Applied Ethics: Medical Ethics Revision Notes
Subject: Religious Studies | Level: A-Level | Exam Board: WJEC
This study guide delves into the contentious field of Medical Ethics for WJEC A-Level Religious Studies, focusing on abortion and euthanasia. It provides a detailed analysis of the critical tension between the Sanctity of Life and Quality of Life, equipping students to apply complex ethical theories with the precision required by examiners.
Revision Notes & Key Concepts
Key Terms & Definitions
- Sanctity of Life
- The belief that human life is sacred, holy, and has intrinsic value from conception to natural death.
- Quality of Life
- The idea that the value of a life is not intrinsic but depends on its quality, including factors like happiness, autonomy, and consciousness.
- Personhood
- The philosophical status of being a 'person', often defined by criteria such as rationality, self-consciousness, and the ability to feel pain.
- Doctrine of Double Effect
- A principle in Natural Law that permits an action that has a foreseen but unintended negative consequence (e.g., death), provided the original intention was good.
- Agape
- Unconditional, selfless love. The sole guiding principle in Joseph Fletcher's Situation Ethics.
- Preference Utilitarianism
- A form of utilitarianism, associated with Peter Singer, which argues that the right action is the one that maximizes the satisfaction of the preferences of those involved.
Worked Examples
Worked Example
Question: Explain the application of the Doctrine of Double Effect to the issue of euthanasia. (12 marks)
Solution: **Introduction**: The Doctrine of Double Effect is a principle within Natural Law ethics that allows for an action with a negative consequence, provided the intention was good. It is particularly relevant in end-of-life care, where it creates a moral distinction between permissible pain relief and impermissible killing. **Paragraph 1 - The Principle Explained**: The doctrine, often attributed to Aquinas, states that for an act to be moral, four conditions must be met: 1) The act itself must be morally good or neutral. 2) The good effect must be intended, not the bad effect. 3) The good effect must not be produced by means of the bad effect. 4) There must be a proportionally grave reason for permitting the bad effect. In the context of euthanasia, the act of administering strong painkillers (like morphine) is in itself a neutral act. **Paragraph 2 - Application to Palliative Care**: A doctor administering high doses of morphine to a terminally ill patient in extreme pain is a classic example. The doctor's primary intention is to relieve the pain (a good effect that follows the precept of preserving life by caring for it). It is foreseen that these high doses may also suppress the patient's respiratory system and shorten their life (a bad effect). However, according to the doctrine, this is morally permissible because the death is an unintended, secondary consequence. The intention was not to kill, but to manage pain. **Paragraph 3 - Distinction from Euthanasia**: This is critically different from active euthanasia. If a doctor were to administer a lethal injection with the primary intention of ending the patient's life, this would be a direct violation of the primary precept to preserve life. The Doctrine of Double Effect cannot be used to justify active euthanasia, as the intention would be to bring about death. This distinction allows Natural Law to maintain its absolutist stance against murder while allowing for compassionate palliative care. **Conclusion**: The Doctrine of Double Effect provides a crucial ethical framework for Natural Law, allowing it to navigate complex medical situations without abandoning its core principles. It draws a clear line between the permissible act of alleviating suffering, even at the cost of life, and the impermissible act of intentional killing.
Worked Example
Question: ‘Situation Ethics is the most compassionate approach to abortion.’ Evaluate this view. (20 marks)
Solution: **Introduction**: This essay will evaluate the claim that Joseph Fletcher's Situation Ethics provides the most compassionate framework for addressing the issue of abortion. While its flexibility and focus on personal circumstances appear compassionate, I will argue that its lack of clear principles can lead to unjust outcomes, and that a 'Weak Sanctity of Life' approach may offer a more balanced compassion. **Paragraph 1 - The Case for Situation Ethics**: Situation Ethics, with its guiding principle of *agape*, is inherently compassionate. It rejects the rigid legalism of theories like Natural Law, which condemns abortion in all but the most indirect cases. Fletcher would argue that in a situation of rape, severe disability of the foetus, or a threat to the mother's life, forcing the pregnancy to continue is unloving. By applying the principles of Pragmatism and Personalism, Situation Ethics focuses on the real people involved and seeks the most loving result for them, which could well be abortion. This appears deeply compassionate. **Paragraph 2 - The Critique of Situation Ethics**: However, the subjectivity of 'agape' is a significant weakness. Who decides what is 'loving'? The theory could be used to justify abortion for trivial reasons, such as not wanting to disrupt a holiday. This lack of objective criteria could be seen as a failure to protect the vulnerable foetus. Furthermore, some critics, like Pope Pius XII, condemned Situation Ethics as being individualistic and ignoring the objective moral law established by God. This suggests its compassion may be selective and ultimately flawed. **Paragraph 3 - Alternative Approaches (Natural Law & Utilitarianism)**: Natural Law, while seemingly uncompassionate with its absolutist stance, would argue that true compassion involves upholding the sacred value of all life. Its clarity and consistency could be seen as a strength. Utilitarianism, particularly Singer's Preference Utilitarianism, offers a different kind of compassion based on reason. It would weigh the preferences of the woman against the non-existent preferences of the foetus, arguing that the most compassionate outcome is to respect the woman's autonomy. However, this can be seen as cold and calculating, reducing the moral status of the foetus to zero. **Paragraph 4 - A More Balanced Approach?**: A 'Weak Sanctity of Life' position, which accepts that life is precious but not absolute, may offer a more holistically compassionate approach. It allows for abortion in difficult circumstances (like the Abortion Act 1967 permits) but maintains that life should not be ended for frivolous reasons. This balances compassion for the woman with a respect for the potential of the foetus, avoiding the extremes of both absolutist Natural Law and relativistic Situation Ethics. **Conclusion**: In conclusion, while Situation Ethics' focus on love is appealing, its lack of clear guidance makes it a problematic candidate for the 'most compassionate' approach. Its subjectivity can be a flaw, not a feature. A 'Weak Sanctity of Life' position, which acknowledges the tragedy of abortion while permitting it in hard cases, arguably provides a more robust and ethically consistent form of compassion that recognizes the complex web of duties and relationships involved.
Worked Example
Question: Explain the legal framework governing abortion in the UK. (12 marks)
Solution: **Introduction**: The legal framework for abortion in the UK is primarily defined by the Abortion Act 1967, which was later amended by the Human Fertilisation and Embryology Act 1990. These acts establish the conditions under which an abortion can be legally performed, moving from a position of illegality to one of regulated access. **Paragraph 1 - The Abortion Act 1967**: This act legalized abortion in Great Britain (but not initially Northern Ireland) on certain grounds. It requires the agreement of two registered medical practitioners that the abortion meets one of the specified criteria. The key criteria include: the continuance of the pregnancy would involve risk to the life of the pregnant woman; or risk of injury to the physical or mental health of the pregnant woman or any existing children of her family, greater than if the pregnancy were terminated. The act originally set a time limit of 28 weeks. **Paragraph 2 - The Human Fertilisation and Embryology Act 1990**: This act significantly amended the 1967 Act. Its most important change was to reduce the main time limit for abortions from 28 weeks to 24 weeks of gestation. This was based on medical advancements showing that a foetus could be viable at 24 weeks. However, the 1990 Act also introduced exceptions to this 24-week limit. Abortions can be performed after 24 weeks in specific, grave circumstances, such as to save the mother's life or if there is a substantial risk that the child would be born with a severe physical or mental disability. **Paragraph 3 - The Current Situation**: Therefore, the current legal position is that abortion is legal up to 24 weeks if two doctors agree it meets the health-based criteria. After 24 weeks, it is only legal in very limited and serious situations. It is important to note that the law does not grant abortion 'on demand'; the medical criteria must be met. This legal framework reflects a 'Weak Sanctity of Life' position, balancing the woman's well-being against the increasing moral status of the foetus as it develops. **Conclusion**: The UK's legal framework for abortion, established by the 1967 Act and refined by the 1990 Act, provides a regulated system for accessing abortion. It is based on medical and health grounds, with a standard time limit of 24 weeks that can be waived in exceptional circumstances. This demonstrates a pragmatic legislative attempt to balance competing moral claims.
Practice Questions
Question: Explain the concept of 'personhood' in the debate about abortion. (12 marks)
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Question: ‘Natural Law is not helpful when dealing with the issue of euthanasia.’ Evaluate this view. (20 marks)
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Question: Explain how a follower of Situation Ethics might respond to the issue of abortion. (12 marks)
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Question: To what extent is Utilitarianism a good ethical theory for making decisions about euthanasia? (20 marks)
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Question: Explain the main arguments for and against the Sanctity of Life principle. (12 marks)
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