Med.Sci.Educ. Seeker B. View Kantian vs Utilitarian Analysis - Case Study.pdf from ETHICS 209 at Harvard University. << /Length 5 0 R /Filter /FlateDecode >> %���� Komrad MS. A defence of medical paternalism: maximizing patients’ autonomy. stream

These duties, for Kant, originate apart from superstition, religion, tradition, and notably from empiricism as well, instead being derived from rational thought. Gregor M, et al. Kant identifies rational thought as the unique characteristic of humans that separates man from beast, and this characteristic thereby accords an inherent dignity and worth to each human. For Kant, on the other hand, the physician-patient relationship would be more akin to a physician as guide, the patient’s Virgil in scaling the maze of the medical system and medical decision making, with the physician explaining different medical options and based on his or her understanding of the patient’s values and perspective, would help the patient arrive at the most reasonable choice for that patient. %���� Of course this is not true: moral conflict is inevitable and the framing of the specification process may be very different between two different people so as to confirm the moral intuition of the individual. Beauchamp TL, Childress J. A more profitable place to look to capture the essence of the difference between the three theories is rather in the question, what do they take the central ethical activity to be. endobj The implications for contemporary medical practice of this interpretation are significant. J Med Philos. Dawson A, Garrard E. In defence of moral imperialism: four equal and universal prima facie principles.

Metrics details. Benefits of Kantian ethics: The Challenge from Prudence: Since we're meant to be more than just happy, the fact that our moral requirements will sometimes make us unhappy shouldn't bother us.

1990;19(Fall):279–310. stream Among bioethicists, and perhaps ethicists generally, the idea that we are obliged to respect autonomy is something of a shibboleth. There is no perfect ethical theory that is philosophically rigorous, practical, and accessible to the physician. Traditionally, medical education has emphasized knowledge and procedural-based competencies while assuming the presence of the “softer” characteristics of the physician such as a developed ethical intuition and empathy. This gives new meaning to the idea of physicians in training “taking ownership of their patients” and generally has the potential to change the disposition of the physician in training to viewing modern medicine, even with all of its discontents, as a much more solemn and sacred enterprise, changing what is a job into a vocation. 126 Altmetric. @:��~�vT=:�r d�|"7��{���}�&�nM�Ґ���w����}�8�^���)M�"5�]��Ov���{"�쮿N����HM|�� �C���3��>?�}��n��D�EJ�ʯ�^��Pzj[���� T�(�_h����,Jɋq�sd���-�����͞���N�n������g�i���&���XAs��`-��{s��ưIWQ��v�ŏ�Z��Ƚ��w��D1���/�ΡҪ\�ě�^H�3aˮ�&����(tQ���ȗP�ȃb���06��ZC�~F�җ~1( "�.�3� V@p�py��S��$ݴ�� ��N��K��M����� �����PL�GK�����DW�Ǚ��w�hi�+FĈ��,&YR�)�-����h���x�b��(�Gd��Z$���]I܂���tU3�q���h�B�e]N�4(wc4�QB���T���܁]� Block L, Habicht R, Wu A, et al.

Solutions to this conflict have been exhaustively worked out in the bioethics literature over the past few decades, but they quickly become very technical, and therefore difficult to internalize and utilize in daily practice, particularly for physicians without prior exposure to, or experience with, medical ethics. 1994;69(8):670–9. By focusing on intentionality as opposed to outcomes, Kant’s philosophy also is applicable to the “blame and shame” medical culture, establishes a deeper sense of duty for the physician, and is clinically helpful for patient and peer interaction. The potential contribution of Kantian ethics will be the focus of the remainder of this paper. endobj This sentiment is unfortunately often absent from contemporary medical culture. %PDF-1.4 <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Humans are said to act autonomously when they act in accordance with reason because when one utilizes reason, his or her humanity is asserted. Pellegrino ED, Thomasma DC. << /Length 5 0 R /Filter /FlateDecode >>

The concept of autonomy is discussed, specifically how Kant’s idea of autonomy is very different from that in contemporary medicine, and is in fact more nuanced and helpful for the ethical development of physicians. The Concept of Autonomy and its Role within Kantian Ethics Bioethics and Autonomy Among bioethicists, and perhaps ethicists generally, the idea that we are obliged to respect autonomy is something of a shibboleth. Using Kantian Ethics in Medical Ethics Education, ��=}?�g�p��[&Xf!�E�;a�‚�w��y�l���T���㶘tuV�}�%��l�����y�A!`�?�������Q�e�R~��Ϙ⫴�% ���*��N*@�7:��^���Q�?�k��ޠj�Z|�2d��=�NQ���G��oDQU-*��#���XQ�_�1ʕę��=e�!Pg[5��E+.e×° w�B]�t��ojj�rڂR��&�0�����~��y��a���#'�����5I26r4P4p�p��nj����L)h��a`v��;�2�����C\+�'�e#��6c�h �,�6T��ŨN��\h�[D�Q��n*`��_ϰ�9��rp'��x�G�,�a�M��z�^����#�aw'j&&]��u ���TK��`8:Ѥ�|�:ks�U��LdDI�"��11 �s~;< 5y�?��iй:���®奀�q-_�W"�:?��T4ꢬ &wP�5k ������"z�3��ݻÃ�r�/T�3)�W8:02�ɜ˧�n������� ��s#�YT[eO��. Therefore, patients’ preferences can be wrong if, because of emotion, false perceptions, or an inadequate understanding, their decision making is not in line with either objective information or their value systems. BMC Med Educ. Beauchamp and Childress attempt to answer the criticism of contradictory principles by arguing that the principles must be balanced and that one principle can override another given that “adequate reasons are presented [11].” A set of criteria for doing this is provided, the primary one being that “better reasons can be offered to act on the overriding norm than on the infringed norm.” Another attempt to salvage principlism is through the development of the concept of specification, whereby the principles are interpreted in the specific context (who, what, when, where, etc.) endobj Other criticisms identify principlism as being overly reductive in its approach by narrowing the scope of focus on ethical inquiry to just the four principles, thus blinding the medical learner to other moral obligations in their medical practice such as making amends for medical errors or acknowledging and attempting to allay patient suffering [10]. Pellegrino E. The four principles and the doctor-patient relationship: the need for a better understanding. Oxentenko AS, West CP, Popkave C, et al. The more ethically literate physician would then be one who recognizes the origins of the diversity of opinions in medical ethics which would not only help the patient, but from a Kantian perspective, would compel the budding physician towards his or her imperfect duty of self-development, the sine qua non of education itself. 1983;9(1):38–44. endstream Utilitarianism, Kantian Ethics, Natural Rights Theories, and Religious Ethics A “utilitarian” argument, in the strict sense, is one what alleges that we ought to do something because it will produce more total happiness than doing anything else would. %PDF-1.3 Ethics RS (religious studies) revision section covering Kantian ethics, Immanuel Kant, Good Will and Duty, The Categorical Imperative, The Summum Bonum, Three Postulates of Pure Practical Reason, Strengths of Kantian Ethics and Weaknesses of Kantian Ethics. Electrical Engineering DEONTOLOGY Lecturer: Ing. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Philos Public Aff. 1 0 obj The choice between consequentialist and Kantian ethics is a difficult one, as there are many examples which are challenging to each sort of view. x��XɎ�0��+t.P�����{� ��. Utilizing Kant’s philosophy for medical education is not a panacea. For Kant then, humans are compelled to follow this universal law, the Categorical Imperative, by virtue of being human, and transgressing this law is a denial of that which makes one human [17]. >> /F1.0 9 0 R >> >> The current model has the relationship between physician and patient being an almost consumerist one, where the physician evaluates the patient and offers options among which the patient chooses with minimal intervention from the physician, so as to not obstruct the patient’s autonomy. Though inadequate as a sole paradigm for the whole of medical ethics, with principlism, among others, still needing to serve a major role, utilizing Kant’s Categorical Imperative in medical education as one of the ethical paradigms used to educate trainees about medical ethics could prove helpful to address the challenges unique to contemporary medicine. In the moment when weighing the sometimes very different motivations in deciding how to act, or when competing obligations exist, the Kantian approach to primarily consider the intention of the physician in using patients as ends in themselves is appealing and easier to apply than an abstract consideration of disparate principles. New York: Cambridge University Press; 1997. 157 ",#(7),01444'9=82. Ng SL, Kinsella EA, Friesen F, et al. Do clinical clerks suffer ethical erosion?


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