Next we turn our attention to duty based ethics, also known as deontology (from the Greek ‘deon’ meaning duty), which is heavily influenced by the work of Immanuel Kant (1724-1804). Whilst consequentialist ethics bases what is morally right or wrong on the consequences of the action, duty based ethics claims that there are certain actions which are morally right and wrong regardless of the consequences they bring about. Kant claimed that we ought to act in accordance with a universal moral law. Furthermore, he introduced the concept of categorical imperatives. These are universal moral laws which ought to be followed regardless of our own motivations or desires. You can find the full text of Kant’s Groundwork for the Metaphysics of Morals by clicking here.

Duty based ethics is often seen as a series of rules which it is our duty to follow. In healthcare, these come in the form of professional standards or duties. These rules, or duties, outline our obligations to our patients, to our peers and also to ourselves. They can be seen as the tenants of our conduct and professionalism. A simple and universal example of this in practice is the professional duty to ‘first, do no harm.’ 

Whilst this seems like an intuitively straightforward guide to medical ethics it is not without fault and we will now look at some of the drawbacks. During the Covid-19 pandemic, the difficulty clinicians faced is assessing which patients to admit when resources were stretched to capacity. In such cases, they were being required to triage patients and assess whether they should be treated. The challenge this poses to healthcare professionals is that it can lead to ethical duties coming into conflict. On the one hand our ethical duty is to do good (beneficence) and help patients as much as possible. On the other hand, with resources stretched we are having to consider whether we can do this for each patient on an individual level or whether we should refuse treatment for the benefit of others (healthcare justice). This is something which is a criticism of duty based ethical frameworks in general. They do not, in most cases, give us a way of ranking or prioritising our duties when such conflict occurs. 

Another criticism of this model is that the rules prescribed can be too rigid and inflexible. A famous example of this can be seen in Kant’s views on lying. Kant believed that we should not lie under circumstances and that this was a rule that could not be broken regardless of the consequences. He gave the following example in the video below: 

For a Summary of Duty Based Ethics Check out the Videos Below!

For more information on duty based ethics follow the links below:

https://plato.stanford.edu/entries/ethics-deontological/

https://plato.stanford.edu/entries/kant-moral/

https://www.iep.utm.edu/ethics/