Tuesday, October 28, 2008

Physicians of integrity..

I intend to be a Physician with integrity and character. That is, I don't intend to mislead my patients. I do intend to at the same time my autonomy and theirs. That is, they may choose whether or not to permit my course of treatment or may choose from a less desirable option so long as I'm permitted the freedom to consent as well. This all comes from a more or less libertarian philosophy that people have the freedom to choose what is done to them (granting some exceptions, like children, emergencies, and the mentally unstable) as well as the freedom for Doctors to choose when it comes to non-elective procedures.

This all, of course, relies on a Doctor's commitment to "first, do no harm" and to do to the best of my ability "for the good of my patients".

These are ethical statements. These are philosophical positions that we take as Physicians that are far more fundamental to the profession than biochemistry and physiology.

I'm not the sort of person that accepts big concepts arbitrarily. Surely these ethical principles come from somewhere... but where do they come from?

I think that in order for people to be good Physicians, they must at one point question how we can come to know what is "right" and what is "wrong". Without any concept of this, then how can we take the Hippocratic Oath with any intellectual honesty?

This question is too big for a single entry, much less a blog, to discuss. But I think it is worthwhile talking about a few of the wrong answers to the question of ethics.

Wrong answer #1 There is no absolute morality. It is relative to upbringing, culture, the powerful, etc (insert justification). Why do I think this is wrong? The simple answer is that it fails the law of non-contraditon. That is, in order for the statement to be true it would have to be false. Isn't stating that "morality is relative" in itself a relative statement?

Secondly, I don't think a whole lot of people really believe in moral relativism. The easy way to convince people of this is to do something they might not like, like kick them in the shin. "That wasn't nice!" they might respond. "Well according to your morals it wasn't right. But according to mine, it was morally just." This is a trite example, you could get more complex, but you get the point.

Wrong answer #2 We get our morals from God (or some other transcendent law-giver). Now, my problem isn't if the morals themselves are somehow transcendent or metaphysical in nature, but with the idea that there is some being... some moral law-writer.

Here's why: Is something "good" or "right" because God commands it? Or does God command it because it is "good" or "right"?

If the latter is true, then "good" exists outside of the supposed "law giver". However, if the former is true, then morality is relative to God's Will. So that if God asked us to kill our kid (a la Abraham) it would be a "good" thing. Also it doesn't follow that just because the law giver can't do wrong if we define what he/she does as "good" that he/she "won't" do (by our understanding) evil.

Then again, none of this is a big problem. Because in order to take this question seriously, you've got to presuppose that there is a God. Since you can't prove this presupposition, our concept of "good" and "evil" is suddenly outside of our realm of knowledge.

I feel so Greek.

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