Normative Theories

...

- The Universal Law formula is Kant’s first formulation that says a person should “act only on that maxim through which you can at the same time will that it becomes a universal law” (Kant, Categorical Imperatives: Universal Law, 2002).

- Humanity as an end in itself: Humans must learn at all times to act in a manner that respects human rationality in others and ourselves (Shaw & Barry, 2015).

- Kingdom of Ends: the idea that an ideal community in which all people “are treated as ends (meaning treated as if they and their well-being are the goals), not as means to an end for other people” (Wikipedia Foundation, Inc, 2016).

Ethics is important in medicine and guides medical practitioners. There are several moral dilemmas in medical ethics that surface due to disputes in duties or responsibilities faced by staffs in medical facilities. Bioethics is based on four principles: beneficence, autonomy, justice, and non-maleficence. Modern day medical ethics shows how professionals face moral dilemmas that come up in the circumstance of a patient’s autonomy and the principles of confidentiality and informed consent. According to (Cordess, 2000), a complete look of treatment of freedom was obtained from Immanuel Kant, which examines “disclosure dilemmas as to people treating each other as a means to someone else’s ends.” In medical, to respect a patient’s autonomy includes acts of obtaining informed consent for treatment, diagnosis, disclosing medical information, maintaining confidentiality, etc.

In the scenario above, Kant would stress on a regular duty of care, and of justice for me to take regardless of the circumstance. In Kant’s philosophy, the duty of care is absolute regardless of disease. Kant would consider my obligation to care and maintain the patient’s confidentiality binding without taking into account my personal virtues. Kant would also argue that I should treat the Schizophrenic Patient same way as I would like to be treated (Universal Law). In this circumstance, Kant would suggest that I maintain patient confidentiality since I am required by law to do that.

On the other hand, given that my decision to maintain patient confidentiality could lead to another life-threatening situation to the children, it is true that the school would also like to know and would agree that I treat them the same way. This is in all likelihood a Universal Law also. In this case, the bets are high and overturn the ethical scale against the stance of obedience to the law to protect patient confidentiality, and that an ethical acumen to disclose information should be binding on all people. If I interpret the situation this way, Kant would suggest that I am obligated to the school and not the patient (not because my daughter attends the school, where the patient teaches). I am then bound to the universal moral law and will tell anyone should they find out. Nevertheless, Kant’s moral law also says that when a person makes a promise, it should be kept. Therefore, my commitment to patient confidentiality at work will take precedence over what looks like the clear categorical imperative. Kant would also agree with the moral action where I reach out to the medical office superiors and request for them to inform the school if they have not already done so, or else I would release the information. In this option, the categorical imperative identifies that disclosing the information to the school is in blatant violation of the law. By telling my superiors; however, will reduce the likely outcomes because the result will be that the school will be informed, but not through me. Consequently, the Kantian will not violate the law, but it undertakes what is ethically right.

The Application of John Stuart Mill’s Consequential theory to the Scenario. The theory of consequentialism is always associated with John Stuart Mill. Mill was born in the 1800s and raised by his father- James Mill who was a philosopher. He was raised to abide by the works of Jeremy Bentham as a moral guide. After studying Bentham’s theory of Utilitarianism with relation to pleasure, Mill gave a detailed explanation in justification of Bentham’s theory. Bentham’s devotion to the “Greatest Happiness Principle” was a fundamental declaration of the Utilitarian principle – “actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness, is intended pleasure, and the absence of pain; by unhappiness, pain, and the privation of pleasure (Mill, Utilitarianism, p.55 (as cited in Mulgan, 2014)). Even though he supported Bentham’s utility principle, Mill did not agree with the idea that pleasure can be quantified. Mill assumed that some pleasures that humans experience are different from each other in qualitative ways. (Kemerling, 2011) states that Mill claimed, “Only those who have experienced pleasure of both sorts are competent judges of the relative quantity.” Mill suggested that to achieve happiness positively is hard, and that humans are often vindicated morally when they seek to reduce the general amount of pain experienced due to their actions.

In the 1700s, Bentham claimed that any human action has a hedonistic value and is readily determined by how extreme a person feels pleasure, how long the happiness lasts, how sure and quick the pleasure occurs when humans act, and how easy it is to produce good, and evade harm at the same time. Bentham’s critics such as Thomas Carlyle called Bentham’s views the “Pig philosophy.” Carlyle asked that if pigs do feel pleasure same as humans, and if pleasure is all that matters, is it okay to conclude that people are like pigs? Carlyle’s objection led to Mill’s new explanation of pleasure. Mill advises that there is no way one can compare a pig’s life with human life because people go through valuable experiences than pigs. He went forward to say that it is important to realize that some types of pleasure are more advantageous and precious than others (Mill, 2000). Mill suggested it is important to base our results not only on quantity but quality as well. In this new explanation, we see that Mill has instituted the difference between higher pleasures and lower pleasures. To know which pleasure is the better one, one has to experience both. (Mulgan, 2014) states that individuals who have undergone both higher and lower pleasures prefer the greater pleasure. As such, the greater pleasures come top and preferable. In summary of Mills Principle of utility, we agree that the principle “is the core tenet of utilitarianism, which advises that the total good is the greatest happiness of the greatest number of people” (MacMillan Publishers Ltd., 2002). Since Mill says happiness is the maximization of pleasure, and minimization of pain, we