Deontology

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Deontology

• Rels 300 / Nurs 330
• 10 sep 2008

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DEONTOLOGY

• An act is right if it conforms to a moral rule.
• It is your duty to do what is right.
• An act cannot be judged by its consequences.
• Immanuel Kant (1724-1804)
• Kantian deontology is an ethic
• of respect for persons
• for oneself
• for others

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KANTS CATEGORICAL IMPERATIVE

• Supreme principle of morality
• general formal principle
• specific moral maxims or duties are derived from
  the formal principles
• Kant uses 2 formulations of the categorical
  imperative
• they are the two formal principles which underlie
  Kants deontological theory

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Categorical Imperative 1

• ACT ONLY ON THAT MAXIM THROUGH WHICH YOU CAN AT
  THE SAME TIME WILL THAT IT SHOULD BECOME A
  UNIVERSAL LAW
• You would approve of this action being one that
  every other person would also follow
• do not lie
• help others in distress
• treat others fairly
• treat others as you would want to be treated

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What does universal mean?

• Dont make exceptions for yourself
• Dont make exceptions for people that you DO or
  DONT like
• Dont make exceptions in particular contexts or
  situations.
• So, do not lie OR always be truthful means just
  that in all circumstances in deontology or duty
  ethics.
• It is not OK to lie if it makes things easier for
  you, or if someone is sick, or if someone else
  will get into trouble.

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Categorical Imperative 2

• ACT IN SUCH A WAY THAT YOU ALWAYS TREAT
  HUMANITY,
• WHETHER IN YOUR OWN PERSON OR IN THE PERSON OF
  ANY OTHER,
• NEVER SIMPLY AS A MEANS, BUT ALWAYS AT THE SAME
  TIME AS AN END.
• also known as the practical imperative
• do not use people for your own ends (or goals, or
  purposes, or to get what you want)
• respect people as ends in themselves

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RESPECT FOR PERSONS

• The 2 formulations of the categorical imperative
  provide the foundation for Kantian deontology as
  an ethic of respect for persons.
• Each person is a rational being,
• We are all capable of making our own decisions,
  taking responsibility for our own actions, and
  establishing our own goals and values.
• Each person is unique, irreplaceable, and
  deserves respect.

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What does this mean in practice?

• Is it OK for medical students to practice
  performing pelvic exams on women anesthetized for
  surgery? Why or why not?
• Is it OK for a surgeon removing a prostate gland
  to extract sperm for use in artificially
  inseminating an infertile patient?
• What does it mean to use a person as a means to
  your own ends? Give an example.

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SUMMARY

• Deontology as a moral theory insists that we have
  moral duties to do certain things because the
  action is inherently right.
• Respect is primary.
• Differences in contexts, participants, or
  cultures do not change our duties.
• Consequences, whether foreseen or not, do not
  change our duties or relieve us of them.
• You will be a moral person if you reason out for
  yourself the human moral duty in the situation
  and fulfill it.
• Any questions?

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Geographic Information Systems Code of Ethics
(2003) (example of a deontological code of
ethics)

• Respect Privacy
• Protect individual privacy.
• Be especially careful with new information
  discovered about an individual through GIS-based
  manipulations
• Respect Individuals
• Encourage individual autonomy.
• Avoid undue intrusions into the lives of
  individuals.
• Be truthful when disclosing information about an
  individual.
• Treat all individuals equally, without regard to
  race, gender, or other personal characteristic.

• Be Honest in Representations
• State professional qualifications truthfully.
• Make honest proposals that allow the work to be
  completed for the resources requested.
• Deliver an hours work for an hours pay.
• Describe products and services fully.
• Be forthcoming about any limitations.

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Case Studyadapted from http//www.acponline.org/c
linical_information/journals_publications/acp_inte
rnist/mar08/four.htm

• An 83-year-old woman of Russian descent is
  hospitalized with progressive dyspnea and a chest
  X-ray highly suggestive of metastatic cancer,
  which is confirmed on bronchoscopy. Her two sons
  adamantly insist to the attending physician
  that their mother not be told that her illness is
  terminal. Their father died of cancer when they
  were young, they explain, and their mother is
  consequently so terrified of cancer that she
  would be devastated by the diagnosis, even
  potentially suicidal.

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According to a deontological perspective

• What should the physician consider when deciding
  what she should do?

• What duties does the physician have toward her
  patient?