The object of this thesis is the foundation of ethics. The question is whether there exists a universal core to ethics consisting of a fundamental ethical principle across cultures. This principle could for example be the so-called Golden Rule, which goes as follows: ‘You should do to others what you want them to do to you’. The Golden Rule is to be found in many of the world’s religions and is also reflected in secular society. The rule can for example be found in a political version in legal declarations e.g. the Humans Rights Declaration of 1948. There are philosophersand scientists who interpret the Golden Rule secularly. If one looks at the Golden Rule from a non-religious point of view, it can be understood for instance in the following ways: 1) As a rule which is followed to fulfil self-interest and 2) As a rule concerning role reversal. In this thesis we will go into detail on these two interpretations of the Golden Rule, because as we will see, they can be seen as two very different views of human nature. We will discuss which of the two interpretations of the Golden Rule is most adequate in connection with the description of human beings as moral agents having reason, motives, freedom and responsibility. Furthermore we will focus on the Golden Rule in a Nordic context, in this connection we will look at whether the Golden Rule corresponds to the four bioethical principles presented by the two American philosophers Tom L. Beauchamp and James F. Childress. These principles are the principle of respect for autonomy, the principle of nonmaleficence, the principle of beneficence and the principle of justice. According to the Danish physician Henrik R. Wulff one cannot use Beauchamp and Childress’ bioethical principles as a tool for solving ethical problems in the North, because they do not correspond to the Golden Rule. Wulff argues that the Golden Rule is a moral ideal within the health services in the Nordic countries. The purpose of the thesis is, among others, to analyse and discuss whether the four bioethical principles are implicitly contained within the Golden Rule and whether Beauchamp and Childress’ method can be used to analyse bioethical problems in a Nordic context. Finally, we will set forth an ethical assessment of a treatment within biomedicine. As an example of the application of the four bioethical principles, we will look at whether human somatic gene therapy is an ethical acceptable treatment. Thus my thesis is that the Golden Rule can be viewed as a fundamental ethical principle across cultures and that Beauchamp and Childress’ four bioethical principles correspond to the Golden Rule. That is, I think there is a reason to maintain, that the bioethical principles can be of use for solving bioethical problems across cultures.

<p>The object of this thesis is the foundation of ethics. The question is whether there exists a universal core to ethics consisting of a fundamental ethical principle across cultures. This principle could for example be the so-called Golden Rule, which goes as follows: ‘You should do to others what you want them to do to you’. The Golden Rule is to be found in many of the world’s religions and is also reflected in secular society. The rule can for example be found in a political version in legal declarations e.g. the Humans Rights Declaration of 1948. There are philosophersand scientists who interpret the Golden Rule secularly. If one looks at the Golden Rule from a non-religious point of view, it can be understood for instance in the following ways: 1) As a rule which is followed to fulfil self-interest and 2) As a rule concerning role reversal. In this thesis we will go into detail on these two interpretations of the Golden Rule, because as we will see, they can be seen as two very different views of human nature. We will discuss which of the two interpretations of the Golden Rule is most adequate in connection with the description of human beings as moral agents having reason, motives, freedom and responsibility. Furthermore we will focus on the Golden Rule in a Nordic context, in this connection we will look at whether the Golden Rule corresponds to the four bioethical principles presented by the two American philosophers Tom L. Beauchamp and James F. Childress. These principles are the principle of respect for autonomy, the principle of nonmaleficence, the principle of beneficence and the principle of justice. According to the Danish physician Henrik R. Wulff one cannot use Beauchamp and Childress’ bioethical principles as a tool for solving ethical problems in the North, because they do not correspond to the Golden Rule. Wulff argues that the Golden Rule is a moral ideal within the health services in the Nordic countries. The purpose of the thesis is, among others, to analyse and discuss whether the four bioethical principles are implicitly contained within the Golden Rule and whether Beauchamp and Childress’ method can be used to analyse bioethical problems in a Nordic context. Finally, we will set forth an ethical assessment of a treatment within biomedicine. As an example of the application of the four bioethical principles, we will look at whether human somatic gene therapy is an ethical acceptable treatment. Thus my thesis is that the Golden Rule can be viewed as a fundamental ethical principle across cultures and that Beauchamp and Childress’ four bioethical principles correspond to the Golden Rule. That is, I think there is a reason to maintain, that the bioethical principles can be of use for solving bioethical problems across cultures.</p>

Acceso restringido a texto completo / Memoria (licenciado en ciencias jurídicas y sociales)

Thesis (MPhil)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: Introduction From the postmodern ethical perspective [the postmodernist would say Jrom the ethical perspective], there is something suspicious and inherently unethical in a system of ethics supported by a comprehensive, cohesive and universal metanarrative, a set of fixed and unbending ethical rules and laws, without the ready possibility of revision [Cilliers, 1998, pp.114, 137-140; Cilliers, 2001, p. 3; Cilliers, 1995, p.125]. Based on the ideas of especially Winkler [1993, pp. 343-365] I have concluded that contemporary mainstream biomedical ethics, represented and directed by the work of Beauchamp and Childress [1994] are caught in such a crush. The primary objective of this assignment is to evaluate the 'principles' of biomedical ethics [respect Jar autonomy, beneficence, non-maleficence and justice] which were developed in their water-shed publication [Principles of Biomedical Ethics, Oxford University Press, first published in 1979, and now in a fifth edition, 2002] against a background of postmodern ethics. Methodology and conclusions I have argued that Beauchamp and Childress' conception of principlism is a contextual legalistic-philosophical response to the contemporary American situation, developed primarily from legal decisions [often litigation]. It may be regarded as acceptable practice guidelines, but represents a system of ethics without morality. I have given a concise rendering of Winkler's notion of context-based bioethics with the criticism that this also does not guarantee morality. Following that, there is a description of postmodern society in terms of complexity theory. I have indicated how the characteristics of complexity can be developed and applied contextually in bioethics. The postmodern moral society is the locus where morality develops in a non-controllable agonistic interactive process within which the postmodern moral agent unintentionally finds himself. The postmodern ethical position is not an unethical, come-as-you-may anything-goes position; it simply is not predictable, controllable, universal, rational [in a Kantian context] and eternal. Modernity, it can be argued exhibits a far greater degree of relativism. The postmodern ethical position represents a return to morality in ethics, morality of a very personal, face-to-face responsibility from which we as participants of society cannot hide. From a postmodern ethical perspective, an analysis of principlism and its underlying principles exhibits the characteristics of modernity: eternal moral rules which as such cannot be presented as morality. I have acknowleged Beauchamp and Childress' attempts at adding morality to their conception [in the 4th edition] by means of employing character ethics. They have nevertheless not made any radical changes in the format of their presentation and maintain the central and primary role of principles. I have also argued the limitations of the postmodern approach in terms of enclaves of strictly controlled modernity and artificial witholding of information in medicine which limit the free flow of information essential to the postmodern approach. My conception of complexity and the postmodern approach do not pretend to be a panacea for biomedical ethics. It attempts to redefine the meaning of morality in bioethics and questions the unbridled application of this conception of principIism. Finally I have discussed the burning issue of justice in the practice of medicine from the postmodern perspective. Do I as a person have a right to health care; what are the moral issues of dealing with 'life's lotteries'; what is the state's responsibility in health care, and: what are my personal responsibilities in health care? In contradistinction to libertarian concepts, the postmodern approach clearly argues in favour of the acceptance by the state of its role in health care [a responsibility abrogated in many societies, none more so than contemporary South-African society]. / AFRIKAANSE OPSOMMING: Inleiding Daar IS uit die perspektief van die postmoderne etiese standpunt [die postmodernis sou sê, uit die etiese perspektiej], iets verdags, iets inherent oneties aan 'n sisteem van etiek wat 'n enkele goed omskrewe, kohese en omvattende universele metanarratief voorhou, 'n stel vaste en onbuigsame etiese reëls en wette voorskryf en afdwing sonder om konteks en gevolge te oorweeg, en sonder die geredelike moontlikheid van revisie [Cilliers, 1998, pp.114, 137-140; Cilliers, 2001, p. 3; Cilliers, 1995, p.125]. Dit is, n.a.v. die denke van veral Winkler [1993, pp. 343-365] my oortuiging dat die hoofstroom-denke in biomediese etiek in so 'n drukgang vasgevang is, en verteenwoordig word en gerig is deur die denke van Beauchamp en Childress [1994]. Hierdie werkstuk gaan in hoofsaak daarom om Beauchamp en Childress se toepassing van die beginsels van biomediese etiek soos sedert 1979 in hul waterskeidingsboek 'Principles of Biomedical Ethics' [Vierde uitgawe, Oxford University Press, 1994; daar is nou ook 'n vyfde, 2002] uiteengesit, ontwikkel, bespreek en gepropageer [respek vir outonomie, weldadigheid, non-kwaadwilligheid en geregtigheid] teen die agtergrond van 'n postmoderne etiese beskouing te evalueer. Metodologie en gevolgtrekkings Ek het in hierdie werkstuk aangetoon dat Beauchamp en Childress se weergawe van prinsiplisme 'n kontekstuele wetlik-filosofiese reaksie op die kontemporêre Amerikaanse situasie is, hoofsaaklik uit regsaksie [dikwels litigasie] voortvloei, as goeie praktyksriglyne beredeneer kan word maar etiek sonder moraliteit verteenwoordig. Ek het 'n kort uiteensetting van Winkler se weergawe van 'n konteks-gebaseerde benadering gegee, maar aangetoon dat ook dit nie moraliteit waarborg nie. Daarop het ek 'n beskrywing van die postmoderne samelewing n.a.v. kompleksiteitsteorie gegee, en aangetoon hoe die eienskappe van kompleksiteit kontekstueelontwikkel kan word om in bioetiek toegepas te word. Die postmoderne gepostuleerde morele gemeenskap is die lokus waar moraliteit ontstaan deur 'n onbeheerbare agonistiese proses van interaktiewe wisselwerking waarby die postmoderne morele agent homself onwillekeurig betrokke vind. Die postmoderne etiese posisie is nie onetiese, lukraak, doen-soos-jy-wil relativisme nie; dit is bloot nie 'n voorspelbare, ewige, beheerbare, universele en [Kantiaans-] rasionele sisteem nie; moderniteit is [was?] in effek veel meer relativisties. Die postmoderne etiese standpunt verteenwoordig in my interpretasie 'n terugkeer tot moraliteit in etiek, moraliteit van 'n persoonlike, ingrypende, verantwoordelike aangesigtot- aangesig aard waaraan ons nie kan ontkom nie. Vanuit 'n postmoderne etiese perspektief het ek 'n analise van prinsiplisme en die individuele beginsels gemaak, en aangetoon dat hulle die eienskappe van die 'ewige morele reëls' van moderniteit openbaar en nie sonder meer as morele beredenering voorgehou kan word nie. Ek het erkenning gegee aan Beauchamp en Childress se eie pogings om dit te besweer deur karakteretiek as 'n essensiële tot hul formule toe te voeg, maar die kritiek uitgespreek dat hulle desnieteenstaande hierdie belangrike erkenning, nie bereid is om die formaat van hul aanbieding [ook in die jongste vyfde uitgawe, 2002] radikaal te wysig nie. Hulle oorbeklemtoon die beginsels steeds as sentraal en primêr. Terselfdertyd het ek die beperkings van die postmoderne benadering uitgelig, veral in terme van enklawes van streng-beheerde moderniteit in geneeskunde en 'n kunsmatige weerhouding van die vrye vloei van informasie wat kompleksiteit en die postmoderne situasie kenmerk. My konsepsie hou nie kompleksiteit en 'n postmoderne benadering voor as 'n panakeia vir biomediese etiek nie; dit dien eerder om die betekenis van moraliteit in bioetiek te herdefinieer en die kontemporêre algemene en ongekwalifseerde toepassing van hierdie weergawe van prinsiplisme te bevraagteken. Laastens het ek die brandende vraag van geregtigheid in die praktyk van geneeskunde vanuit 'n postmoderne perspektief bespreek, veral of ek as persoon kan aanspraak maak op 'n reg tot gesondheidsorg, die morele implikasies van 'life's lotteries', die staat se verantwoordelikheid in gesondheidsorg en les bes, persoonlike verantwoordelikheid in gesondheidsorg. Dit is duidelik dat 'n postmoderne benadering tot bioetiek, in teenstelling met libertêre konsepsies, die staat se rol in gesondheidsorg onderskryf ['n rol wat die staat byna universeel, en veral in Suid-Afrika, verwaarloos].