This Is Bioethics. Udo Schüklenk. Читать онлайн. Newlib. NEWLIB.NET

Автор: Udo Schüklenk
Издательство: John Wiley & Sons Limited
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Жанр произведения: Медицина
Год издания: 0
isbn: 9781118770733
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saying,” she demanded, “that if I sleep with my boyfriend, I should sleep with him out of a sense of duty?” My response: “And when you’re through, you should tell him that you would have done the same for anyone in his situation.” What could I say.’ He then goes on to lament that impartialist ethical theories are something of a no‐go area when you are looking for an ethics of personal relationships. Hardwig isn’t entirely correct here, Kant would have answered the student’s question in the affirmative only if the couple had been in a legal marriage. The student probably would not have considered that response much more plausible.

      2.23 Kass’ treatise on the Wisdom of Repugnance earned the scorn of many a bioethicist, not least because his line of reasoning arguably leads to arbitrary conclusions about what is right and what is wrong, based on who you ask about their feelings on a particular matter. To be fair to Kass, he advanced other arguments against human cloning that we will be looking at in Chapter 8. Still, strongly felt repugnance is indicative of a sound moral intuition to him.

      2.24 Where would reason‐based ethics take us in terms of the formal structure of ethics? Kant insists it would take us to something he called the Categorical Imperative. There are slightly differing formulations of the Categorical Imperative, and not unexpectedly they have led to much scholarship generated by philosophers. That notwithstanding, the basic arguments underlying the Categorical Imperative are these: whatever moral rules we identify must be rules that are categorical, that is they are absolute, and they must be binding on us and everyone like us. Accordingly, these rules must be universal rules that we would be happy for all humans to follow them. Like utilitarians rule‐based philosophers think that we must not create rules just for ourselves.

      2.27 The principles they propose are: non‐maleficence, beneficence, respect for autonomy and justice. Let us have a closer look at each of these principles and at how they interact with – and sometimes against – each other in order to get a better handle on the Georgetown Mantra. Keep in mind that these principles are considered prima facie by Beauchamp and Childress, that is – with good reason – every one of them can be overridden by competing stronger demands.

       2.5.1 Non‐Maleficence

      2.28 You might have heard of the often‐cited ‘first rule’ when it comes to health care practice: Primum non nocere – First do no harm. Non‐maleficence means little other than that. This principle is more strongly associated with Kantian thinking.

       2.5.2 Beneficence

      2.29 Beneficence requires health care professionals do to what is best by their patients. As we shall see, this can give rise to justifiable paternalistic actions by health care professionals. This principle is more strongly associated with consequentialist thinking.

       2.5.3 Respect for Autonomy

       2.5.4 Justice

      2.32 Justice then seems to be a thing that is very much in the eyes of the beholder, subject to the vagaries of one’s personal ideological convictions. A Marxist will hold a quite different view on resource