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Monday, 23 September 2013

The third and fourth medical isms-Consequentialism and Utilitarianism

Consequentialism is the philosophical system which can be divided into these types:  Mohist consequentialism, also known as state consequentialism,[4] is an ethical theory which evaluates the moral worth of an action based on how much it contributes to the welfare of a state. (wiki). This type is directly related to the Utilitarianism of Jeremy Bentham, who is mentioned in the curriculum I am looking at today.


...rule consequentialism holds that moral behavior involves following certain rules. However, rule consequentialism chooses rules based on the consequences that the selection of those rules have. Rule consequentialism exists in the forms of rule utilitarianism and rule egoism. (wiki) And, egoism here means that... Ethical egoism can be understood as a consequentialist theory according to which the consequences for the individual agent are taken to matter more than any other result. (wiki)

Obviously, both of these approached of consequentialism, and there are more, move far away from any Faith-based philosophy of morality.

A doctor who has a Faith-based morality in some countries and states would not be able to point out any other moral system or guide the patient to a religious based one if that is not the patient's own framework.

Pragmatism is the goal of consequentialism. The goal is merely to help the patient do something-decide on an action. 

What is ignored here, is St. Thomas Aquinas' idea of double effect from the Catholic point of view. Sadly, the med students would not be taught that important nuance that consequences. In case you forgot what that is, here is a summary, which really needs to be flushed out.

 Thomas Aquinas is credited with introducing the principle of double effect in his discussion of the permissibility of self-defense in the Summa Theologica (II-II, Qu. 64, Art.7). Killing one's assailant is justified, he argues, provided one does not intend to kill him. Aquinas observes that “Nothing hinders one act from having two effects, only one of which is intended, while the other is beside the intention. … Accordingly, the act of self-defense may have two effects: one, the saving of one's life; the other, the slaying of the aggressor.” As Aquinas's discussion continues, a justification is provided that rests on characterizing the defensive action as a means to a goal that is justified: “Therefore, this act, since one's intention is to save one's own life, is not unlawful, seeing that it is natural to everything to keep itself in being as far as possible.” However, Aquinas observes, the permissibility of self-defense is not unconditional: “And yet, though proceeding from a good intention, an act may be rendered unlawful if it be out of proportion to the end. Wherefore, if a man in self-defense uses more than necessary violence, it will be unlawful, whereas, if he repel force with moderation, his defense will be lawful.”
Aquinas does not actually say that intending to kill the assailant as a means to self-defense would be prohibited. The passage can be interpreted as formulating a prohibition on apportioning one's efforts with killing as the only goal guiding one's actions, which would lead one to act with greater viciousness than the goal of self-defense would allow. In contrast, Augustine had earlier maintained that killing in self-defense was not permissible, maintaining that “private self-defense can only proceed from some degree of inordinate self-love.”
Later versions of the double effect principle all emphasize the distinction between causing a morally grave harm as a side effect of pursuing a good end and causing a harm as a means of pursuing a good end. We can summarize this by noting that for certain categories of morally grave actions, for example, causing the death of a human being, the principle of double effect combines a special permission for incidentally causing death for the sake of a good end (when it occurs as a side effect of one's pursuit of that end) with a general prohibition on instrumentally causing death for the sake of a good end (when it occurs as part of one's means to pursue that end). The prohibition is absolute in traditional Catholic applications of the principle. Two traditional formulations appear below.
The New Catholic Encyclopedia provides four conditions for the application of the principle of double effect:
  1. The act itself must be morally good or at least indifferent.
  2. The agent may not positively will the bad effect but may permit it. If he could attain the good effect without the bad effect he should do so. The bad effect is sometimes said to be indirectly voluntary.
  3. The good effect must flow from the action at least as immediately (in the order of causality, though not necessarily in the order of time) as the bad effect. In other words the good effect must be produced directly by the action, not by the bad effect. Otherwise the agent would be using a bad means to a good end, which is never allowed.
  4. The good effect must be sufficiently desirable to compensate for the allowing of the bad effect“ (p. 1021).
The conditions provided by Joseph Mangan include the explicit requirement that the bad effect not be intended

I am amazed that there are any Catholic doctors in some nations and wonder how long it will be before America has none.

to be continued....