Ethical questions are central to health care practice. What is a just allocation of health resources? Who ought to receive treatments if resources are limited? Ought we to use eggs from aborted fetuses for infertility treatments? Ought requests for voluntary euthanasia be granted? Under what circumstances is it justifiable to use individuals for medical research? Who ought to take health care decisions? These examples, which are by no means exhaustive, are illustrative of the important dilemmas that are faced in health care.
It is important to realise just how pervasive ethical issues are. Even the naming of the recipients of health care as 'patients' or 'clients' has ethical implications. Accordingly, throughout this book the authors have used the term 'individual' to refer to the recipient of health care in order to avoid prejudging the nature of the relationship between health care practitioners and the recipients of health care.
In addition to being designed as a foundation textbook for all health care courses and applied moral philosophy courses, a feature of this book is the authors' argument for the positive thesis that decision making in health care should be a matter of participation between members of the health care team and the individual receiving treatment. The importance of the autonomy of the individual is taken as central and a paternalistic model of decision making is rejected. This centrality of the consumer in the decision-making process highlights the importance of a consideration of the rights of individuals receiving treatments.
It is argued that a knowledge of ethical codes of conduct is not sufficient to answer the sort of important ethical questions illustrated above. Rather, a detailed analysis of the Principles of Autonomy, Justice, Beneficence and Non-maleficence are needed to assist reflection on these issues.
These principles and the differing justifications that are offered for them within consequentialist and deontological theories are considered in Section 1. Section 2 of the book considers the detailed application of these principles to contemporary health care dilemmas. The first part of this section addresses life-and-death issues and the second part concentrates on issues of daily practice. Within these sections, Jane Singleton, a lecturer in philosophy, wrote Chapters 1-11 and Susan McLaren, a nurse, wrote Chapters 12-17. This combination of two disciplines is seen as particularly valuable in this area where both an understanding of the philosophical issues and an awareness of health care practice are crucial.
In order to assist cross referencing between the philosophical discussion of the ethical principles and their application, a numbered system of cross referencing is used. The first number refers to the chapter number and subsequent numbers to the sections within that chapter. In addition, certain material is repeated in order to clarify the exposition.