Two Opposing “Moral” Orders: Who to Respond to?
In The Medical Profession As A Moral Community, Pellegrino argues that a main dilemma of professional ethics that the physician faces is “an unenviable choice between two opposing moral orders, one based in the primacy of our ethical obligations to the sick, the other in the primacy of self-interest and the marketplace” (Pellegrino 221). To clarify, physicians are forced to choose between focusing on aiding sick individuals versus helping benefit the marketplace, which can be more or less looked at as the debate between beneficence and self-interest. I believe that physicians should focus on the ethical obligations of the sick, both because pursuing an act of self-interest is immoral and is not always noticeable in the grand scheme of things.
What would a moral order be comprised of? In my opinion, a moral order would have to originate from a moral community, whose “members are bound to each other by a set of commonly held ethical commitments and whose purpose is something other than mere self-interest” (Pellegrino 225). If conforming to the character of the market “legitimates self-interest over beneficence and makes vices out of most of our traditional virtues” then how could it be moral? (Pellegrino 221). We could further argue the statement that, “medicine is at the heart a moral enterprise and those who practice it are de facto members of a moral community” (Pellegrino 222). Yes, medicine is intended to be moral but the focus can vary from self-interest to beneficence; hence, this does not ensure that a moral community exists or that moral enterprise is taking place. Similarly, when physicians speak about medical procedures, we cannot to prove they are acting in any way besides their self-interests, also showing that medicine does not guarantee morality.
Another good reason to stand firm on the belief that being a physician imposes certain necessities that impede turning ourselves primarily to entrepreneurs or businessmen is that individual aid is seen on an individual level; whereas acts reflecting the economic policy may go unnoticed. If an individual was aided economically in disease-treatment, beneficence is much more prevalent than if an economic policy arose that attempted to increase health for all, but truly did not make an impact. Since, beneficence is defined as, “an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation,” responding to those in need is clearly moral. (Kisinger 44).
In conclusion, the ethical obligations to the sick should take precedence in the “who to respond to” debate, because of one: the morality associated with helping those in need and two: the concept of making a difference in an individual’s life. Business-like, fiscal behavior can be understandable for economic reasons during times of deficits; however, when we look at the larger picture, beneficence and morality represent what medicine should consist of.
1.) Kisinger, Frank Stuart. “Beneficence and the Professional’s Moral Imperative.” NCBI. N.p., Dec. 2009. Web. 19 Apr. 2014. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342811/>
2.) Pellegrino, Edmund D. “The Medical Profession As A Moral Community.” N.p., May 1990. Web. 19 Apr.2014.