Moral Theories in Health Care

Desai pinky HSC601:-Healthcare Policy and Medical Ethics Date: - 10/06/2009 Question 2: What moral theories are the most important in the healthcare reform debate? The four moral theories which have been refereed in the book satisfy one or the other aspect of the ethical analysis and also keep the foundation for further analysis. However no theory satisfies all the relevant criteria. All the four theories have pointed out their ways and means to reach a decision which is correct and ethically considered.

All the theories have reached some of the goals in the common like autonomy, privacy, beneficence yet with different perspectives. The utilitarian mainly focuses on the value of the well being, which is analyzed in the terms of the pleasures, happiness welfare, preference satisfaction whereas the Kantianism believes that the morality is grounded in reason, duty rather than the sympathy, emotions. This indicates that the person have to act not only in an accordance with but for the sake of the obligation. Utilitarianism is divided into two: - the rule utilitarianism and act utilitarianism.

The rule utilitarian considers the consequences of adopting certain rules whereas the act utilitarian disregards the level of the rules and sticks only to the principle of the utility. Thus the advantage of the rule utilitarianism is that it considers the parameters like justice, beneficence and laws and legal rights which lacks in the act utilitarianism. Kantianism mainly rotates around the following objectives. According to Kant “maxim” is the moral worth of an individual’s action that depends exclusively on the moral acceptability if the rule on which the person acts.

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Since the maxim applies to every individual that performs the similar act in the similar condition it has been declared as an universal law. The second objective of the Kantianism is the “categorical imperative”, which stresses the importance of the what must be done irrespective of our desires and the final objective of the Kant theory is the autonomy which typically refers to the judgments and actions one can take with their own will. However the importance of the autonomy is that if and only if the individual knowingly act in accordance with the universally valid moral principles that pass the requirements of the categorical imperative.

In the utilitarian theory the major flaw is immoral preference and actions. Even if the individual performs the act to produce the overall utility for everyone but if accidental the greatest possible utility is not achieved then the action will be wrong and it will be considered against the act. According to this theory the individual should perform the act in such way that it provides benefit to the most of the people regardless of their feelings and preference of their opinion.

This has led a question that an individual should have to consider every action and their consequence before implementing this theory. Additionally one has to take into account the proposed alternatives before performing the action as any unexpected results would prove utilitarian theory wrong and unethical as it was not able to provide the benefit to the society. Another major flaw with this theory is that difficulty in defining the line between morally obligatory actions and supererogatory action. The heroic donation of the bodily parts such as an kidney to save another person life is unethical.

Whereas with Kantianism the main flaw is the duty is given prime importance neglecting virtue, emotion. But these motives do count morally. Another major flaw is the conflicting obligation. It generally arises from a single moral rule rather than from two different rules, since it fails to take into account the consequence of the one situation, it becomes even more difficult when a conflicting condition arises at the same time. Both the theory attempts to explain the moral principles but have different viewpoints to guide the individual towards ethical analysis.

The utilitarian’s considers the act to be morally valid if the results produced provide maximal values in terms of happiness or pleasure. It holds that actions are right or wrong according to the balance of their good and bad consequence. If the actions have more good consequences then it is morally appropriate and if the actions have more bad consequences then it morally inappropriate. Since this is based on the individual context, this theory cannot be universally accepted and merely depends on the situational analysis.

As the utilitarian lacks the universal set of rules which defines morality, hence one has to analyze the situation individually. In outweighing the benefits of the good or bad consequences to attain the maximum utility and also considering the alternative consequences makes this theory bit complex, tedious and time consuming. Whereas Kantianism is based on the autonomous and maxim. One has to perform the duty at his will without considering the whether the consequences are favorable as he is imbibed to perform the duty which is otally contradictory to the utilitarian theory. From the analysis it seems that it is more logical theory and has a set of universal rules which has been widely used in the health care reforms and in the healthcare industry. From the above analysis , Kantianism theory seems to be more appealing to me but when the healthcare reforms are involved I feel every theory has their positives and negatives and should be included in the healthcare reform debates as every pieces of theory has a lot to provide to the health care reforms.

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