Immanuel Kant
Immanuel Kant, in his famous work titled ‘Groundwork of the Metaphysics of Morals,’ stated that a human being is a rational being with morals and free will to act in a conscientious manner (Butts & Rich, 2008). Kant stated that ethical conduct is guided by universal moral laws and moral actions should not be a means to achieve individual goals but rather an unconditional personal duty. In his work, Kant identified two foundations of his theory; categorical imperatives, which comprise of universal laws, duties and maxims; and hypothetical imperatives, which are laws that must be observed to achieve particular ends (Butts & Rich, 2008). Thus, for an action to be considered ethical it must adhere to universal rules.
Kant’s Ethical Theory: Deontology
The ethical theory of deontology was proposed by Immanuel Kant in the late 18th century. This theory defines a moral action as an action that adheres to certain universal maxims. In other words, ethical action is judged by the motivations of action not the consequences of the action (Butts & Rich, 2008). Therefore, Kant argued, people should behave and act according to some universal maxims or categorical imperative. Kant advanced two approaches of categorical imperative; first, the maxim of an individual’s action should be universal; and second, a person should treat another with dignity, not as means to reach personal objectives. Deontology focuses on the moral worth of action not the outcomes of an action.
Nursing and Health Care Practices
Kant’s deontological theory has many applications in healthcare settings. Kant’s second imperative (hypothetical imperative) states that individuals should treat others with dignity, not as a means to reach their goals (Beauchamp & Childress, 2009). A modern principle that is similar to this imperative is the principle of autonomy; it refers to the respect to a patient’s right to self-determination during care delivery (Beauchamp & Childress, 2009). Thus, choices regarding issues such as end-of-life experiences should be made by the patient not the healthcare professional. Also, the principle of justice, which accords each person fair and equal treatment (Beauchamp & Childress, 2009) is consistent with Kant’s second imperative. Justice requires that all patients are accorded medical services without favor or bias.
Some nursing practices contradict Kant’s theory. For instance, Kant’s first imperative (i.e. categorical imperative) requires truthfulness and commitment in nursing practice. It contradicts the principle of fidelity, which states that a healthcare professional should be loyal and truthful to the patient, as a virtue of care delivery (Pojman, 2010). Based on Kant’s imperative, it would be unethical not to disclose the results of a prognosis or diagnosis to a patient. However, rationally, if this action will cause emotional harm or distress to the patient, lying would be more ethical. Therefore, the principle of fidelity seems to contradict Kant’s categorical imperative.
Nursing Code of Ethics
The American Nurses Association (ANA) stipulates the code of conduct for all nurses. The Code guides nursing professionals to make ethical decisions when in an ethical dilemma. Section 5.3 of the Code states that nurses should have a “moral point of view” in the course of their duty (ANA, 2006). This statement is consistent with deontological theory, which states that individuals’ actions should be guided by universal maxims or morals. Also, section 2 states that a nurse should show commitment to the patient, as part of ethical practice (ANA, 2006). This guideline is similar to Kant’s categorical imperative, which requires commitment and truthfulness as part of nurses’ professional conduct.
References
American Nurses Association (ANA) (2006). Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: American Nurses Publishing.
Beauchamp, T. L., & Childress, J. F. (2009). Principles of biomedical ethics (6th Ed.) New York, NY: Oxford University Press.
Butts, J. B., & Rich, K. L. (2008). Nursing ethics across the curriculum and into practice. Sunbury, MA: Jones and Bartlett.
Pojman, L. P. (2010). Ethical theory: Classical and contemporary readings. Florence, KY: Cengage Learning, Inc.