The 2nd approach to medical ethics
is going to be ethical principles.
Let's first go back to a little bit of core ethics or
philosophy, think about 2 approaches to principalism.
First is something called deontology,
which is duty-based ethics.
And this is the idea that the moral agent, you know,
the person performing actions has rationality
and they use their reasoning ability to figure out
what to do, you know, how they're going to perform.
And that is based on
What are your obligations in a particular
case and are you fulfilling your obligations?
So, the idea here is that the right
action is based on following rules.
That's what deontology is.
The other main approach to principalism
is something called utilitarianism.
You may have heard of that before. Or
otherwise called consequentialism.
So what are the
consequences of the action?
And in this philosophy, this philosophic
approach, the idea is you want to produce
maximal balance of the good
consequences over the bad consequences.
So each action is going to
have a mix of good and bad,
but at the end of the day you want to make
sure that you do more good than harm.
And in this case, the right action
is based on maximizing net utility.
Utility is just another term for benefit. So
we want to benefit our patient to, you know.
Take a patient to surgery, there's
going to be some harm involved
and you're going to cause some pain from an incision
and so on and they have to recuperate from that.
But is there a net benefit? Are they going to
get better and get healed of their illness?
So, let's apply these ideas of
principalism to biomedical ethics.
Anyway, we usually think about
that as 4 main principles.
The first is respect for
autonomy or respect for persons.
And we're going to get in to the ideas of both the
idea of respect but also the idea of autonomy.
So, we'll focus on that. Next is
non-maleficence, doing no harm.
So maleficence just means harm,
and not harming the person.
Beneficence, doing good,
actually achieving benefit.
So again, that's the thing about
the consequences of our actions.
So on the one hand we're not
harming them with non-maleficence.
On the other, we're benefiting them with beneficence.
And then lastly, justice.
So thinking about healthcare
resources for instance
and there are going to be various ways of
thinking about justice, but it's about fairness.
It's how do we distribute
resources in a fair and just way.