Foundations of Healthcare Ethics Theory to Practice

In the last decade, there has been a resurgence of utilising a Kantian theoretical approach in healthcare ethical reasoning. Kant (1909, 1991, 1997) argues that morality does not depend on how one feels about a particular action, but rather on whether one approaches the action with a good will. Kant believes that the moral life is based purely and simply on duty or obligation, and not on a utilitarian calculation of the best consequences or on a natural law respect for the basic human goods. So Kant holds a deontological view of ethics – an ethics of duty or obligation. Kant says that the most important thing is to will to do what is rational to do, and what reason commands. He says that the principle according to which we should act is to do what we would want to be a universal law – that is, we would want everyone to act in the same way. In healthcare ethics, this means that duties and rights are taken into account in our ethical decision-making.

Kant’s deontological approach to ethics

Kant’s main discussion of ethics can be found in Groundwork for the Metaphysics of Morals (1997), The Critique of Practical Reason (1909) and The Metaphysics of Morals ((1991). The first of these is generally taken to encapsulate Kant’s novel contribution to the discussion of ethics. Throughout his work on ethics, Kant takes a contrary view to those who claim that we can determine what is morally good by an appeal to the good, which he claims we cannot know, as well as those – such as virtue ethicists – who claim that the end of ethical behaviour is happiness. The latter, he thinks, cannot adequately be established. Kant provides us with a view of ethics that he believes is based on reason, the distinguishing mark of a human being. He distrusts emotion, holding that doing what is good is an imperative of reason: the recognition of doing what is right and the will to do this, irrespective of how one feels about what one has to do.