The morality of a decision depends on the consequences. If the consequence is good then the decision was right but if they are bad then the decision was wrong. Within this category is Utilitarianism, which says that the best consequence is that people are happy, and so the best decision is one in which the most people are happy.
Although this seems like a reasonable guide, the reality is more complex. How do we know what the consequences will be? It’s impossible to predict every eventuality. And what about when the best consequence which will benefit the most people, depends on you doing something immoral? If you killed a man and then used his organs to save the lives of several others, then consequentially you did the right thing.
Consequentialism serves the masses and not the individual and so leads to situations like the Postcode Lottery wherein decisions are made and the budget set so that the majority of people benefit, but in doing so individuals may slip through the cracks.
Argues that certain things are always right or wrong, regardless of the consequences.
Deontology in many ways counters the inhibitions we may have towards consequentialism. So it would never be acceptable to murder an innocent person, even if doing so would be to the benefit of many others, or you should always tell the truth because lying is wrong. However, there is no room for flexibility in deontological ethics and so to stick rigidly to its principles could cause more harm than good in certain situations.
These are based on the teachings and writings of Aristotle and Socrates whereby it is the character of a person and the motivations behind their actions, which are most important. It suggests that a person should aim to be a good person and have good habits and therefore will automatically act in a way that is moral and good. Beauchamp and Childress suggest the five key “virtues” are: compassion, discernment, trustworthiness, integrity and conscientiousness, all habits that doctors and medical students should have.
The problem with virtue ethics is that although it takes into consideration the difficulty we may have deciding what is right, in doing so it also doesn’t provide any solid guidelines and so again, the onus is again on you to try to work out “what feels the most moral”.
This was put forth by Tom Beauchamp and James Childress, and is a highly respected system by which to make medical ethics decisions. The balancing of four key principles is set out as a universal framework by which to assess a situation and come to the most moral decision. Although all four are to be considered and given value, most would agree that the first, autonomy, is the most important.
- Autonomy – A person’s right to make their own decisions and have that decision respected, so long as they understand the consequences of their choice and are competent enough to make the decision.
- Beneficence – This is the duty of doctors to do good for their patients and act in the best interests oftheir patients.
- Non-Maleficence – More commonly stated as above all, do no harm and refers to the obligation doctorshave to not inflict harm on others.
- Justice – The obligation to treat everyone equally and try to ensure as fair a decision as possible.