76

CMF FILE

A VERY SHORT
INTRODUCTION TO ETHICS
Trevor Stammers shows the relationship of the key Trevor Stammers
is a Former Associate Professor
theories of ethics to Christ and the Christian faith. of Medical Ethics at St Mary’s
University

I t’s hard to deny that some things

are morally right and others wrong.
Those claiming they don’t believe in
objective morality soon backtrack
when a perceived injustice is done to them!
Moral realism is the view that ethical claims
report facts and are true claims if they get
limited number of virtues. What would be
the extremes, for example of the virtue
of love? Nevertheless, virtue ethics
emphasises that we can get a good
outcome from actions arising from our
ethical decisions, and yet still have
unethical motives. Doctors’ motives for
feels the same way. This, however, is to
focus on feelings rather than reason. Also,
to introduce a caveat such as ‘if they were
suffering unbearably’, is in Kantian thought,
a hypothetical rather than a categorical
imperative. Hypothetical imperatives
always have an explicit or implied ‘if’ in their
those facts right. better care of some patients rather than formulation. Suicide, murder, and lying are
In practice, ethical decisions are often others can have a similar spectrum of always wrong for Kant; the formula of
made based on many factors, such as motivations. Virtue ethics emphasises ‘universal law’ is exactly that – it must
feelings, social pressure, conscience, or that motives matter in ethics. always apply across the board.
predicted outcomes. Acting on such factors
may or may not lead to appropriate ethical deontological ethics utilitarian ethics
responses but in medicine we need to make Deontological ethics (meaning rule-based Most contemporary medical moral
ethical decisions in a grounded way. This rather than God-based) is associated with decision-making, especially in resource
whistle-stop tour explores the best-known Immanuel Kant (1724-1808), allocation, is utilitarian in
ethical models, followed by a Christian a Prussian polymath best nature. Rather than asking
appraisal. known for his formulations ‘what is the rule?’ most
of the famous ‘categorical Doctors’ contemporary bioethicists
historic ethical frameworks imperative’ (CI). The most motives for focus on ‘what is the
There are three major historical ethical frequently well-known outcome?’
frameworks, and one more modern expression of Kant’s CI is the better care The ethics of utility is
framework that we will consider. formulation of ‘universal of some usually attributed to Jeremy
law which is (in my own Bentham (1748-1832).
virtue ethics paraphrase), ‘Act on the
patients rather The central idea is that
Virtue ethics dates back to Aristotle principle that at the same than others ‘the greatest happiness of
(384-322 BC). Virtue ethics, rather than time, you can will everyone the greatest number’ 1 is the
can have a ...
focusing specifically on what is the right else to act upon as well’. measure of right and wrong.
thing to do, instead asks what sort of moral This principle is often spectrum of Whilst this at first sounds
character we ought to cultivate in order to misapplied in contemporary motivations reasonable, and certainly
flourish as human beings. It focuses on the medical ethics. For example, appealing, it soon runs into
motive for our actions rather than on the Kant considers suicide is obvious difficulties, as not
actions themselves. unethical because, even if all forms of pleasure are
Aristotle’s view of the virtues was that you yourself desire it, you cannot also of equal value to everyone. Bentham’s
they always lay in a mean between two reasonably want everyone else in the world follower, John Stuart Mill (1806-1873),
extremes of corresponding vices. For to kill themselves as well. Sometimes recognising this, introduced the concept
example, in the case of courage, the vice appeals to Kant’s CI are made to justify of ‘higher and lower pleasures’, famously
of deficiency is cowardice, while the vice assisted suicide and euthanasia on the stating that, ‘It is better to be a human being
of excess is recklessness. grounds that if I were suffering intolerably, dissatisfied than a pig satisfied; better to
Aristotle’s concept of virtue as the I would want to die in this way, and thus be Socrates dissatisfied than a fool
‘golden mean’, however, only works for the I could also will it for everyone else who satisfied...’. 2 

1
 CMF FILE 76 | A VERY SHORT INTRODUCTION TO ETHICS
 principlism
All three of the previous three foundations a biblical appraisal of ethical theories
of ethics were eclipsed in 1977, when the
first edition of Beauchamp and Childress’ Elements of each of the previous systems find support fromScripture.
Principles of Biomedical Ethics was published
and soon became the ‘bible’ of Western virtues: motivated by Christ’s love
bioethics. With its four key principles of Living virtuously is obviously vital for those Peter encourages to ‘make every effort to
autonomy, beneficence, non-maleficence, supplement your faith with virtue’, 3 and instructs ‘to proclaim the virtues of him who called you
and justice, the system as a whole is known out of darkness into his wonderful light.’ 4 The fruit of the Spirit – love, joy, peace, patience,
as ‘principlism’. Within principlism, the kindness, goodness, faithfulness, gentleness, and self-control 5 – could be considered as
concept of autonomy is understood in a list of Christian virtues. As could Paul’s other list of things on which we should focus our
terms self-rule and personal choice. thoughts – honesty, being honourable, justice, purity, loveliness, excellence – all of which
Beneficence and non-maleficence are ‘doing he clearly states as praiseworthy virtues. 6
good’ and ‘not-doing harm’ respectively,
and justice in principlism is often, though rules: obedient to Christ’s commands
not exclusively, solely regarded as Christians are ‘not under law, but under grace,’ 7 and hence are not motivated merely by
distributive justice. obedience to rules but out of love for Christ. Nevertheless, Jesus says that if we love him,
The widespread adoption of principlism is we will keep his commandments. 8 As the Scriptures, including the Old Testament, contain
not hard to explain. It is easy to understand the things concerning Christ, 9 so Christians looking to make ethical decisions Christianly
(certainly in comparison to Kantianism) and need growth in familiarity with biblical teaching that helps to form the mind of Christ
therefore easy to teach. It does not require in his followers. 10
any metaphysical beliefs so can be used
by atheists and religious believers alike, consequences: conforming to Christ’s wisdom
and it is easily applied to medical ethical Though Christians may consider utilitarianism the least likely framework to deliver
dilemmas. One of its main problems is consistently ethical outcomes, Jesus’ saying that ‘wisdom is proved right by all her children’ 11
there is no clear way to decide what to should give pause for thought. Furthermore, in the parable of the unjust steward, 12 the
do when application of one of the four commendation is related to the outcomes, which demonstrated how savvy the steward was.
principles conflicts with one or more (Note that though Jesus does not say the master commended the steward for his dishonesty,
of the others. but rather for his shrewdness.) Outcomes were clearly important to Christ.

principlism: holding together in Christ

All four principles of principlism are present in the Bible. That is one reason why it works so
well in many cases. God has given us autonomy and the responsibility of exercising it wisely. 13
The Gospels are full of examples of how Jesus ‘went about doing good’ 14 and the New
Testament commands his followers to do likewise. 15 Jesus never acted maleficently in word
or deed, 16 and taught his disciples to speak and act likewise. 17 Finally, justice is a major
foundational theme running throughout the entire Bible. 18

FILE REFERENCES
1. Hutcheson F. An Inquiry into the Original of our Ideas of
Beauty and Virtue, Wolfgang Leidhold (ed.), Indianapolis:
Liberty Fund, 1726 & 2004. p125
2. Mill JS. Utilitarianism. 1863. Chapter 2.
CMF RESOURCES
Order online at cmf.org.uk/bookstore
utilitarianism.com/mill2.htm
3. 2 Peter 1:5 (English Standard Version, Anglicised – ESV-UK)
4. 1 Peter 2:9
5. Galatians 5:22-23 (ESV-UK) WHA EVER
6. Philippians 4:8
CROSS-CENTRED ETHICS THAT POINT TO JESUS

7. Romans 6:14 A GUIDE TO

8. John 14:15 CHRISTIANITY
FOR NHS EMPLOYERS
9. Luke 24:27
10. Philippians 2:5
11. Luke 7:35
12. Luke 16:8
13. See for example Genesis 3:1-13, Deuteronomy 30:19,
Joshua 24:15, Philippians 1:22, James 4:4. 1 Peter 4:3
£8.00 £4.00 £2.00 GILES CATTERMOLE £7.50
14. Acts 10:38
15. See for example Matthew 5:44, Luke 6:35, Galatians 6:10 Matters of Life Freedom of A Guide to Whatever
16. 1 Peter 2:22 & Death Conscience in Christianity for Giles Cattermole
17. 1 Peter 3:9
18. See especially Psalm 89:14, Micah 6:8, Revelation: 19:1-2. John Wyatt Healthcare NHS employers
The word ‘justice’ occurs at least 143 times overall. Rick Thomas CMF