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Chapter: Paediatrics: Paediatrics, ethics, and the law

Paediatrics: Ethics

The development of ethical frameworks has a history as long as medicine itself.

Ethics

 

The development of ethical frameworks has a history as long as medicine itself. Today, ethical traditions can be broadly categorized into three tradi-tions:

·  virtue ethics;

·  deontology;

·  consequentialism.

 

More recently, principlism has been proposed as a unifying approach.

 

‘Virtue ethics’

 

Often associated with the tradition of Aristotle and emphasizes the char-acter and moral behaviour of the person or agent. Aristotle proposed nine key virtues: wisdom; prudence; justice; fortitude; courage; liberality; magnificence; magnanimity and temperance.

 

‘Deontology’

 

Most commonly associated with Immanuel Kant who formulated the con-cept of the categorical imperative. The tradition emphasizes individual dig-nity, truth telling, non-malefi cence, benefi cence, and autonomy. The good will and motive of the individual determine the rightness of the act.

 

‘Consequentialism’

 

In contrast to deontology, emphasizes that the rightness of an action is determined by its consequences. The tradition is often associated most with the utilitarians such as Jeremy Bentham.

 

‘Principlism’

 

Traces its origins to the Nuremberg Code (1948), the Declaration of Helsinki (1964), and the Belmont Report (1979) all of which focus on research on human subjects. Beauchamp and Childress have championed moral decision-making in medicine based on principlism emphasizing four moral attributes: autonomy, non-maleficence, beneficence, and justice.

 

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