Sir Francis Bacon (1561-1626) is responsible for the division of the practice of medicine into three separate parts. The first area is the preservation of the patient’s health, the second area is the curing of disease, and the third area is the prolongation of life. This influences many doctors in this period, and shortly after the release of this ethical work, physicians declared that the prolongation of life was their primary function. Prima Facie Duties were defined as W. D.
Ross, as guides to solving ethical problems. These duties are: duties of fidelity, duties of gratitude, duties of justice, duties of beneficence, duties of self-improvement, and duties of non-maleficence. Ross felt these duties to be intuitional and conditional. The definition of fidelity in this instance is to avoid on ones promises or contracts. Gratitude is to be grateful for kindnesses and if possible, benefit others. Justice is defined in one’s ability to evenly distribute benefits and burdens.
The duties of beneficence are the duty to good to others, not only to care for their health but their security, and happiness as well. In turn, the duties of self-improvement are the obligation to improve oneself. Non-Maleficence or non-injury means to avoid doing harm physically, or psychologically to another. Hippocrates was a Greek physician around 460 to 375 B. C. , who was responsible for writing the Hippocratic oath, the first professional code of ethics for physicians. He was said to be inspired by Pythagoras, who is credited with developing some of the first known moral philosophies.
W. D. Ross (20th century) of Oxford University, developed a set of rules based on the fulfillment of professional duties, which were specific to professional behavior. These rules are known as the prima facie duties. Microallocation is the distribution of scarce resources on a very intimates scale. This can range from dialysis schedules, distributed drugs available in limited amounts and feeding tube or ventilator issues. The decisions are made by the physician and are based on the interpersonal relationship between him and his patient.
One of the best examples of this would be the distribution of organs for transplantation. Making the decision of this magnitude requires knowledge of the patient and their circumstances, something that only a physician that has long worked with a patient knows. Deontology is one of the three schools of thought in ethics- the other two being teleology and virtue ethics. Immanuel Kant, an ethicist that practice one of the purest forms of deontology, expanded on Aquinas’s Natural Law of Ethics, and further expanded it to state that consequences are not important it is the good will of the doer.
Deontologists believe that morals derive from reason and that any principle that is derived from reason must be able to stand as a universal truth. Thomas Aquinas (13th century) reasoned that moral truths could be discovered if we would observe the simple nature of things and apply logic. He felt the ability to reason was a trait given to us by God and recognized that it was unique to humans. By giving us this trait, God was showing us that we have an inborn morality and that this morality should be explored and used to advance man in many directions.
This moral law is known as The Natural Law of Ethics, and is most of today’s bioethics is based on it. Macro allocation is decisions made for groups of individuals regardless of their individual statuses. Congress, state legislatures, insurance companies or other such large concerns usually make these decisions. An example of macro allocation would be how a hospital would divide funds given to them in trust- whether to improve the current facility or make and addition that will further research or help the community.
Teleology is the ethical school that looks at the consequences of the action rather than the action itself. Under teleological thought the action that produces the greatest happiness or the least unhappiness is the “good” action. Core values are values that are common across racial, religious and social boundaries. The ten that have been identified as these core values are accountability, promise keeping, loyalty, fairness, integrity, respect for others, responsible citizenship, pursuit of excellence, caring and honesty.
Accountability means that you not only take responsibility for your actions, but are liable for them as well. In the medical field, this would mean making sure you give the best possible treatment or examination to a patient. Promise-keeping, means adhering to an agreement, whether it’s between colleagues or a patient.. Loyalty, which is similar to promise-keeping, is better defined as a keeping of ideals- we promise to do no harm under the Hippocratic oath- our adherence to that promise is loyalty. Fairness means to perform ones duties honorably and with justice in mind at all times.
Integrity entails keeping ones promises and remaining loyal, while avoid self-promotion, conflicts of interest or any other improprieties. Respecting others means showing consideration for their feelings, needs , fears and –especially in healthcare- privacy. Responsible citizenship requires making sure that one performs one’s duties with societies values in mind. An example of this would be reporting unsafe or unacceptable practices to superiors or appropriate authorities. Pursuit of excellence means following a path of superior work and care.
Honesty is means being truthful and sincere and refraining from lying or cheating. Caring, which is probably the most significant value to healthcare works, means being genuinely concerned for and interested in those around you. This also includes caring about your work and place of work. References Garrett, Dr. Jan (2004) A Simple and Usable (Although Incomplete) Ethical Theory Based on the Ethics of W. D. Ross r. retrieved from http://www. wku. edu/~jan. garrett/ethics/rossethc. htm#pfd February 1, 2009.