is killed. His general point is that consequences are uncertain. The type of rational approach to ethics that Kant prefers will downplay the importance of consequences due to this unpredictability.
This seems to lead to the implausible conclusion that collecting stamps or collecting anything is immoral. Some who want to defend Kant think that the problem is with how this maxim is phrased.
The maxim specifies two actions: buying and not selling. And when we formulate it some ways like in this case with the stamp collecting it leads to a contradiction, whereas formulating it other ways does not.
For Kant, just doing the right thing is not sufficient for making an action have full moral worth. He believes that a good will is essential for morality.
This is intuitively plausible because it seems that if an otherwise good action is done with bad or selfish intentions, that can rob the action of its moral goodness. If we imagine a man who goes to work at a soup kitchen to help out the poor, that seems like a good action.
Less intuitive is that Kant thinks the only possible genuine good will is respect for the moral law. That is, when you do something because it is the right thing to do, that alone counts as good will. Schopenhauer thought that good people are good because they want to do good actions and they feel love and compassion towards others. If we return to the example of working in the soup kitchen, if the person is showing up to the soup kitchen because he likes helping people or he feels compassion for the people he helps and wants to improve their lot, Schopenhauer would say this is a good person and thus a virtuous action.
Kant defended his position on good will by saying that an action done out of love or out of compassion is not fully autonomous. Autonomy means self-rule, and Kant saw it as a necessary condition for freedom and morality. If an action is not done autonomously, it is not really morally good or bad. Again, if our friend at the soup kitchen is working there because of some implant in his brain by which another person is able to control his every action, then the action is neither autonomous nor morally commendable.
Concerning acting out of love and compassion, Kant believed that when people act due to their emotions, then their emotions are in control, not their rationality. To be truly autonomous, for Kant, an action must be done because of reason. An action done because of emotion is not fully free and not quite fully moral.
The important point is that reason you do an action should be because you have determined that it is the right thing to do. The idea underlying the second formulation is that all humans are intrinsically valuable. What has a price is a thing, but a person has dignity and is thus beyond price and irreplaceable. To treat someone merely as a means is to not give the person the proper respect—to fail to treat the person with dignity, to treat the person as a thing.
But if you use a person in such a way, it devalues the person. Similarly, if you harm someone, take advantage of someone, or steal from someone, then you treat that person as a thing, as a means to your ends.
Conversely, if you treat someone as having unlimited value, if you treat the person with dignity and respect, then you treat the person as an end. For example, imagine that your pipes need fixing, and you call a plumber. By paying him the agreed-upon amount, you are making his end earning a living your end.
One way to think of the idea of treating someone as ends and means is that, when you treat people as ends, you make their ends your ends, and when you treat people as means, you force them to make their ends your ends. In our example, you made the false promise because you needed to borrow money to pay off debts; thus, your end was to pay off debts, and by lying to your friend, you are forcing him to make your end paying off debts his end.
If you told your friend that you needed money and might not be able to pay it back, your friend would be able to decide. He might decide to make your end his end to pay off your debts for you , but by depriving him of that choice, you are treating him as an object.
For similar reasons, we can also conclude that any time we deceive someone, we are treating the person as a mere means to our ends. We can also look at the other example from the first formulation discussed above and see that it leads to the same conclusion.
0コメント