Bioethics

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The case of Dr. Lowell and Mrs. Jackson revolves around a conflict between the doctor, who advocates the implementation of a particular treatment and the patient who disagrees with the doctor and wishes to do things her own way. The doctor feels that the suggested course of action is disastrous and threatens to have the patient declared mentally incompetent. The question now is whether or not the doctor is morally justified in taking action against the patient in order to implement the course of treatment she feels would be most effective. Is this an infringement on the autonomy of the patient or is the doctor morally obliged to do everything that he/she can possible do in order to restore the patient’s health even if that includes to go so far as to take this decision out of the hands of the patient?
I would like use Rule utilitarianism and Kantian deontology to help determine what course of action could be morally justifiable in this case. Rule utilitarianism says “A person ought to act in accordance with the rule that, if generally followed, would produce the greatest balance of good over evil, everyone considered.” (Mappes & Degrazia, 13) So according to rule utilitarianism, when one faces a moral dilemma one should map out the consequences of one’s action and then act in so as to produce the greatest net amount of utility or happiness. So if I was faced with a moral dilemma concerning whether or not I should cheat on an exam, I should follow the rule that creates maximum happiness, which in this case would be that I should not cheat because if every one in the world cheated on every exam then there wouldn’t be a need to take or give exams. There would no longer be a dependable system to gauge a student’s knowledge on a subject. Kantian deontology however follows a different path. According to this moral theory, consequences are of no matter and duty is what is important. (Lecture, 01/27) Just as in rule utilitarianism, Kant says that an act can be considered morally right when it is in observance with a rule. This rule, however, must satisfy the conditions of what he calls the categorical imperative. There are three formulations of the categorical imperative (Lecture 01/27) that each maxim or rule must adhere to. Firstly, “Act only according to that maxim by which you can at the same time will that it should become a u...

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...rity over a patient, since it is the patient who is directly affected by any course of treatment taken, the final decision should remain in the hands of the patient. The risk of losing patient autonomy by allowing doctors a free hand with what they think is the correct treatment seems to be too high. The patient should have the right to accept or reject any course of treatment so long as that decision is made with informed consent. Thus it would be ethically incorrect for Dr. Lowell to try and coerce her patient into following her recommended treatment. However, I think that Dr. Lowell would not be morally incorrect in trying to explain to Mrs. Jackson about the details of the treatment. Perhaps Mrs. Jackson has a fear of losing her hair during chemotherapy and Dr. Lowell could explain to her that hair loss does not occur inevitably with chemotherapy but varies person to person. Maybe if Mrs. Jackson knew more about what the treatment entails she might change her mind about it.

References:

Mappes, Thomas A., David Degrazia. Biomedical Ethics – Fifth Edition. Fairfield, PA:
Mc-Graw Hill Higher Education. 2001

Robert, Jason Scott. Lecture. Bioethics. LSE 106, ASU, Tempe, AZ

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