PubMed · 8699382
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P A Morrin. Ethical issues in nephrology.. https://pubmed.ncbi.nlm.nih.gov/8699382/
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Philosophical disagreement about justice rages over at least two questions. The most immediate is a substantial question, concerning the conditions under which particular distributive arrangements can be said to be just or unjust. The second, deeper, question concerns the nature of justice itself. What is justice? Here we can distinguish three views. First, justice as mutual advantage sees justice as essentially a matter of the outcome of a bargain. There are times when two parties can both be better off by making some sort of agreement. Justice, on this view, concerns the distribution of the benefits and burdens of the agreement. Second, justice as reciprocity takes a different approach, looking not at bargaining but at the idea of a fair return or just price, attempting to capture the idea of justice as equal exchange. Finally justice as impartiality sees justice as 'taking the other person's point of view' asking 'how would you like it if it happened to you?' Each model has significantly different consequences for the question of when issues of justice arise and how they should be settled. It is interesting to consider whether any of these models of justice could regulate behaviour between non-human animals.
Vaccines against human papillomavirus (HPV) may soon be licensed. In contrast to most vaccine-preventable diseases, which are transmitted by air or casual contact, HPV is primarily transmitted by sexual contact. An analysis that applies ethical theories, such as utilitarianism, rule of double effect, and principlism, is needed for policy considerations. These analyses reveal that HPV vaccination can be recommended universally, including at ages 11-12 years. However, given concerns for autonomy, justice, as not all persons are at risk, and non-maleficence, HPV vaccine should not be mandated for school entry. Economic justice indicates a need to provide vaccination for the disadvantaged.
Professional responsibility provides the groundwork for medicine since the existence of the Hippocratic Oath. Physicians must be prepared to justify their decisions and actions, based on scientific issues but also considering the underlying professional responsibilities. Ethical theories form a major part of such justification. A number of competing ethical theories may be identified. The maximal, minimal and excellence ethical theories agree with our experience with moral uncertainties. But veracity ethics is a new form of answering moral questions. Clinical situations are unavoidably conflictive. Lucid understanding of the necessary character of these conflicts leads to self-recognition and the itinerary of veracity ethics runs from misunderstanding to recognition. The self-awareness that veracity offers to physicians is difficult and painful due to the narcissistic humiliation that it inflicts on them.