[Book Review of] Medical Ethics: The Moral Responsibilities of Physicians , by Tom L. Beauchamp and Laurence B. McCullough
Year: 1986
Type: book-review
Abstract: This book attempts to analyze many contemporary problems in medical eth ics according to the norm s estab li shed by the principles of beneficence and autonomy.The a uthors contend that neither beneficence nor autonomy is sufficient to determine the ethically correct courses of action in va rious insta nces , and they a rgue in behalf of the dominance of the principle of beneficence limited by the principle of autonomy .Autonomy and beneficence are primafacie principl es which can be overridden by other moral principles.but ordinarily cons id erations of utilit y or good consequences justify overriding these principles.They argue that the principle of beneficence mu st be weighed against variou s goods and harm s caused by medical intervent ions , and this reduces to a uti litarian or co nsequentiali st reduction of the moral principles.The fundamental problem with this book is that the notions of benefice nce and autonomy are mad e to carry too much freight, and more principles are needed.The authors admit that the autonomy-based model has crept into American medicine since 1972 and they appear to be uncomfortable with this development.The autonomybased model is a clear rejection of th e con ve nant-ba sed mod el espoused by Paul Ramsey, and the autonomy model in practice tends to eliminate the duties and ~bligations to care for and treat patients.If pure contentless patient autonomy is the model for decision-making.the phys ician ha s no rights before the patient.The "therapeutic privilege" may be in vo ked .but how it wou ld fare is not at all clear.Another fundamental problem with this theory of ethics is that medical-ethical problems are becoming more and more complicated and , des pite this fact.their theory is excess ively simpli stic and formal.There is no material content give n to either the principles of beneficence or of autonomy.and the authors refuse to articulate any " middle principles" which wou ld give material content to these principles.The result is that their application is highly co lo red by social and cultura l biases.In an age of increasin g et hical co mplexity, this trend to mak e et hical theory purely formal and abstract should be inhibited rather than promoted.This book traces the hi story of these two principles and aims at determining what courses of action are ethica lly appropriate in various so rt s of "hard cases".The foundation for the beneficence model in the Hippocratic Oath is mentioned.but the force of the Oath is discounted by an assertion that it was an Oath adopted by a small religious sect a nd that the Oath was in conflict wit h itself because doing good so metimes required doing harm.The authors complete ly ignore the medieval and high scholastic periods of ethics and moral theo logy where fundamental and derived moral principles were given clear and specific
Author: Robert Barry
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2993382954