ABSTRACT
Along with scientific knowledge, moral issues and value judgements have always been a very important part of medical practice. Over the last 250 years these issues have been analysed and two fundamental theories on medical ethics have been particularly influential in Western medicine:
Consequentialism (utilitarianism): Simplified, this asks for the consequences of each action to be addressed and that with the foreseeable most favourable consequence is the best path to follow. The most favourable consequence is one where there is the least human suffering and the most happiness.
Duty-based ethics (deontological): This theory dictates that we are duty-bound to certain actions in our medical practice irrespective of the consequences. For instance, it is important to always be honest with our patients. In contrast, a utilitarian may argue that it is better to lie to a terminally ill patient about their prognosis if the truth is likely to add to their suffering.
In real life, often the two theories coexist in medical practice. For instance, it is often important that we tell the patient the truth about a terminal diagnosis. However, we may not be absolutely frank about their prognosis. I've often heard colleagues, when directly challenged, say things like, '... I'm sorry I don't have a 2crystal ball that tells me the future', or even, 'Well how long is a piece of string?'