Great Ideas of Philosophy

VII. Moral philosophy, as such, is not a problem-solver or even a means by which to find the better of equallyunwelcome choices.A. Moral philosophy can, however, make clear to those who must decide such matters the principle thatappears to be guiding the decision and the implications arising from such a principle.B. Contemporary medical ethics recognizes the principle of nonmaleficence, which is different frombeneficence.1. Beneficence is the disposition to bring about good effects.2. Nonmaleficence comes into play when the options are all likely to harm the patient in some way.3. “Do no harm” is modified to “Do the least harm where harm itself is unavoidable.”C. But complications stalk the application of every principle. In many instances, a course of action may haveboth positive and negative effects.1. The textbook example features a pregnant woman suffering from a treatable cancer, but where thecourse of radiation therapy almost certainly will kill the fetus. Here we have the double-effect, oneintended, the other foreseen but not desired.2. As far back as Thomas Aquinas we can find moral guidelines to help those facing such dilemmas.3. First, the action itself must not be one that is intrinsically wrong.4. Second, the sincere intention must be to save a life, not to take one.5. Third, the bad effect is not produced as the means by which to bring about the good one.6. Finally, the good achieved must be greater than the evil unavoidably associated with it.VIII. The moral of this moral tale is that there was moral life before there was moral philosophy, and there weregood and worthy citizens before there were treatises on ethics. The subject matter of philosophy is drawn fromthe actual practices and problems faced by real persons confronting the realities of life.A. It is not philosophy’s mission to limit reality to problems it deals with adroitly. What is faced in themedical clinic and the surgery are issues of such novelty and seriousness that the least helpful instrument inthe circumstance may well be the learned essay in ethics.B. It is a strength and a virtue, not a weakness or a vice, to know and acknowledge one’s limits. Ethics as aphilosophical subject is no stranger to limits.Recommended Reading:Brock, Dan. Life and Death: Cambridge University Press, 1993.Cassell, E. The Nature of Suffering and the Goals of Medicine. Oxford University Press, 1991.Questions to Consider:1. How does one evaluate evils in order to determine which is the lesser?2. Is Kant’s categorical imperative even practicable within the real world of medical treatments and research?3. Under what conditions, if any, would you sacrifice an innocent life to save two?©2004 The Teaching Company Limited Partnership 25