BIOETHICS

• Kant's Ethics is sometimes referred to as "deontologism" due to its emphasis on duty or obligation
• Morality, according to Kant, is exclusively within the human personality and is determined by intent, motive, and will
• Acting morally means doing whatever one is obliged to do, not just acting based on personal desires
• Duty is what an individual is obliged to do despite any inclination to do otherwise
• There are two main types of duty: perfect duty, which must always be observed, and imperfect duty, which is observed only on some occasions
• The essence of morality lies in the nature from which an act is done, and the motive behind the act determines its moral goodness
• To determine one's duty in a given situation, actions should be judged based on how they would appear as a universal law through the Categorical Imperative
• The Categorical Imperative mandates actions without conditions or regard to consequences, while the Hypothetical Imperative includes conditions or limitations
• Two formulations of the Categorical Imperative:

  • Act only on the maxim that can be willed to become a universal law
  • Always act to treat humanity, whether yourself or others, as an end and never only as a means
• In Ross's Ethics, rightness belongs to acts independent of motives, while moral goodness belongs to motives
• Actual Duty is one's real duty in a given situation, while Prima Facie Duty directs what one ought to perform when other relevant factors are not considered
• Two principles to resolve cases of conflicting duties:

  • Act in accordance with the stronger, more stringent, or more severe prima facie duty
  • Act in accordance with the prima facie duty with a greater balance of rightness or wrongness compared to others
• There are 7 types of Prima Facie Duties, including Duty of Fidelity, Duty of Reparation, Duty of Gratitude, Duty of Justice, Duty of Beneficence, Duty of Self-Improvement, and Duty of Nonmaleficence
• In medical contexts, discernment and sensitivity are crucial in making moral decisions, and the focus should be on what is right rather than what is useful
• Rawls's Theory of Justice combines utilitarianism and deontological views, emphasizing the ultimate dignity of human beings and social justice
• Rawls's concept of justice includes the original position, where individuals under the veil of ignorance make fair choices and decisions based on justice as fairness
• Every individual is inviolable in Rawls's Theory of Justice, and the greater good should not justify the loss of freedom for others
• When faced with two erroneous laws, one should choose the one that is less harmful
• An act of injustice can be tolerated if it is necessary to avoid an even greater injustice
• An erroneous theory is tolerable in the absence of a good one
• In a case of tolerable erroneous theory, it must be carried out for the sake of those supposedly benefited or affected by it
• When given 2 erroneous laws, one should choose the better and the less erroneous one
• A wrong or unjust law is better than no law at all
• Individual liberties should be restricted to maintain equality of opportunity
• Restrictions of individual liberties serve as safeguards against abuses and misuses of one’s freedom against others
• Two-fold Principle of Justice:

  • Equal access to basic human rights and liberties
  • Guarantees a system of equal rights and liberties for every citizen; prohibits the bartering away of liberty for social and monetary considerations
  • Example: No citizen may sell his/her right to vote
• Fair equality of opportunity and the equal distribution of socio-economic inequalities
• Deals more with the distribution of social goods and medical resources than with liberty
• A just society is not one in which everyone is equal but is one in which inequalities must be demonstrated to be legitimate
• To promote justice in human relations, there are 4 types of duties:

  1. Fairness in dealing with others

  2. Fidelity

  3. Respect for persons

  4. Beneficence
• Natural Duties:

  1. The duty of justice

  2. The duty of helping others in need or in jeopardy

  3. The duty not to harm or injure others

  4. The duty to keep promises
• The need to rank duties to prioritize them according to higher and lower categories to resolve possible conflicts
• Rawls recommends the legitimacy of paternalism in the medical context
• Exploitation deliberately intended to benefit one person or a group of persons is not morally legitimate
• Rawls justified the allocation of social resources for the training of medical personnel by the benefits it will give to society
• Sanctions the voluntary consent of an individual to become a research subject by virtue of his basic right to decide on what risks he is willing to take with his own life
• Introduced the concept of an order of priority with regard to equal access to health care (equal opportunity and equal distribution of socio-medical resources)
• Rawls does not permit people in the original position to know their goals, plans, interests, and purposes but only their self-respect, wealth, and rationality
• In contrast with his objection against utilitarianism, Rawls’s concept of justice refers to the utility principle of the greatest number
• The source of the moral law in Natural Law Ethics is reason itself, directing us towards the good as the goal of our action