October 2, 2009
NURSING ETHICS – LECTURE 3
I – Ethical Theories
• We have begun the course with an inquiry into theoretical ethics.
• What theoretical framework should govern the examination of ethical
• This is a normative project: what norms, principles, or standards ought
to govern the moral propriety of actions?
• Before we can begin to examine ethical issues or dilemmas that arise
in particular healthcare situations, we need one or more theoretical
frameworks to apply to these dilemmas.
• Last week, we discussed one ethical theory: utilitarianism.
• Utilitarianism: actions that maximize utility (bring about the most
utility for the most amount of people) and minimize disutility are
• This week, we will look another important ethical theory: deontology
(or Kantian ethics).
• Next week we will look at another prominent ethical theory: virtue
II – Deontology
• Immanuel Kant (1724-1804) was a highly influential German
philosopher of the 18 century.
• His importance in the history of philosophy is enormous.
• His contributions were mostly in the areas of epistemology,
metaphysics, aesthetics and ethics.
• As far as ethics goes, Kant was the first to propose the theory known
• Deontology, like all normative ethical theories, attempts to supply us
with norms to govern the moral propriety of actions.
• ‘Deontic’: duty or obligation based.
• ‘Logos’: logic or rationality.
• Kant’s deontological theory views ethics as being based on a logic of
• We will first go over the central features of this theory, and then some
virtues and drawbacks of it.
III – Deontology: Central Features of the Theory
• The first main feature of Kant’s deontological ethical theory is that it
is a duty-based theory.
• This implies that it contrasts with consequentialist theories.
• Consequentialism: the moral justification of actions is assessed based
on the consequences of those actions.
• Unlike any version of consequentialism, deontology does not morally
assess actions based strictly on their consequences.
• Rather, actions are primarily morally assessed in and of themselves.
-Is the action itself a good one?
-More specifically, for the deontologist, the question is not whether
the action has the right kinds of consequences but whether it is done
for the right kinds of reasons.
• The question is, what does it mean for an action to be performed for
the right reasons?
-For the deontologist, an action performed for the right reasons is an
action that one has a duty to perform.
-Generally speaking, if one acts out of a sense of duty, they are acting
for the right reasons.
• Now we might ask, what does Kant mean when he says that we need
to act ‘out of a sense of duty’ to be acting in a morally praiseworthy
-The simple answer is that we need to act in accordance with the
maxim that we treat every person as an end in him or herself and
never merely as a means to our own ends.
• As we will see, it is quite complex how this kind of maxim is
supposed to govern the propriety of moral actions, but let’s leave
aside that point for now.
• Another feature of Kant’s deontological ethical theory is that it is
• Utilitarianism, we’ve seen, is in a sense not based on reason.
• True, we need to calculate the expected utility of an action in a
rational manner to assess its moral status.
• But ultimately what enters into the utilitarian calculus are not reasons
but inclinations desires, pleasures, preferences.
• Inclinations would appear to be psychological rather than logical or
• Kant, on the other hand, claims that the moral assessment of actions
has a rational basis in the form of the duty-based reasons (i.e., logical
reasons) we have to perform certain actions and to avoid certain
• Kant claims that once we look at what reason dictates our duties are,
we isolate a rational basis for the moral assessment of actions.
• The third main feature of Kant’s deontology is that it holds that the
moral assessment of actions has an objective basis.
• This goes hand in hand with the second feature.
• The moral assessment of actions is supposed to be based on the logic
• Duty is supposed to provide us with reasons, to govern the moral
assessment of actions, which are rational (by definition) and objective
they apply universally.
• One way to see this point is to take a look at what Kant claims is the
rational and objective test for the moral propriety of any action.
• Kant claims that for an action to be morally beyond reproach, the
action needs to be universalizable in the sense that it can be willed as
a universal law.
E.G.: I must only keep my promises when they benefit me.
-This cannot be universalized without contradiction.
-It undermines the practice of promise-giving (no one would put
stock in promises).
E.G.: one should never lie.
-Kant calls this a ‘categorical imperative’.
-It tells us what to do in all situations.
-This can be universalized, at least wit