Ideal and Nonideal Moral Theory for Disaster Bioethics

• Authors: Dónal O’Mathúna
• Languages of publication: EN

Abstracts

EN

Moral theory has generally focused on resolving ethical dilemmas by identifying ethically sound options. Whether the focus is on consequences, duties, principles or virtues, ethical cases are often approached in ways that assume morally sound solutions can be found and followed. Such ‘ideal morality’ assumes that moral goodness is always possible, leaving people confident they have done the right thing. Such an approach becomes inadequate in disaster settings where any good solution is often difficult to see. This paper examines recent work on nonideal moral theory as a useful model for disaster bioethics. This approach views moral dilemmas as situations where no choice is ideal and every option involves some element of unavoidable wrongdoing. Rather than straining for ideal answers, this approach acknowledges that sometimes the lesser of two evils is the best that can be done. Such situations inevitably lead to feelings of regret or guilt, commonly encountered in discussions of disaster bioethics. This paper explores the practical implications of nonideal approaches for disaster responders working in tragic situations.

Keywords

EN

nonideal theory; disaster; triage; emotions; personalism

• Publisher: Sciendo
• Journal: Human Affairs
• Year: 2015
• Volume: 26
• Issue: 1
• Pages: 8-17

Dates

published

2016-01-01

online

2015-12-30

Contributors

author

Dónal O’Mathúna

• School of Nursing & Human Sciences Dublin City University Dublin 9, Ireland

References

• Alexander, D. A., & Klein, S. (2009). First responders after disasters: A review of stress reactions, atrisk, vulnerability, and resilience factors. Prehospital and Disaster Medicine, 24(2), 87-94.
• Beauchamp, T. L., & Childress, J. F. (2012). Principles of biomedical ethics (7th ed.). Oxford: Oxford University Press.
• Christen, M., Ineichen, C., & Tanner, C. (2014). How “moral” are the principles of biomedical ethics? - A cross-domain evaluation of the common morality hypothesis. BMC Medical Ethics, 15(47). Retrieved from http://www.biomedcentral.com/1472-6939/15/47
• DeCew, J. W. (1990). Moral conflicts and ethical relativism. Ethics, 101(1), 27-41.[Crossref]
• Fink, S. (2010, February 23). Medical ethics in disasters. Doctors face ethical decisions in Haiti. Public Radio International. Retrieved from http://www.pri.org/stories/2010-02-23/doctors-face-ethicaldecisions-haiti
• Fink, S. (2013). Five days at Memorial: Life and death in a storm-ravaged hospital. New York: Crown.
• Greaney, A.-M., O’Mathúna, D. P., & Scott, P. A. (2012). Autonomy and choice in healthcare: Selftesting devices as a case in point. Medicine, Health Care and Philosophy, 15(4), 383-395.
• Johnstone, M.-J., & Turale, S. (2014). Nurses’ experiences of ethical preparedness for public health emergencies and healthcare disasters: A systematic review of qualitative evidence. Nursing and Health Sciences, 16(1), 67-77.
• Kalokairinou, E. M. (2016). Why helping the victims of disasters makes me a better person: Towards an anthropological theory of humanitarian action. Human Affairs, 26(1), 26-33.
• Krin, C. S., Giannou, C., Seppelt, I. M., Walker, S., Mattox, K. L., Wigle, R. L., & Crippen, D. (2010). So you want to help? BMJ, 340, 290-293.
• Lepora, C., & Goodin, R. E. (2013). On complicity and compromise. Oxford: Oxford University Press.
• Merin, O., Ash, N., Levy, G., Schwaber, M. J., & Kreiss, Y. (2010). The Israeli Field Hospital in Haiti - Ethical dilemmas in early disaster response. New England Journal of Medicine, 362(11), e38.
• O’Mathúna, D. P. (2015). Research ethics in the context of humanitarian emergencies. Journal of Evidence-Based Medicine, 8(1), 31-35.
• Petrini, C. (2010). Triage in public health emergencies: Ethical issues. Internal and Emergency Medicine, 5(2), 137-144.
• Petrini, C., & Gianotti, S. (2008). A personalist approach to public-health ethics. Bulletin of the World Health Organization, 86(8), 624-629.
• Ritchie, J. (2011). Combat medicine: When every turn is toward death. Today’s Christian Doctor, 42(3), 14-17.
• Schwartz, L., Hunt, M., Redwood-Campbell, L. & de Laat, S. (2014). Ethics and emergency disaster response normative approaches and training needs for humanitarian health care providers. In D. P. O’Mathúna, B. Gordijn, & M. Clarke (Eds.), Disaster bioethics: Normative issues when nothing is normal (pp. 33-48). Dordrecht: Springer.
• Sheather, J., & Shah, T. (2011). Ethical dilemmas in medical humanitarian practice: Cases for reflection from Médecins Sans Fronti res. Journal of Medical Ethics, 37(3), 162-165.[Crossref]
• Slim, H. (2015). Humanitarian ethics: A guide to the morality of aid in war and disaster. London: Hurst.
• Tessman, L. (2010). Idealizing morality. Hypatia, 25(4), 797-824.[Crossref]
• Tessman, L. (2009). Feminist eudaimonism: Eudaimonism as non-ideal theory. In L. Tessman (Ed.), Feminist ethics and social and political philosophy: Theorizing the non-ideal (pp. 47-58). Dordrecht: Springer.
• Van Hoving, D. J., Wallis, L. A., Docrat, F., & De Vries, S. (2010). Haiti disaster tourism-A medical shame. Prehospital & Disaster Medicine, 25(3), 201-202.
• von Drehle, D. (2014, December 22). The Ebola fighters. Time Magazine. Retrieved from http://time.com/time-person-of-the-year-ebola-fighters
• Wagner, J. M., & Dahnke, M. D. (2015). Nursing ethics and disaster triage: Applying utilitarian ethical theory. Journal of Emergency Nursing, 41(4), 300-306.
• Williams, B. A. O. (1965). Ethical consistency. Proceedings of the Aristotelian Society, Supplementary Volumes, 39, 103- 124.

Identifiers

DOI

10.1515/humaff-2016-0002