Term Paper on Bioethics

This essay has a total of 1912 words and 7 pages.

Bioethics

The case of Dr. Lowell and Mrs. Jackson revolves around a conflict between the doctor, who
advocates the implementation of a particular treatment and the patient who disagrees with
the doctor and wishes to do things her own way. The doctor feels that the suggested course
of action is disastrous and threatens to have the patient declared mentally incompetent.
The question now is whether or not the doctor is morally justified in taking action
against the patient in order to implement the course of treatment she feels would be most
effective. Is this an infringement on the autonomy of the patient or is the doctor morally
obliged to do everything that he/she can possible do in order to restore the patient's
health even if that includes to go so far as to take this decision out of the hands of the
patient?

I would like use Rule utilitarianism and Kantian deontology to help determine what course
of action could be morally justifiable in this case. Rule utilitarianism says "A person
ought to act in accordance with the rule that, if generally followed, would produce the
greatest balance of good over evil, everyone considered." (Mappes & Degrazia, 13) So
according to rule utilitarianism, when one faces a moral dilemma one should map out the
consequences of one's action and then act in so as to produce the greatest net amount of
utility or happiness. So if I was faced with a moral dilemma concerning whether or not I
should cheat on an exam, I should follow the rule that creates maximum happiness, which in
this case would be that I should not cheat because if every one in the world cheated on
every exam then there wouldn't be a need to take or give exams. There would no longer be a
dependable system to gauge a student's knowledge on a subject. Kantian deontology however
follows a different path. According to this moral theory, consequences are of no matter
and duty is what is important. (Lecture, 01/27) Just as in rule utilitarianism, Kant says
that an act can be considered morally right when it is in observance with a rule. This
rule, however, must satisfy the conditions of what he calls the categorical imperative.
There are three formulations of the categorical imperative (Lecture 01/27) that each maxim
or rule must adhere to. Firstly, "Act only according to that maxim by which you can at the
same time will that it should become a universal law." The second formulation says that
"Act so that you treat humanity, whether in your own person or in that of another, always
as an end and never only as a means." The third formulation says that "Treat others as
autonomous agents, capable of self directed action." So an act would require fulfilling
all these three formulations for it to be morally justified. In a case where there is
debate about the morality of whether or not one should lie, the theory outlines the maxim
that one should never lie. This maxim fulfils all three requirements of the categorical
imperative; one can consistently will this maxim as a universal law, it does not treat
others or oneself only as a means and it does not violate anyone's autonomy, including
oneself.

Applying rule utilitarianism to the case of Dr. Lowell and Mrs. Jackson: the theory says
that the rule that would afford the maximum utility would be one that said that a patient
must follow that course of treatment that the doctor deems most effective. Any other rule
that allowed the opposite to happen, one that said the patient always has the final word
regarding what the treatment should be applied, would result in overall disutility as
patients might chose not to take courses of treatment that might be painful but
beneficial. Such behaviour might result in either prolonging of the disease or further
complications, all consequences that would result in overall increased disutility. The
emphasis in diagnosis would shift to a system wherein a doctor's knowledgeable opinion
comes secondary to a patient's wishes about what course of treatment to follow. After all
it is not likely that a doctor would intentionally try and do a patient harm. A rule that
undermines a doctor's authority would only result in net disutility as it would produce a
devaluation of doctors and courses of treatment based on scientific knowledge and
understanding. Therefore rule utilitarianism would say that the doctor is morally correct
in trying to undermine her patient's wishes. However, another consequence of applying this
rule would be that it would disregard a patient's wishes especially in those cases where
individuals have wishes grounded in religious or personal beliefs. Such disregard for a
patient's autonomy might also produce disutility. Generally speaking, most patients tend
to follow the suggestions offered by their physicians. The disutility suffered by the few
odd patients who experience an infringement upon their autonomy by a disregard for their
personal wishes surely would be far less than the general good that is produced by people
heeding the words of advice given by their doctors. After all, not listening to a doctor's
advice could lead to, in this case, death that produces a great of unhappiness for all the
family and friends involved versus having to endure a course of treatment that one
dislikes producing unhappiness only to oneself.

Continues for 4 more pages >>




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