The video episode “22 Moral Dilemmas Can Ethics Help?” depicts peculiarities of medical care of premature infants in the light of various moral dilemmas (Van Ravenswaay and Jurna). Infants’ parents, as well as doctors, have to make crucial decisions whether to fight for their lives or let them die. They have to decide if it is worth fighting if there is a strong possibility that these children will face the life of suffering and disability. The film approaches these moral dilemmas from the perspective of several ethical positions, but does not give a clear-cut solution because it simply does not exist.
The film starts with Kant’s categorical moral imperative, under which the highest value is human dignity. The consequences are not important if people are loyal to their sense of duty and morality and have a good intention. This theory is also called deontological. Under this ethical position, people should apply only those principles that can become universal laws. In the context of this particular medical case, doctors should ask themselves what they (or anyone else) would want if they were in the place of the child. They should also respect the human dignity of the prematurely born infant and give it a chance to become an independent person. However, focusing on the interests of the child does not necessarily mean saving it because it is probably not in the interests of the infant to become fully dependent on others (Van Ravenswaay and Jurna). Thus, even one theory shows that there are a lot of conflicting motives in this moral dilemma. The full consideration of the case requires an insight into other ethical theories.
According to consequentialism, the consequences of the action are the main factors that define its’ value and morality. Within the framework of utilitarianism, the form of consequentialism, people should pursue those actions that will produce the greatest good and the least harm to the greatest number of people, estimating the costs and benefits for society. Therefore, according to this theory, doctors should not only think about the infant and the parents, but also about how this decision will affect society and all the parties involved. They will have to think about the overall social harm and benefit: whether saving infants will create a problem for the healthcare system or for other patients, which will not get the same level of treatment anymore (Van Ravenswaay and Jurna). Although utilitarianism aims at achieving the greatest good, sometimes it does so by diminishing personal tragedies of particular people, in this case parents, infants, and doctors.
Another form of consequentialism, ethical egoism, claims that people should act in accordance with their self-interests. Only consequences that are beneficial to the doer should be taken into account in decision-making. It does not mean that agents should harm others, but they are not obliged to do them good either; they also should differentiate between short-term pleasures and long-term benefits (Thiroux and Krasemann 36-41). From this point of view, doctors and parents should do what they want without even considering social implications or the future destiny of the infant.
Virtue or Aristotelian ethics puts virtue and the human character in the center of every moral dilemma. The ultimate goal of every individual is to live a full happy life. All human values and activities are entwined. Therefore, people should think of what kind of behavior virtues require in this particular situation and how their actions will affect the virtues of people involved. For instance, doctors who allow the child to die may become less compassionate or more disheartened. On the other hand, doctors and parents should think about opportunities that this child can have in the future. According to the virtue ethics approach, if patient’s possibilities are so reduced that they cannot lead a full life, people will not consider them humans, but still have to take care of them. Aristotle admitted that there are no absolute categories or universal rules, and every situation is complex and unique (Van Ravenswaay and Jurna). People should do their best to achieve the most reasonable decision, taking into account all peculiarities and contradictions. In medicine, it means that doctors should do their best in treating each patient on an individual basis.
All these theories suggest important issues for consideration, but they do not offer a definite solution. There is simply none in such complex and dramatic situations. All people involved should engage in an honest discussion to reach the most reasonable and acceptable decision, with which they can live and embrace consequences of their actions. It is impossible to do everything right, but it is possible to choose the position and act according to it knowing that the one did everything he or she could.
