There has been debate as to whether healthcare professionals have the right to refuse certain treatments based on their own moral standards. What is driving this debate is abortion and whether a doctor should be obligated to perform one even when their religious beliefs are against it. The problem with this is that it is starting to spill into other areas including birth control pills and certain vaccines like Gardisal. At first, it makes sense to allow this but it is better to step back and first ask, do we want to be ruled by ethics or morals?
Ethics and Morals, though similar, are quite different. Morals are what people develop based on their personal notion of what is right and wrong. This personal notion is greatly influenced by outside perceived authority figures, such as parents, teachers and religious institutions. Human beings are taught what is right and what is wrong according to their authority figures, normally through lessons, rewards and punishments. As a person gets older, those in authority have less power and so the sense of right and wrong can start to change, especially when the person can see the nuance in the issue. This is why a 5 year old child knows that stealing a loaf of bread is morally wrong and yet a teenager might ask the question why the person stole the loaf of bread in the first place. The reason behind it can then influence whether it is then perceived as morally wrong. If the person stole it to feed starving children, the teen might see the moral obligation to feed the starving children and a higher issue than the act of stealing being a moral wrong.
Ethics is different. Ethics looks at what is a right and good life and how to live it. It seems similar but there are some key differences. One is that there is no set definition that someone can back to decide if something is ethical for general living. Though there might be a general framework in some sense, ethics does adapt as aspects of humanity adapt, such as medical breakthroughs and longer life spans (Garlikov, 2008). Many people base their morals on either a religious document or on are socially accepted. Neither of these comes into play as to what is ethical. An example of this would be that two hundred years ago it was socially acceptable to own other people, beat your children and keep lovers while married. Many people claimed to have the society, the Bible and the law on their “moral” side. Even with this, many people found these actions to be unethical for various reasons. This is why Ethics cannot allow these standard touch points to be its basis. Society, interpretations of religious documents and laws change. Ethics cannot change so easily or else it cannot claim any certain truths it might have.
Let’s look at an example. Most people deal with ethics in the abstract but the medical profession deals with it daily. Let’s say that two patients enter the ER. One patient, patient A has accused patient B of rape. The reason they are admitted is because supposedly patient A went over to patient B’s dwelling and shot them and then took a bunch of pills. The first issue to deal with is treatment. Morally some people might take issue with treating patient B because of the accusation of rape. Others might take moral issue with treating patient A because of the attempt to take both lives. Ethically, it’s a no brainer, the first tenant is to do no harm (Caplan and McGee, 2004). This is an emergency the physicians and medical staff are obligated to treat both per the medical society code of ethics.
Now time has passed and both patients are stabilized and are recovering, probably on separate floors of the hospital for security reasons. Now while working on patient B, the physicians become aware that patient B has an STD. Here is another quandary, do they inform patient A? Morally a lot of people would state yes, patient A needs to be tested and treated and therefore should be told. But ethically, the answer is no. The reason is so that patients can trust doctors and in turn feel the freedom to tell them everything. This is crucial for a doctor to diagnose and treat any patient. Even not knowing if a patient is taking a multivitamin can cause issues. Informing patient A breaks the patient confidentiality ethical code. Now does that mean the doctor does nothing concerning this for patient A? Well no, that breaks the first do no harm ethical stance. The doctor can try to get consent to test by discussing various things including that it would be wise simply because of the rape. But to inform that patient B is positive for an STD is not an option.
I could continue with this thought experiment, and cover many other ethical dilemmas those in the medical profession face every day. And that is not even touching the large ones ranging from abortion to stem cell research. But I hope this thought experiment helped to highlight the main difference between morals and ethics. Like the difference between the 5 year old and the teenager, there is a maturity difference between morality and ethics. Ethics goal is to predict the consequences to the actions on not only the people involved, but also all those who can be impacted by the action in question, in essence the ripple effect. Because of the much larger scope, ethics will come to different determinations from a personal moral approach on occasion. They are not mutually exclusive by any stretch, but will head down different paths on occasion. This is because ethics will stop and ask questions that a moral standpoint might not ask ranging from what if the accusation proves to be false, what if patient A is mentally ill and therefore not aware of their actions or the consequences from them, etc. Though these might not be true, they need to be considered or else not only will patient A and B’s lives be forever changed, but everyone in their lives will be impacted.
References:
Garlikov, R. (2008) The Point of Studying Ethics. Retrieved from
http://www.garlikov.com/philosophy/ethpoint.htm
Caplan, A. and G. McGee. (2004). An Introduction to Bioethics. BioEthics. Retrieved from
http://www.bioethics.net/articles.php?viewCat=3&articleId=1