Applied Philosophy II: Medical, Professional, Media and Legal Ethics, and Philosophical Counselling

The rest of Unit 10 covers medical ethics (surrogacy, the doctor-patient relationship, abortion, euthanasia and female infanticide), professional ethics (corporate governance and ethical responsibility), media ethics (privacy, cyberspace, pornography, and representation and the marginalisation of difference), legal ethics (law and morality, legal obligation, and the authority and validity of law) and philosophical counselling as a way of managing everyday problems. These are academic topics: the chapter sets out the positions, the arguments for each and the main objections, and it cites Indian law only where it states a fact relevant to the debate. NET Law's jurisprudence chapters treat law and morality and the validity of law as legal theory; here they are questions of ethics.

1. Medical ethics: principles, the doctor-patient relationship and surrogacy

Much of medical ethics is organised around the four principles of Tom Beauchamp and James Childress (Principles of Biomedical Ethics, first edition 1979): respect for autonomy, non-maleficence (do no harm), beneficence (act for the patient's good) and justice (fair distribution of benefits and burdens). They are prima facie principles in Ross's sense, to be balanced when they conflict.

  • Doctor-patient relationship: the traditional model was paternalism, the doctor deciding what is best for the patient. Modern ethics stresses autonomy through informed consent (disclosure, understanding, voluntariness and competence), confidentiality and truth-telling. Ezekiel and Linda Emanuel (1992) distinguished four models, paternalistic, informative, interpretive and deliberative, and defended the deliberative model, in which the doctor helps the patient reflect on which health-related values are worth pursuing.
  • Surrogacy: a woman carries a pregnancy for intended parents, either altruistically or for payment (commercial surrogacy), and either with her own egg (traditional) or with an embryo created from others' gametes (gestational). Arguments for permitting it appeal to reproductive autonomy and to helping those unable to bear children. Arguments against appeal to the commodification of women's bodies and of children, the risk of exploiting poor women, and the difficulty of ensuring free and informed consent. India's Surrogacy (Regulation) Act, 2021 prohibits commercial surrogacy and permits altruistic surrogacy for eligible couples and certain women, alongside the Assisted Reproductive Technology (Regulation) Act, 2021.

2. Abortion, euthanasia and female infanticide

The main philosophical positions on abortion
PositionCentral argumentMain objection
ConservativeThe fetus is a human being with a right to life from conception; Don Marquis ("Why Abortion Is Immoral", 1989) argues that killing is wrong because it deprives a being of a "future like ours", which the fetus hasBeing genetically human may not settle moral status; the future-like-ours argument may extend to contraception
LiberalMary Anne Warren (1973): personhood requires traits such as consciousness, reasoning and self-awareness, which the fetus lacks; Judith Jarvis Thomson ("A Defense of Abortion", 1971) argues that even if the fetus is a person, the right to life does not include a right to use another's body (the violinist analogy)Warren's criteria may also exclude newborns; Thomson's analogy may not fit pregnancies that follow voluntary intercourse
ModerateMoral status grows gradually with development, for example with sentience or viability, so the permissibility of abortion depends on the stage and the reasonsAny line drawn may seem arbitrary
  • Euthanasia is classified as active (causing death, as by lethal injection) or passive (withholding or withdrawing treatment), and as voluntary, non-voluntary (the patient cannot consent) or involuntary (against the patient's wishes). James Rachels ("Active and Passive Euthanasia", 1975) argued, with his case of Smith and Jones, that there is no morally important difference between killing and letting die. Defenders of the distinction appeal to the doctrine of double effect, and opponents of legalisation to the sanctity of life and to slippery-slope arguments. In India the Supreme Court permitted passive euthanasia with safeguards in Aruna Shanbaug (2011) and recognised living wills (advance directives) in Common Cause v Union of India (2018).
  • Female infanticide and sex-selective abortion: the killing of girl children, and the selective abortion of female fetuses made possible by prenatal sex determination, are driven by son preference and have produced skewed sex ratios; Amartya Sen's essay "More Than 100 Million Women Are Missing" (1990) brought the scale to wide attention. The ethical analysis is one of discrimination and gender justice: the practice treats being female as a reason for death. The Pre-Conception and Pre-Natal Diagnostic Techniques Act (1994, amended 2003) prohibits sex selection in India. The case also shows that the defence of abortion by reproductive choice is not a defence of every reason for abortion.

3. Professional and media ethics

Professional ethics concerns the obligations that come with specialised roles. In business, the central debate on corporate governance and ethical responsibility is between the shareholder view, stated by Milton Friedman ("The Social Responsibility of Business Is to Increase Its Profits", 1970), that managers' duty is to maximise profit within the law and ethical custom, and the stakeholder view, developed by R. Edward Freeman (Strategic Management: A Stakeholder Approach, 1984), that a firm must balance the interests of all who are affected: employees, customers, suppliers, communities and the environment. Corporate governance addresses the accountability of managers to owners and to society (the Cadbury Report, 1992, in Britain); related issues are conflicts of interest, codes of conduct and whistle-blowing. India's Companies Act, 2013 (section 135) requires companies above certain thresholds to spend on corporate social responsibility.

  • Privacy: Samuel Warren and Louis Brandeis's "The Right to Privacy" (1890) defined it as "the right to be let alone", prompted by intrusive photography and newspapers. Media ethics weighs privacy against the public interest, distinguishing what is of legitimate public concern from what merely interests the public. In India, Justice K. S. Puttaswamy v Union of India (2017) held privacy to be a fundamental right.
  • Cyberspace raises questions of anonymity and accountability, hate speech, misinformation, online harassment, surveillance and the power of platforms over speech; the older frameworks of press ethics (truthfulness, harm-minimisation, independence, accountability) are being extended to users and algorithms.
  • Pornography: the liberal position, from Mill's harm principle, holds that adults' consensual expression and consumption should be restricted only to prevent harm to others; Ronald Dworkin's "Is There a Right to Pornography?" (1981) defended a right grounded in equal concern. Catharine MacKinnon and Andrea Dworkin argued that pornography is not merely speech but a practice that subordinates women and contributes to harm; others raise the exploitation of performers and the effects on minors. The debate turns on the evidence of harm and the scope of free expression.
  • Representation and difference-marginalisation: media representations shape how groups are seen and see themselves (Stuart Hall's work on representation). Stereotyped, absent or distorted portrayals of women, castes, religious minorities, tribal communities, persons with disabilities and sexual minorities can reproduce marginalisation; the ethical demands are accuracy, fairness, diversity in newsrooms and giving groups a voice in how they are represented.

Key takeaways

  • Beauchamp and Childress's four principles: autonomy, non-maleficence, beneficence, justice; informed consent and the four Emanuel models; surrogacy's arguments of autonomy against commodification; India's Surrogacy (Regulation) Act, 2021 permits only altruistic surrogacy.
  • Abortion: Marquis's "future like ours", Warren's personhood criteria, Thomson's violinist, and moderate gradualism. Euthanasia: active and passive, voluntary, non-voluntary and involuntary; Rachels against the killing-letting die distinction; double effect.
  • Female infanticide and sex selection as discrimination (Sen's missing women; PCPNDT Act, 1994). Corporate ethics: Friedman's shareholder view against Freeman's stakeholder view; governance, whistle-blowing, CSR.
  • Media ethics: privacy as "the right to be let alone" (Warren and Brandeis, 1890; Puttaswamy, 2017); cyberspace; pornography between the harm principle and MacKinnon and Dworkin's subordination argument; representation and marginalisation.
  • Legal ethics: Hart against Devlin; grounds of legal obligation and philosophical anarchism; positivist and natural-law accounts of validity, Fuller and Raz. Philosophical counselling: Achenbach (1981), Marinoff's PEACE process, not therapy but clarification.

Practice questions (10)

Attempt each one before opening the answer. Every explanation names the tempting wrong option as well as the right one, because that is where marks are lost.

  1. The "violinist" analogy in the abortion debate is due to:

    1. Judith Jarvis Thomson
    2. Mary Anne Warren
    3. James Rachels
    4. Don Marquis
    Show answer

    Answer: A — Judith Jarvis Thomson

    Thomson's "A Defense of Abortion" (1971) imagines being connected to a famous violinist who needs one's kidneys, to argue that the right to life does not include a right to use another's body. Marquis argues from a "future like ours", Warren from personhood criteria, and Rachels wrote on euthanasia.
  2. Euthanasia performed on a patient who is unable to give or refuse consent is called:

    1. Voluntary
    2. Involuntary
    3. Non-voluntary
    4. Passive by definition
    Show answer

    Answer: C — Non-voluntary

    Non-voluntary euthanasia is performed when the patient cannot express a wish (for example, in a persistent vegetative state). Involuntary euthanasia goes against the expressed wishes of a competent patient. Active and passive is a separate distinction, about the means.
  3. "The social responsibility of business is to increase its profits" is the view of:

    1. Milton Friedman
    2. R. Edward Freeman
    3. Amartya Sen
    4. E. F. Schumacher
    Show answer

    Answer: A — Milton Friedman

    Friedman's 1970 essay states the shareholder view, profit maximisation within the rules of the game. Freeman developed the rival stakeholder theory; Schumacher argued for appropriate technology.
  4. In the Hart–Devlin debate, Lord Devlin defended:

    1. The harm principle as the only ground for restricting liberty
    2. The service conception of authority
    3. Philosophical anarchism
    4. Legal moralism: society may enforce its shared morality through law
    Show answer

    Answer: D — Legal moralism: society may enforce its shared morality through law

    Devlin's The Enforcement of Morals (1959) argued that a shared morality holds society together and may be protected by law. Hart defended the harm principle against him; philosophical anarchism is Simmons's and the service conception Raz's.
  5. James Rachels's case of Smith and Jones is designed to show that:

    1. The doctrine of double effect justifies all palliative sedation
    2. The bare difference between killing and letting die is not in itself morally important
    3. Passive euthanasia is always worse than active euthanasia
    4. Doctors should never withdraw treatment
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    Answer: B — The bare difference between killing and letting die is not in itself morally important

    Smith drowns his cousin for an inheritance; Jones, intending the same, merely lets the cousin drown. Since both seem equally culpable, Rachels argues the killing/letting-die difference does no moral work by itself, undermining the medical distinction between active and passive euthanasia. He does not claim passive is always worse.
  6. Assertion (A): Philosophical counselling does not aim to diagnose or treat mental illness. Reason (R): Gerd Achenbach opened the first modern philosophical practice near Cologne in 1981. Choose the correct option.

    1. Both A and R are true, and R is the correct explanation of A
    2. Both A and R are true, but R is not the correct explanation of A
    3. A is true, but R is false
    4. A is false, but R is true
    Show answer

    Answer: B — Both A and R are true, but R is not the correct explanation of A

    Both are true, but R does not explain A. A states the scope of philosophical counselling, which helps clients clarify concepts, assumptions and values rather than treating disorders. R is a historical fact about the movement's origin and gives no reason for that scope.
  7. Assertion (A): Legal positivists hold that an unjust law cannot be a valid law. Reason (R): For Hart, the validity of a law depends on the rule of recognition accepted by officials. Choose the correct option.

    1. Both A and R are true, and R is the correct explanation of A
    2. Both A and R are true, but R is not the correct explanation of A
    3. A is true, but R is false
    4. A is false, but R is true
    Show answer

    Answer: D — A is false, but R is true

    A is false: that is the natural-law thesis (lex iniusta non est lex); positivists separate a law's validity from its moral merit. R is true: Hart's rule of recognition supplies the criteria of validity, which is exactly why an unjust law can still be valid for him.
  8. Which of the following are among Beauchamp and Childress's four principles of biomedical ethics? Select all that apply.

    1. Respect for autonomy
    2. Non-maleficence
    3. Justice
    4. Sanctity of life
    Show answer

    Answer: A — Respect for autonomy; B — Non-maleficence; C — Justice

    The four are respect for autonomy, non-maleficence, beneficence and justice. The sanctity of life is an important principle in religious and some secular bioethics, but it is not one of the four.
  9. Which of the following have been offered as grounds of a moral obligation to obey the law? Select all that apply.

    1. The philosophical anarchism of A. John Simmons
    2. Fair play in a cooperative scheme (Hart, Rawls)
    3. Consent to the laws, as in Plato's Crito
    4. Legal moralism as defended by Devlin
    Show answer

    Answer: B — Fair play in a cooperative scheme (Hart, Rawls); C — Consent to the laws, as in Plato's Crito

    Consent and fair play are classic grounds of political obligation. Simmons's philosophical anarchism denies that there is a general obligation, and legal moralism is a view about which conduct the law may prohibit, not a ground of the citizen's duty to obey.
  10. How many stages are there in Lou Marinoff's PEACE process of philosophical counselling? Type the number.

    Numerical answer — type the value.

    Show answer

    Answer: 5

    Five, one for each letter: Problem, Emotion, Analysis, Contemplation and Equilibrium (Plato, Not Prozac!, 1999).