Quilicot
Quilicot
1. In what ways may the principles of beneficence and non-maleficence come in conflict? In cases where these two come in conflict, how should doctors decide?

2. After careful considerations of the various ethical theories/views we discussed, what “personal moral system or code” can you come up with and which you can adopt? Be sure to talk about the values, precepts/ideas, and other elements that should comprise this “personal moral system or code”. Include your conception of freedom and accountability in this given moral system and your view of what it means to be a moral individual.

Beneficence is the principle wherein a physician does a certain procedure to benefit a patient — wherein doctors try to save a patient by all means possible, despite the procedure one is actually about to undergo. It takes a lot of risk as it involves experimentation of techniques in medicine not used conventionally in the medical field, and usually, these techniques carry with them the potential to inflict harm as well.

Non-maleficence on the other hand is a medical principle wherein a doctor is supposed to not do harm completely nor carry treatments which may be, in the long run, ineffective. Of course, upholding this principle give little advise to physicians as many beneficial therapies also come in the package of including many risks. This is where the issue of benefits versus risk take place. If harm outweighs a certain benefit, a procedure is completely not done at all.

The conflict between these two principles can be portrayed in a recent tragedy that chanced upon our family. My uncle, who was 35 and was enjoying the peak of his game, crashed into a wall during a freak accident involving his motorbike. His body crashed head on, not scratching the bike, but leaving him almost for dead.

He was rushed to the ICU and was fitted with a life support system – they inserted a feeding tube to his body and was in a coma for about a week or two. All the doctors deemed it as a hopeless case and was asking the family if they wanted to remove the tube or to further the operations despite the fact that it can ultimately cause his death.

Doctors presented all the possible scenarios of the different treatments that they could give him. After stating all the facts, our family was left to decide which treatment they would like my uncle to undergo (of course, with medical advice). If the procedure caused more harm, they would want to shift to another treatment. They wanted to use ALL MEANS, as long as my uncle survives. With the help of the immense insurance money my uncle conveniently invested on, money was not an option.

For the second question, how should doctors decide if the principles conflicted in a certain case, I think that what the American doctors did was the most ethical – PRESENT ALL POSSIBLE SCENARIOS, TREATMENTS AND PROCEDURES TO THE VICTIM’S FAMILY, THEN ASK THEM HOW THE OPERATION SHOULD BE DONE AND RESPECT THEIR DECISION. More often than not, the family knows the best for their relative and asking for their opinion should be done so. This is, of course, in lieu if the patient is unable to answer for himself (either if the patient is in a coma or is not in the right mind of thinking). The family members are the ones who will suffer the loss anyway, so let them decide how to handle the case.

Miraculously, despite his Cambodian “room mate” in the ICU who had almost the same brain damage die after 3 days, my uncle survived and made incredible progress. Despite broken bones, damaged skulls, and the almost complete paralysis of the left side of his body (right brain), my uncle walked again, got married and even traveled to the Philippines, a year after his life altering accident. Until now, he’s healing.

So far, doctors are dumbfounded by his ability to progress and recover so quickly. Thus, they continue to treat him, as he is a recipient of America’s most up-to-date medical experimentation to save his life. His skull is made of stomach fat, he is taking pills so as to get the hormones and neurotransmitters his body stopped producing and his eye nerves were also operated with the newest technology that has been barely used before. Right now, he sings (though very off key; not much difference), he eats lechon and he makes jokes and picks on my grandmother.

After going through Philosophy 171, I have been enlightened and thought that I’d adopt three ethical perspectives: existentialism with its position on freedom and accountability, Kantian ethics with its perspective on Kingdom of Ends and Universalizable maxims, and Utilitarianism in the perspective that what is good should be pleasurable.

First, with freedom and accountability. I very much agree with Sartre’s we are condemned to be free. In one of Michel Foucault’s theories on the origins of prisons, freedom is the only thing common in all people, despite economic class and whatnot. Hence, as a consequence of our freedom, we are all given the choices with corresponding consequences; with your priorities and sense of obligation taken into consideration, we all have the power to choose the general direction of our lives. And since we are the decision makers, we are burdened to be accountable of all our actions. Besides, what ever decision we make, we are directly (usually) affected by our decisions.

Given my perspective on freedom, how do we make the decisions then and how do we maneuver the direction of our lives according to our priorities and obligations? Well, I always believed that when a person makes a decision, all the factors of his personhood is present -- past decision are considered, as well as the values that has molded him to become the person he is, in his lifetime. Hence, one should act in according to his/her cultural beliefs of what is right and wrong. And as a bourgeoisie Filipino raised by a military father and a religious mother, I was always taught to think of the effect of my actions with how will it affect me and the people around me. Hence, this is where Kant comes into the picture and his world of Universalizable maxims are recognized -- that if everyone did the same, would the world end up in a better place? That is part of what I was taught -- to uphold my duty as a person of the world. Then, since we are free, we function with the dual role of legislators and citizens that whatever we decide on doing and decide on upholding, like moral beliefs, we are also expected to act it; this is another emphasis on duty and the freedom to choose whether to do our self imposed duties or not.

But I think that when we do good, we should also feel good about it and not do something insincerely. The concept of sacrifice to me is not the most appealing hence I’d like to do good because I want to and not because I have to. Hence, despite the fact that I fulfill my duties and do what is right, I want to be willing to do them and not because I HAVE to do them. Then again, if I am indeed forced to do something that I do not want, that is when my power of choice takes place. But generally, I want to be happy to do what I think is good and not JUST BECAUSE it is expected of me.

Hence, what is a moral person for me?

A moral person is a person with a defined set of values and sense of responsibility. She does what is good because this makes her happy and because she finds pleasure in fulfilling what is expected of her and what she expects from herself. She takes control of her life and does not blame anyone else when the decision she makes ruins her life, or of the sort.