Common Morality Principles in Biomedical Ethics: Responses to Critics

2021 ◽  
pp. 1-13
Author(s):  
James F. Childress ◽  
Tom L. Beauchamp
Keyword(s):  
Medical Ethics ◽  
Moral Theory ◽  
Biomedical Ethics ◽  
Common Morality ◽  
Moral Change

Abstract After briefly sketching common-morality principlism, as presented in Principles of Biomedical Ethics, this paper responds to two recent sets of challenges to this framework. The first challenge claims that medical ethics is autonomous and unique and thus not a form of, or justified or guided by, a common morality or by any external morality or moral theory. The second challenge denies that there is a common morality and insists that futile efforts to develop common-morality approaches to bioethics limit diversity and prevent needed moral change. This paper argues that these two critiques fundamentally fail because they significantly misunderstand their target and because their proposed alternatives have major deficiencies and encounter insurmountable problems.

Why a New Approach to Medical Ethics Is Needed

2020 ◽  
pp. 9-43
Author(s):  
Rosamond Rhodes
Keyword(s):  
Medical Ethics ◽  
Medical Practice ◽  
Systematic Approach ◽  
Biomedical Ethics ◽  
Common Morality ◽  
Medical Professionalism ◽  
New Approach ◽  
Good Medical Practice ◽  
Everyday Ethics ◽  
The Common

The Trusted Doctor: Medical Ethics and Professionalism rejects the well-entrenched views of medical ethics as everyday ethics or common morality applied to medicine. This chapter lays the foundation for the original account of medical ethics that follows in the book’s succeeding chapters. By presenting vivid examples and general arguments the author demonstrates ways in which the ethics of medicine is distinct and different from common morality. The chapter discusses the most popular common morality views, namely, the four principles approach expounded by Tom Beauchamp and James Childress in Principles of Biomedical Ethics and the ten rules approach presented by Bernard Gert, Charles Culver, and K. Danner Clouser in Bioethics: A Systematic Approach by presenting arguments that challenge their applicability to medical practice. A chart identifies some stark differences between the common morality approach and good medical practice and shows how everyday ethics is incompatible with medical professionalism.

scholarly journals The Theory of Common Morality of Bernard Gert

2019 ◽  
Vol 15 (1) ◽  
pp. 1-14
Author(s):  
Flávio R. L. Paranhos Paranhos ◽  
Volnei Garrafa ◽  
Jan Helge Solbakk
Keyword(s):  
Moral Theory ◽  
Critical Analysis ◽  
Biomedical Ethics ◽  
Common Morality ◽  
Moral Agents ◽  
Moral Ideals ◽  
Intuitive Appeal ◽  
Step Procedure ◽  
Moral System ◽  
Moral Rules

Tom L. Beauchamp and James F. Childress have been increasingly using a moral theory known as “Theory of Common Morality” as a philosophical basis for their four principle approach to biomedical ethics, currently known as principlism. In the latest edition (2013) of their Principles of Biomedical Ethics, they acknowledge the contribution of some previous theorists of common morality. Bernard Gert, a critic of principlism, is one of them. The aim of this paper is to provide a critical analysis of Gert’s Theory of Common Morality, as developed in his book Common Morality. Deciding What to Do (2004). According to Gert, common morality is a moral system that everyone uses implicitly when making decisions and judgments. This system consists, basically, of moral rules, moral ideals and a two-step procedure used intuitively by every person to decide whether a given violation of a rule or ideal is legitimate. There are ten moral rules, which can be collapsed into two basic ones, Do not cause harm (Do not kill; Do not cause pain; Do not disable; Do not deprive of freedom; Do not deprive of pleasure), and Do not violate the trust (Do not deceive; Keep your promises; Do not cheat; Obey the law; Do your duty). Moral rules apply to moral agents, which are constituted by all humans able to fully understand the moral rules, as well as predict the consequences of their eventual violation. It is our understanding that, despite the highly intuitive appeal of Gert’s approach, as well as of Beauchamp and Childress’s, the Theory of Common Morality has some fundamental flaws which are discussed in the article.

Medical Ethics: Uncommon Morality and the Implications for Medical Ethics Education

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 17-18
Author(s):  
Rosamond Rhodes ◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Medical Ethics ◽  
Ethics Education ◽  
Thought Experiment ◽  
Medical Knowledge ◽  
Biomedical Ethics ◽  
Common Morality ◽  
Medical Professionals ◽  
Public Confidence ◽  
Medical Ethics Education ◽  
Positive Argument

"Common morality has been the touchstone for addressing issues of medical ethics since the publication of Beauchamp and Childress’s Principles of Biomedical Ethics in 1979. In my presentation, I will challenge that reigning view by presenting two arguments. The negative argument shows why common morality cannot be the ethics of medicine. The positive argument explains why medical professions require their own ethics. I will then explain medicine’s distinctive ethics in terms of the trust that society allows to the profession. By distinguishing roles from professions, I will explicate sixteen specific duties that medical professionals undertake when they join the profession. My derivation of medicine’s distinctive ethics begins with a thought experiment demonstrating that trust is at the core of medical practice. Society allows doctors to develop special knowledge and skills and allows them to employ special powers, privileges, and immunities that could be particularly dangerous to members of society. Society, therefore, has to be assured that professional’s use of their remarkable powers and privileges will be constrained to their intended use. Professions’ publically declared codes and oaths go a long way to engender public confidence in medical professionals. Medical education must complete the job by helping our trainees understand their professional obligations and become clinicians who uphold their profession’s ethics. Medical educators therefor have to help our students comprehend and internalize their duty to “seek trust and be deserving of it,” and uphold their fiduciary responsibility to “use medical knowledge, skills, powers and privileges for the benefit of patients and society.” "

The Trusted Doctor

2020 ◽  
Author(s):  
Rosamond Rhodes
Keyword(s):  
Clinical Practice ◽  
Medical Ethics ◽  
Medical Practice ◽  
Biomedical Ethics ◽  
Common Morality ◽  
Medical Professionals ◽  
Medical Professionalism ◽  
Clear Understanding ◽  
Professional Obligations ◽  
The World

Common morality has been the touchstone for addressing issues of medical ethics since the publication of Beauchamp and Childress’s Principles of Biomedical Ethics in 1979. This book challenges that reigning view by presenting an original account of the ethics of medicine. It begins by demonstrating why the standard common morality accounts of medical ethics are unsuitable for the profession and inadequate for responding to the uncommon issues that arise in medical practice. It then explains medicine’s distinctive ethics in terms of the trust that society allows to the profession. Starting with the obligation to “seek trust and be trustworthy,” the book goes on to explicate sixteen specific duties that doctors take on when they join the profession. By enumerating the duties of medical professionals and explaining their importance with numerous clinical examples, this book presents a cohesive and coherent description of the duties of medical professionals that is largely consistent with codes of medical ethics posted on websites of medical societies around the world. It also explains why it is critical for physicians to develop the attitudes or doctorly virtues that comprise the character of trustworthy doctors and buttress physicians’ efforts to fulfill their professional obligations. Together, the presentation of physicians’ duties and the elements that comprise a doctorly character add up to a description of what medical professionalism entails. This analysis provides a clear understanding of medical professionalism and guides doctors in navigating the ethically challenging situations that arise in clinical practice.

Commentary: Beyond Common or Uncommon Morality

2020 ◽  
Vol 29 (3) ◽  
pp. 426-428
Author(s):  
LESLIE FRANCIS
Keyword(s):  
Medical Ethics ◽  
Common Morality ◽  
Medical Professionals ◽  
Ethical Standards ◽  
Overlapping Consensus ◽  
Healthcare Professions

In “Medical Ethics: Common or Uncommon Morality,”1 Rosamond Rhodes defends a specialist view of medical ethics, specifically the ethics of physicians. Rhodes’s account is specifically about the ethics of medical professionals, rooted in what these professionals do. It would seem to follow that other healthcare professions might be subject to ethical standards that differ from those applicable to physicians, rooted in what these other professions do, but I leave this point aside for purposes of this commentary. Rhodes’s view includes both a negative and a positive thesis. The negative thesis is that precepts in medical ethics—understood as the ethics of physicians—cannot be derived from principles of common morality. The positive thesis is two-fold: that precepts in medical ethics must be derived from an account of the special nature of what physicians do, and that this account is to be understood through an overlapping consensus of rational and reasonable medical professionals. While I agree emphatically with, and have learned a great deal from, Rhodes’s defense of the negative thesis, I disagree with both claims in Rhodes’s positive thesis, for reasons I will now explain after a brief observation about the negative thesis.

Moral Theory and Moral Judgements in Medical Ethics

1989 ◽  
Vol 15 (4) ◽  
pp. 216-216
Author(s):  
D. Dooley
Keyword(s):  
Medical Ethics ◽  
Moral Theory ◽  
Moral Judgements

Toward Reclaiming Our Ethical Heritage: Nursing Ethics before Bioethics

2020 ◽  
Vol 25 (2) ◽  
Author(s):  
Marsha Fowler
Keyword(s):  
Health Disparities ◽  
Medical Ethics ◽  
Nursing Practice ◽  
Code Of Ethics ◽  
Social Ethics ◽  
Historical Review ◽  
Biomedical Ethics ◽  
Nursing Profession ◽  
Nursing Ethics ◽  
The Social

American nursing has an extraordinary body of nursing ethics literature from the 1880s to the mid-1960s. This literature developed prior to the rise of the field of medical ethics (later termed biomedical ethics, then bioethics) in the mid-1960s, and bears little resemblance to its later counterparts. Early nursing ethics was nurse-centric; relationally based; addressed nurses’ ethical comportment in all roles; advanced the social ethics of nursing (especially in response to health disparities); and set forth ethical expectations for the profession as a whole. This first wave of nursing ethics is distinctive and differs significantly from contemporary bioethics, yet it remains grossly under-researched. It offers nurses a wise, comprehensive, generous, and learned ethics that deserves to be reclaimed for today’s nursing practice. This article will offer an author backdrop and an historical review of early nursing ethics literature; consider the nursing profession as a calling; discuss the pivot to bioethics and the Code of Ethics as anomaly.

Duties of Behavior Toward Patients

2020 ◽  
pp. 118-137
Author(s):  
Rosamond Rhodes
Keyword(s):  
Medical Ethics ◽  
Medical Information ◽  
Common Morality ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Case Examples ◽  
Medical Needs ◽  
Numerous Case ◽  
Patient Interactions ◽  
Treatment Plans

This chapter explains three central physician duties that clearly set medical ethics apart from common morality: nonjudgmental regard, nonsexual regard, and confidentiality. Because patients will not trust doctors when they are not confident in the doctor’s devotion and commitment to meeting their medical needs, doctors must avoid any intimation of judging a patient unworthy of care. Because doctors need their patients to trust that the intimacy of the doctor-patient relationship has no sexual overtones in spite of the revelation, nudity, and touching, doctors must maintain nonsexual regard in their patient interactions. Because doctors need patients to divulge intimate personal details about their behavior and history in order to make accurate diagnoses and develop treatment plans, patients must be able to trust their doctors to uphold confidentiality and only share medical information with other professionals on a need-to-know basis. These duties are explained and illustrated with numerous case examples.

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