The limits of ethical principles

Let’s think about two questions.

• How can we tell whether a form of behaviour in nursing care is ethically good or bad?

• What makes a form of behaviour in nursing care ethically good or bad?

Especially if you are familiar with the history of medical ethics since the Declaration of Helsinki after WW II, it is tempting to offer the same answer to both questions. We can tell whether an act is good or bad by whether it fits an agreed set of medical ethical principles. And, an act is good or bad depending on whether it fits an agreed set of medical ethical principles.

But at the same time, anyone familiar with the most famous set of medical ethical principles – the Four Principle Approach – or the International Code of Medical Ethics knows, such principles are inconsistent. That is, they can give conflicting advice in particular circumstances. If that is the case, how can a set of principles answer either question?

How do we deal with such inconsistencies? Could they be avoided? And if not, what does this teach us about ethically good healthcare?

Reading:

• Thornton, T. (2006) ‘Judgement and the role of the metaphysics of values in medical ethics’ Journal of Medical Ethics 32: 365-370

Next session.