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?
The principle of beneficence is defined as the duty to or produce good. Whereas, the principle of non-maleficence means “first, do no harm” or not to cause any harm to another. The two comes in conflict by way of weighing risks over benefits. In the medical field, doctors are often faced with this dilemma: producing good for the patient without inflicting harm. But apparently, most of the medical procedures need to cause a little and of course reasonable harm in order for an act of a greater good to be done. Conflicts arise in situations where it will be a rational decision to cause harm to the patient to achieve a long term good or benefit.
For instance, a person with diabetes has been diagnosed with multiple complications. The choice is either to amputate his right leg or not to do it because the patient refuses to undergo such operation. Obviously, weighing the risk over the benefit, one will choose to let the medical practitioner to proceed with the operation. But at the same time, the harm that will be inflicted is more than just physical pain. The person might suffer from desperation and might even feel that he is worthless or a burden to his family.
Another example would be, a person diagnosed with a contagious disease, such as SARS (Severe Acute Respiratory Syndrome). In this kind of disease, it would be in the best interest of a doctor to prevent its spread to the public. The doctor is faced with the predicament of putting the person in quarantine which would mean the person’s right to confidentiality and of free movement. Looking at the circumstances, more good would be produced if the said disease would be contained even if it would mean restricting the person’s right.
In situations like these, the doctors are expected to weigh conditions in a “risk vs. benefit analysis.” But the person’s right to autonomy supersedes the duty of doctors to decide on matters like this. Provided that the patient is in his rational mind and is able to determine his destiny competently. This also implies that he is able to make decisions with knowledge of the repercussions that will arise from his refusal to undergo a medical procedure, treatment and medications.
Promoting the welfare of patients is the rationale behind providing medical attention. Doctors, possessing the necessary skills and knowledge, are in the best position to decide given that they aim to provide more good than harm. Balancing what acts would be most beneficial should be observed by them. It is also because they are most fit to evaluate the condition because they are the agents of medicine.
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.
I am more of a conformist most of the time. But my concept of morality is not one with what the society ascribes. Being moral for me is doing what I think is the right thing to do regardless of what the others may say. This does not mean that I am absolutely free to do everything I want to do. I am still constrained by the society which I am a member of. But I am fully responsible for all the actions and choices that I make. I consider societal norms only as guide to proper behavior and not as an imposition to abide by.
Yes, I am a little utilitarian at times. I can sacrifice my own wants if doing so will make others happy. By this, I do not mean downgrading reason. I see to it that everything I do is based on rational decisions.
I so believe in Macintyre that people are in continued search for the good life of man. Performing the good coincides with this search because people tend to do what will lead to the long term good of himself and of everyone. Yet there are times when the personal perception of what is good conflicts with those of others, this way the “risk vs. benefit” analysis comes into play.
I also consider myself autonomous in rendering decisions about my medical condition provided that I am able bodied to do so. If otherwise, I am willingly submitting myself to my family and my best friend as attested in my last wishes.
Accountability is a dense principle. Most of the time people act irrationally and does not consider themselves responsible to its consequences. There are also times where in I act irrationally, especially at times when I act based on my emotions. But I think that is human nature, besides nobody learns life’s lessons without committing mistakes and being too emotional at times. I know I am responsible for everything because I always have a choice. I can not escape deciding for myself even in circumstances which I think I am only obliged to act.
As long as I do not harm others with my actions, I know I am moral. Yet there are times when I commit unintentional harm to others and I consider it my fault. I could have evaluated everything with reason.
I want to be as rational as possible, but there are moments when doing otherwise would also teach me something. I welcome mistakes and see it in a positive light. I am guided by my personal moral code, but I do not disregard the possibility of modifying some when I see it fit.
Sun Mar 29, 2009 11:32 pm