Ethical theories are rules or systematic principles governing good behaviour. All practitioners entering a profession have the responsibility to comply with the ethical practices and conduct defined by the profession. Ethical judgments can be based on experience or on the nature or principles of reason. Ethical theories provide some of the decision-making basis for decision-making when biomedical ethics principles are involved because they represent the perspectives from which individuals seek guidance when making decisions. Each theory focuses on different points, a different decision-making style, or a decision rule such as predicting the outcome and respecting the duties toward others in order to achieve what the individual considers an ethical decision correct. In order to understand ethical decision-making, it is important for health professionals to realize that not everyone makes their decisions in the same way, using the same information and applying the same decision rules. For individuals, the ethical theory they use to guide decision-making emphasizes the aspects of an ethical dilemma important to them and leads them to the most ethically correct resolution according to the guidelines of ethical theory. Ethics, utilitarianism, rights and virtues fall into four broad categories.
First, the deontological class of ethical theories states that people must respect their obligations and duties when they are involved in decision-making when ethics is at stake. This means that a person will fulfil his or her obligations towards them, another person or with society, because the respect of one’s duty is what is considered ethically correct. Deontological theory uses rules rather than consequences to justify an action or a policy. The best-known deontological theory is that of Emmanuel Kant in the eighteenth century. “Kantianism” is a modern term that refers to a focus on homework and rules similar to Kant’s. Kant defended rules such as “do not lie”, “keep his promises”, “and do not kill” on what he claimed to be a rational motive. The rules must conform to the categorical imperative. For example, a compliance officer will always keep his promises to a friend and respect the law. A person who adheres to the ethical theory will produce very consistent decisions since they will be based on the tasks defined by the individual. Ethics contains many positive attributes, but also defects. One of the shortcomings is that there is no reason or logical basis for deciding the tasks of an individual. For example, a doctor may decide that it is his duty to always be on time at meetings. Although this seems like something good, we do not know why the person chose to do his duty.
Another ethical theory is the utilitarian that relies on the ability to predict the consequences of an action. For a utilitarian, the choice that provides the greatest benefit to the greatest number is one that is ethically correct. There are two types of utilitarianism, active utilitarianism and government utilitarianism. Act utilitarianism adheres precisely to the definition of utilitarianism as a person who performs the acts that benefits people the most, regardless of their personal feelings or the constraints of society such as laws. The utilitarian rule takes into account the law and is concerned with fairness. A utilitarian rule seeks to benefit the greatest number, but through the most just and just means available. Therefore, utilitarian rule has the additional benefit of valuing justice and including charity at the same time. To act and govern, utilitarianism has drawbacks. Although people can use their life experiences to try to predict outcomes, no one can be sure that their predictions will be accurate. Uncertainty can lead to unexpected results, making the utility decision maker implausible over time, as the choice made did not benefit most people as expected. Another hypothesis is that a utilitarian decision-maker must make concerns on the ability to compare different types of consequences against each other on a similar scale. However, it is very difficult to compare material gains, such as money, to intangible gains, such as happiness, because their qualities differ so much. A decision-maker of acts is anxious to achieve the maximum of good. Thus, the rights of an individual can be violated to benefit a greater number of people. In other words, the utilitarianism of an act does not always concern the justice, benevolence or autonomy of an individual if his oppression leads to the solution that benefits a majority of people.
In rights-based ethical theories, rights established by a society are protected and accorded top priority. Rights are considered ethically correct and valid as a large number of people approve them. Individuals may also grant rights to others if they have the capacity and resources. For example, someone can say that their friend can borrow her laptop for the afternoon. The friend who had the opportunity to borrow the laptop is now entitled to the laptop in the afternoon. A major complication of this theory on a larger scale is that it is necessary to decipher what are the characteristics of a right in a society. Society must determine what rights it wants to defend and give to its citizens. For a society to determine the rights it wants to assert, it must define its goals and ethical priorities. Therefore, for the theory of rights to be useful, it must be associated with another ethical theory that will explain in a coherent way the objectives of the society. For example, in America, people have the right to choose to be treated by religion because that right is guaranteed by the Constitution.
Finally, there is an ethical theory of virtue that judges a person according to his character rather than an action likely to deviate from his normal behaviour. It takes into account a person’s morality, reputation and motivation when assessing unusual and irregular behaviour that is considered unethical. The ethics of virtue can be perceived in the way that we feel is the “right” way to behave towards patients and colleagues. For example, a virtuous doctor or nurse would take the time to explain a patient’s treatment options and determine what he or she wanted. One of the weaknesses of the ethical theory of virtue is that it does not take into account the moral change of a person. The ethics of virtue is the name given to a modern renewal and revision of Aristotle’s ethical thought. The ethics of Aristotle, although not generally considered consequentialist, is certainly teleological. For him, the purpose of a human life is to live according to reason. This leads to “happiness” in the sense of human fulfilment. This development is obtained by the usual practice of moral and intellectual excellence, or “virtues”. For Aristotle, excellence is of two types. A moral virtue is an excellence of character, a “villain” between two vices. One of Aristotle’s virtues is courage, a means between recklessness and cowardice, which are vices. The ethic of modern virtue sets itself the task of discerning the virtues of our time. In a health facility, we want doctors, nurses to possess virtue of self-control, self-worth, generosity, compassion, discernment, integrity. Aristotle also identified a second type of excellence, the intellectual virtues, which constitute a preference for truth over lies and clarity over confusion, both in pure reason and in practice.