Moral Agency

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Moral Agency
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• The Concept
• "Moral agent" is a term us to distinguish someone
  who can be held accountable for ethical
  decision-making from others whose decisions and
  actions may cause harm or even death, but the
  person is not seen as capable of moral
  responsibility.
• There are two requirements of moral agency. These
  are
• (a) Cognition The capacity to know a decision or
  act is good v. evil.(b) Volition The freedom to
  choose one course of action as opposed another.
• In the first requirement (that of cognition) we
  would not consider a person a moral agent unless
  they could tell good from evil. This is the
  requirement of moral knowledge. Generally
  children are not considered capable of
  distinguish fact from fantasy and, thus, good
  from evil. Consequently, we tend not to hold
  children to the same standards of conduct as
  adults are held to. In the second requirement
  (that of volition), we would ordinarily not
  consider a person accountable for their acts if
  those acts were not freely chosen. This is the
  requirement of free will. If the person were
  biologically or socially determined or if the
  person were under a threat of violence or
  coercion, it is hard to consider their actions
  freely chosen.

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Moral Status
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The ConceptThe question of moral status often
arises when two entities are in conflict or when
there is an attempt to resolve a moral dilemma by
examining the ways in which we evaluate claims
made by or for a particular entity. The term
"moral status" refers to the relative moral
weight assigned to the thing in question. For
example, philosophical debates have raged over
the moral status of animals, fetuses, pregnant
women, infants, the disabled, the mentally
retarded, and patients whose competence is in
question. In determining moral status, we are
basically asked to assign value and that is
compared to the moral status of others.
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Self Determination
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The ConceptThe term "self-determination" refers
to self-governance. In terms of decision-making
authority, there are many cases in which
paternalism has prevailed over individual
autonomy. Whereas a paternalist makes decisions
for another presumably for the person's best
interests, the exercise of autonomy may not
necessarily be in what others see one's own best
interests. For example, paternalistic parents may
be very protective (at times too protective!) of
their children -- to the point of restricting
their actions and limiting their choices to one's
the parents consider suitable. Of course,
children often bristle against such paternalism
and want a degree of freedom that parents may not
take kindly to. Mill's concept of liberty
reinforces the notion that competent adults
should be able to make decisions for themselves,
so long as no one else is harmed. The question
is, what if the individual decision-maker may be
harmed by the decision they make? The history of
medicine up to the 20th Century has been a
history of paternalism. The last century,
however, saw a rise of personal autonomy where
the concept of self-determination is central.
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Informed Consent
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The Concept"Informed consent" is a term that has
evolved in the 20th C to protect patients who are
going to participate in human experimentation or
receive medical treatment. There are two main
components of this concept first, that the
subject is informed of the nature of the
experiment (or treatment), along with the
potential risks and benefits. Second, the
subject's participation should be voluntary. The
requirement for informed consent in
experimentation or medical treatment (remember
the consent form the doctor asks you to sign
before surgery or other kinds of treatment?) is
intended to protect the subject/patient from harm
or from being treated in dehumanizing or
exploitative ways.
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Its use in Medical TreatmentIn the sphere of
medical treatment, informed consent has its roots
in the recognition of the right of
self-determination. Through a series of legal
cases, that right was acknowledged ("every human
being of adult years and sound mind has the right
to determine what shall be done with his own
body") and refined. From a broad notion of
consent to medical treatment, it has moved to
include the requirement that the patient be
informed -- not just of the main risks of a
course of treatment, but all known risks, however
small the probability. Courts saw the dependence
of the patient on the doctor for information, the
centrality of trust in the patient-doctor
relationship, and the fact that, for consent to
be meaningful, it must be informed.
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Its use in ExperimentationThe protection of
human subjects is fundamental to the Nuremberg
Code, which came into being as a reaction to the
gross mistreatment of prisoners by the Nazis
during World War II. Nazi doctors and others
(many without any medical qualifications)
subjected prisoners to experiments with no regard
whatsoever for human life or for pain and
suffering. Abuse of informed consent has been
present in experiments in the United States as
well. The most infamous example is the Tuskegee
Syphilis Study of poor, black men in Alabama.
Without their knowledge or consent, men who had
syphilis were used in an experiment financed by
the federal government and extending over
decades. The subjects were deceived and used
without any regard for their health or dignity.
Even after penicillin was discovered (which would
have cured their syphilis), the treatment was
withheld from the subjects of the study.
Consequently, many suffered and died. Only after
the experiment came to public light was it
discontinued.