Moral Principles in the Medical Practice

Introduction 

Bioethics refers to the ethical issues that are brought about by the significant advances in medicine and biology. In this case, it is evident that technological development has played a major role in the advances made in the field of medicine and biology. As a result, typical controversial issues may arise to the new possibilities that be undertaken in medical practice. This also calls into question the issue of moral discernment as it is incorporated in the policies governing medical practice and how they are implemented. The following paper looks into the various moral principles and the ways they can be applied into medical practice. 

Kantian Deontology 

Kantian deontology is an ethical position that identifies that acting in a morally right way will require the individual to act from duty. Additionally, Immanuel Kant argued that the consequences of actions do not make them wrong or right but the motive of the individual undertaking the action (Chapman, 2015). In this way, medical practitioners have a duty to attend to the medical and health care needs of a population regardless of the patient’s character or position in the society. The medical practitioners are seen to be acting by duty when providing care and treatment options to the members of the society. Furthermore, morally right actions will require the individual to act purely from duty by achieving the highest good that is good in itself and good without qualification. When an action is good in itself it is seen to be intrinsically good while one that is good without qualification means that its addition does not make a situation ethically worse (Chapman, 2015). Hereby, a medical practitioner who derives pleasure from watching criminals suffer from health conditions without providing his or her skills only makes the action ethically worse. 

Deontology is hence identified as a moral principle as individuals are provided with the various ways of acting in their various capabilities or vocations. This is evident in medicine where the nurses and physicians are required to alleviate pain and suffering from an individual by following the acceptable medical practices. The Kantian theory argues that there is only one thing that is truly good and that is good will. The individuals demonstrate their good will by acting in respect of the moral law (Chapman, 2015). The individual is seen to be respectful of the moral law when he or she thwarts self-love in treating humanity. In this case, the medical practitioner will provide the appropriate care for a patient despite the fact that the individual may have been involved in negative actions such as murder or rape. 

Utilitarianism 

Utilitarianism is identified as a normative ethical position that holds the belief that the best moral action is one that seeks to maximize utility. In this regard, utility though it may be defined in various ways will often refer to the well-being of sentient entities. According to the founding father of utilitarianism, Jeremy Bentham, it is the aggregate pleasure that is derived after deducting the suffering of all participants involved in an action. Further, John Stuart Mill indicated that utility should not only focus on the quantity but also the quality of pleasure derived in key focuses of the rules involved not the individual moral action (Playford, Roberts & Playford, 2015). The consequences derived from any action are used to determine whether it is right or wrong. For instance, though a patient may undergo numerous surgeries that are in some cases dangerous and could lead to death, the result of a good health will identify the actions of the participants as morally right. 

This normative ethical position is identified as a moral principle as it seeks to identify the resulting outcomes of the patients and how they feel about these outcomes. In this case, utilitarianism recognizes happiness as the only form of good. In Bentham’s research he was able to introduce a method of calculating the value of pleasure or pain that is derived from an action (Playford, Roberts & Playford, 2015). He believed that these are measurable in terms of intensity, certainty/uncertainty, duration and propinquity or remoteness. Therefore, through this moral principle every action is considered in its ability to resulting in sensations of the same kind or the possibility it has of not being followed by opposite kind of sensations. This way, the actions of medical practitioners are required to maximize the good which is pleasure and for the greatest number of people. 

Pullman Principle of Respect for Human Dignity 

In Pullman’s principle of respect for human dignity, he identifies this as a concept invoked during discussions of end-of-life decision making. This is where individuals particularly patients have the right to make a decision on the ways their deaths will take place. He disagrees with the belief that human dignity is a concept that is redundant and all of mankind would be better off without it. Instead, he believes it is a concept that is indispensable in moral discourse. This is evident where unmitigated pain and suffering will usually be associated with robbing human beings of their dignity (Pullman, 2002). As a result, medical practitioners and other care providers have a duty to relieve their patients from significant pain and suffering when encountered in their vocational practices. Death at times when pain and suffering cannot be controlled is identified as a preferred option that would ensure the individual does not lead a life without dignity. 

The author identified two conceptions of the principle of human dignity. In the first view, it is the inherent dignity that is accorded to every human being irrespective of rank, station of other qualities of the person. This is identified as basic dignity as an individual does nothing to earn it and it cannot be taken away from him or her (Pullman, 2002). On the other hand, there is the dignity that is more individualistic, transient and particular in nature. This has been the main conception incorporated into the “death with dignity” debate known as personal dignity. Therefore, through an understanding of the relation of personal dignity to pain and suffering will help in sorting the implications in regarding quality of death. An individual with a severed spinal cord, for example, may not experience physical pain but suffers as a result of losing body function and dependence on other human beings (Pullman, 2002). This is seen that suffering is a consequence of personhood and hence compromises human dignity. 

There are No Universal Ethical Principles 

In the quest to identify ethical principles that should be incorporated into the bioethics discourse, Decker believes that it is nearly impossible to ensure universal adherence. In this regard, points out three reasons why ethical principles in medical practice and research cannot be incorporated into the entire world. The first is that these moral principles are tools and not standards for practice. It is therefore, important to understand the historical contingence in each of them (Decker, 2014). The second is finding universal principles that can be incorporated into divergent practices are arbitrary as these principles continue to be contested each day by the various medical professionals. The final thought is that the normative forces of moral principle that may seem universal usually have come about from a wide array of sources. Most common is the pre-existing relationships observed between moral agents and their various patients. This makes it difficult for individuals to calibrate moral principles in medicine for the entire world. 

This does not mean that everything is permissible. Rather on the contrary as the author identifies the principal aim of ethics is to formulate justifiable principles that will enable medical practitioners to implement where there are conflicting interests to determine which one should be given preference. In this case, the justifiable principles of ethics are usually closely associated with the particular society in regards to their beliefs of death, attachment and other cultural beliefs (Decker, 2014). This is evident where numerous countries where liberal democracy is practices will usually advocate for induced death of a patient who is seen to experience pain and suffering as continued living compromises their dignity as human beings. On the other hand, other cultures will not condone the practice as they believe that it is only divine beings that have the power to give and take life and not through the action of mankind. 

References 

Chapman, A. (2015). The Foundations of a Human Right to Health: Human Rights and Bioethics in Dialogue.  Health & Human Rights: An International Journal ,  17 (1). 

Decker, K. S. (2014) There Are No Universal Ethical Principles That Should Govern the Conduct of Medicine and Research Worldwide. In A. L. Caplan and R. Arp (Eds.), Contemporary Debates in Bioethics: Contemporary Debates in Philosophy . (1 st Ed., pp 27-35). New York: John Wiley & Sons, Inc. 

Playford, R. C., Roberts, T., & Playford, E. D. (2015). Deontological and utilitarian ethics: a brief introduction in the context of disorders of consciousness.  Disability and rehabilitation ,  37 (21), 2006-2011. 

Pullman, D. (2002) “Human Dignity and the Ethics and Aesthetics of Pain and Suffering.” Theoretical Medicine and Bioethics , 23, 1: 75-94.