Ethical theories and their applications

¶ … Cruzan Case through a variety of medical ethical perspectives

The Consequentialist Paradigm

The ethical paradigm of consequentialism, as its name suggests, is the view that "normative properties," in other words, ethical actions in the world, should be judged upon and "depend only" upon their resultant consequences. (Sinnott-Armstrong, 2003) The Nancy Cruzan case is famous legal a 'right to die' case whereby, after Nancy Cruzan was almost killed in a car crash, "years later, Cruzan's parents wanted to withdraw the artificial hydration and nutrition that kept their daughter alive," whom was deemed 'brain dead' or in a permanent vegetative state, at the time (Healthcare ethics, 2004)

The general approach of consequentialist ethics could be applied in this case regarding the moral rightness of acts, holding that "whether an act is morally right depends only on the consequences of that act or of something related to that act (such as the motive behind the act or a general rule requiring acts of the same kind)." So long as the act, in other words, to preserve their daughter's wishes and will, even though she can no longer articulate her wishes, has good intentions, thus the will of Nancy's parents should be carried out. A consequentialist might also ad because Cruzan is in a vegetative state, because she has a poor quality of life, overall her body should be allowed to die and fulfill its natural cycle and course, regardless of the legal implications of the case. (Sinnott-Armstrong, 2003)

But "on June 25, 1990, the U.S. Supreme Court affirmed the right of the State of Missouri to demand clear and convincing evidence of a person's expressed wishes made while competent." (Healthcare ethics, 2004) Cruzan was only a young woman when she died, and had never enacted a living will, not foreseeing what could have occurred. The majority opinion of the court also held that competent patients have a constitutionally protected liberty" and interest in refusing "unwanted medical treatment" under the narrower uses of the term, but because Cruzan's own wishes could not be determined, the court feared that the case could be used to justify withdrawing support from victims who could not speak for themselves, and whose parents or legal guardians might not be so willing to uphold the unspoken interests of the patient.

Consequentialism's exclusive focus on consequences would counter that one must focus on the immediate implications of this one decision, and not extrapolate more from this one deicision, to other cases -- namely that all that matters is the consequences, ethically, of what happens to Cruzan and her family.

The Morally Relativsitic Paradigm

"Moral relativism has the unusual distinction -- both within philosophy and outside it -- of being attributed to others, almost always as a criticism, far more often than it is explicitly professed by anyone. Nonetheless, moral relativism is a standard topic in metaethics, and there are contemporary philosophers who defend forms of it." (Gowans, 2003) It is interesting to apply moral relativism to the Nancy Cruzan right to die case because one arrives at a similar end statement as the consequentialist point-of-view, but from a different dynamic and mode of reasoning. In contrast to the consequentialist, the moral relativist views moral judgments to lack any truth-value at all in an absolute or universal sense -- either in a specific, consequentialist manner, or in a generally applied terms through the law.

Thus the moral relativist would deny the importance and implications of life as an absolute value of society, saying that these statements existed simply as a question of terminology in deciding the case in legal terms. Quality of life would be arbitrary for the moral reatavist, for such a notion was dependant upon society's philosophic norms. Such moral determinants of quality would be simply part of a set of moral judgments that lack any external truth-value altogether, and were part of rhetorical justifications deemed of significance in a particular cultural context. (Gowans, 2003)

Culturally, the moral relativist might suggest, American society and law reifies choice and individual autonomy. However, in an unexpected right to die case, where the dead woman leaves no living will, such values are difficult if not impossible to uphold, and indeed are culturally constructed. The consequentialist argument rests upon and depends upon certain societal values of fitness, stressing that the means are justified by the ends, whether the ends be happiness or the vague notions of individual quality of life -- notions that the relativist stresses are indeed morally relative. But in the absence of the ability to define an absolute set of values in the case, the moral reativist would also stress the need to set values for this specific occasion, and defer to the expressed, personal needs of the family

The Alternative Buddhist Paradigm