Theoretical background

Ethical thinking in health-care setting is often mainly connected to utilitarianism, deontological ethics and consequentialism. But also, the perspectives from virtue ethics and the ethic of care are highly useful. They are discussed in the section Being a professional.

Utilitarian views

The most basic aim of health care institutions is to improve their patients’ condition – to cure and to treat. Sometimes the only possible way is to maintain a patients’ current condition or to ease suffering when there is no viable treatment option. In utilitarian ethics the goodness of any practice is measured by asking whether it can promote or produce good, or more precisely, as much good as possible to as many as possible.

Traditional utilitarian thinking was flawed by the possibility of promoting good to one group at the expense of another. This flaw can be corrected by using the concept of basic rights. In health care, this means that there is some basic quality of care to which all patients are entitled. This can be determined by legislation, ethical guidelines, patient’s rights, or other considerations. Thus, it is not allowed to treat any patient poorly even if this could be said to contribute to some “greater good”.

Deontological ethics

This ethical view is based on the concept of duty. A person is doing the right thing if she follows her ethical duties. All ethical guidelines and specific laws of standards of health care are basically deontologically motivated. They describe what the most important duties in some particular field or profession are. Doing one’s duty is of course one basic pillar of all morality. However, it can be also the source of moral blindness, for duties can also be harmful sometimes.

The duty perspective is very important in professional ethics, but it should always be viewed with critical thinking. It must be asked what the real consequences of following a duty are, and what kind of circumstances could make the duty harmful and, thus force us to reconsider.

Consequentialism

All ethical assessment usually boils down to the question: What are the actual consequences of an action, decision or principle? From this point of view, it can be said that any activity that causes unjustified harm, serious or unnecessary risk or offence, is morally wrong. Both the duty approach and the utilitarian assessment of goodness eventually needs some connection to consequentialist thinking.

Perhaps the most renowned principle in this field is “never do harm” from Hippocrates. The phrase summarizes beautifully all above-mentioned theoretical perspectives: It represents a fundamental duty to maintain or improve a patient’s health.