The contribution of Kantian moral theory to contemporary medical ethics: A critical analysis

Abstract

Kantian deontology is one of three classic moral theories, among virtue ethics and consequentialism. Issues in medical ethics are frequently addressed within a Kantian paradigm, at least --although not exclusively--in European medical ethics. At the same time, critical voices have pointed to deficits of Kantian moral philosophy which must be examined and discussed. It is argued that taking concrete situations and complex relationships into account is of paramount importance in medical ethics. Encounters between medical or nursing staff and patients are rarely symmetrical relationships between autonomous and rational agents. Kantian ethics, the criticism reads, builds on the lofty ideal of such a relationship. In addition to the charge of an individualist and rationalist focus on autonomy, Kantian ethics has been accused of excluding those not actually in possession of these properties or of its rigorism. It is said to be focussed on laws and imperatives to an extent that it cannot appreciate the complex nuances of real conflicts. As a more detailed analysis will show, these charges are inadequate in at least some regards. This will be demonstrated by drawing on the Kantian notion of autonomy, the role of maxims and judgment and the conception of duties, as well as the role of emotions. Nevertheless the objections brought forward against Kantian moral theory can help determine, with greater precision, its strengths and shortcomings as an approach to current problems in medical ethics.

Withdrawal Life Support and Let Dying Ill Patients: Right or Wrong Decision

“…Therefore, it seems that the autonomy is not absolute and the individual does not have the full right on his own life. It is very clear from Kant's point of views that the individual's autonomy cannot qualify self-determination [6]. Therefore, in the above scenario, that even the decision was made by the patient and family about the withdrawal of life support is not correct.…”

Patient autonomy and choice in healthcare: self-testing devices as a case in point

“…This understanding of Kantian ethics is often misconstrued as referring to the autonomous agent and his autonomous choices. However, contrary to misinterpretation, Kant's autonomy of the will does not refer to autonomous action; rather it refers to the practical reasoning employed in "determining choice to action" (Heubel and Biller-Andorno, 2005, p.7).…”

“…Similarly, Heubel and Biller-Andorno (2005) note that in applying the Law of Universality, the first formula of Kant's categorical imperative, one is obliged to consider the accordance of one's maxims with those of others. Therefore an accurate understanding of Kantian morality appreciates that Kant "cannot reasonably be accused of ignoring the fact that autonomy is about our commitments to other people" (Paley 2002, p.135).…”

Ethical and Legal Issues in Emergency Research: Barriers to Conducting Prospective Randomized Trials in an Emergency Setting

“…The theory contends that the moral duty of all individuals is to pursue the ''right'' course of action, (which he denoted as ''categorical imperatives''), regardless of the ultimate consequences of the act. Further, he has argued, that for an act to meet the criteria of a categorical imperative, it must be both ''universal'' (applicable to all equally) and ''reversible'' (that those acting upon the imperative be willing to have such and act equally applied to themselves) [49]. However, as applied to the situation of emergency medicine and implied consent, many ethicists have argued it falls short of its own criteria, as it fails to rise to a level of exclusiveness, where all those faced in a similar situation would agree.…”