Medical ethics are ‘the values and guidelines governing decisions in medical practise’ as noted by The Free Dictionary (2012). By discussing the controversial topic of Euthanasia I will compare contrasting ethical principles and theories and the legal issues surrounding this topic. The ethical principles outlined will be; autonomy, non-maleficence, benevolence and utility.
Furthermore the ethical theories supporting these principles that will also be outlined are; utilitarianism, deontology (both Ross and Kant’s version), Rawls’s theory of justice, natural law ethics, virtue ethics and care ethics (Schwartz, Preece and Hendry, 2002). Utilitarianism An ethical theory which falls into the bracket of Autonomy, meaning; ‘the quality or state of being independent, free and self-directing’ Merriam-Webster. om (1831) is Utilitarianism which claims that people should act to increase human well-being (BBC 1997) the principle of Autonomy relates to this ethical theory because allowing a patient to be autonomous can sometimes be the answer to maximising human well-being as; a patient being independent to make their own decisions in regard to treatment or refusal of treatment takes into account that every individual patient knows themselves better than anyone and therefore should be able to make the best decision to maximise their well-being.
However this theory could also relate to the fact that medical professionals are the most qualified to make any medical decisions concerning a patient in order to maximise their welfare and this is further highlighted by the ethical principle of Benevolence, which is the ‘disposition to do good’ Merriam-Webster. com (1831). An example of a case where the ethical theory of Utilitarianism could encounter opposition from legal factors that are involved is with Euthanasia which is; ‘the act or practise of killing someone who is very sick or injured in order to prevent any more suffering’ Merriam-Webster (1831).
Euthanasia, which is sometimes called a mercy killing, is currently illegal in the United Kingdom due to concerns that people may take advantage of this for example; killing elderly parents to earn an inheritance, to relieve a person from the responsibility of becoming a carer for a dependant sick relative, there are also concerns that euthanasia being legalized could award doctors too much power (Schwartz, Preece and Hendry, 2002).
However the theory of Utilitarianism could be used to justify euthanasia if the patient’s quality of life was extremely poor then the best way to maximise human welfare may be to end the patients suffering in the form of a merciful and fast death, patients that may be more inclined towards choosing euthanasia are those with debilitating diseases such as; Multiple Sclerosis, which is an autoimmune disease that causes nerve damage and affects the central nervous system negatively (Schwartz, Preece and Hendry, 2002), (White and Cocchi, 2012). Deontology
Deontology, also known as duty-based ethics is ‘an approach to ethics that focuses on the rightness or wrongness of actions themselves, as opposed to the rightness or wrongness of the consequences of those actions’ (Mastin 2008). This theory provides every person with a set of moral rules and duties that should be upheld and Holland (2007) also emphasises that some actions should always be implemented and other actions should always be avoided in deontology claiming that ‘moral value can be independent of consequences’ therefore this theory carries an aspect of certainty.
Mastin (2008) mentions that there are two slightly contrasting branches of Deontology; Kant’s version and Ross’s version, Kant’s version states that certain actions are always wrong despite how good the consequences of those actions may be whereas Ross’s version allows for modification of some rules to provide a better balance of duties (BBC 1997).
The ethical principle of autonomy is limited in Deontology as every person is following the same set of moral rules. However the principle of Benevolence is followed continually within this theory as a person’s intentions have to be good in order to satisfy the moral outlook of Deontology therefore there is a ‘disposition to do good’ Merriam-Webster (1831).
In relation to Euthanasia, deontology does not support this act as it involves the killing of an innocent person and this is morally wrong despite the possible positive consequences such as; relieving the pain and suffering of a severely ill or dying person. Both Kantian Deontology and Rossian Deontology are against the act of Euthanasia as in Kantian Deontology there are many perfect duties which a person must follow including ‘the duty to keep promises’ (Puthota 2011) and as all octors must take the Hippocratic Oath and promise ‘…to use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them’ (Dr Sokol 2008) they must uphold this promise, within Rossian Deontology prima facies duty dictates that a person must perform the actions relative to the greater good therefore treating a patient in a beneficial way in order to increase their quality of life not to end their life (Puthota 2011).
Rawl’s Theory of Justice Rawl’s theory explores the idea of justice being equal to fairness and promotes equality in every form of human life, for example; equal opportunities being available to all people from all walks of life as reported by Garrett (2005). Virtue Ethics and Care Ethics Mastin (2008) observes that the theory of virtue ethics considers an individual’s nature as the fundamental component of ethical thinking and takes into account a person’s moral character, instead of considering consequences or rules.