Kazem Sadegh-Zadeh     Philosophy of Medicine     HAPM




Medical Deontics

Morality, ethics, metaethics, and deontics are distinguished. By "medical deontics" is meant the deontic-logical analysis and philosophy of morality and law in medicine. Moral as well as legal rules are representable as deontic sentences in the language of deontic logic. A notion of a deontic rule is introduced to demonstrate that all deontic rules are actually ought-to-do rules. Conditional ought-to-do rules, called conditional obligations, are of particular importance not only in medical ethics and law, but also in clinical medicine. It has been shown in an earlier chapter that diagnostic-therapeutic knowledge is practical knowledge consisting of conditional obligations. On this account, clinical medicine belongs to the realm of medical deontics. This discussion is continued later on.

A minimum collection of moral ought-to-do rules is referred to as minimum morality. A minimum morality shared by all or most members of a community represents the common morality of that community. A human society is characterized by a specific common morality. The rules of its common morality are constitutive of particular social practices such as charity, care, prevention of criminality, etc. These deontically generated social practices structure the society in that they partition it into the set or category of those people who satisfy a particular deontic rule, and the set or category of those who do not. Such sets are referred to as deontic sets or categories. A deontic set is not a natural kind. It comes into existence by compliance with, or violation of, deontic rules of the common morality in a society, e.g., the set of 'criminals' or the set of those who are 'in need of help'. It is thus a man-made entity, specifically a deontic-social construct. It is shown that prototype diseases (this concept has been introduced in an earlier chapter) are such deontic-social constructs to the effect that the category of diseases turns out to be a deontic-social construct. Diseases are not natural phenomena. They are man-made.

It was shown in an earlier chapter that clinical-practical knowledge consists of deontic rules. Clinical-practical knowledge is deontic-procedural knowledge concerned with diagnosis, therapy, and prevention. The term “procedural” means to know how to do something, e.g., to diagnose or treat a particular disease state. Diagnostic-therapeutic knowledge of this type is representable by conditional obligations. A conditional obligation, as an ought-to-do action rule, does not logically follow from descriptive or explanatory research that describes how things are, and explains why they occur. It is not justified by purely empirical research and evidence either. It comes from social institutions, i.e., medical communities in the present case, and is justified in comparison with alternative action rules by demonstrating that it is better than the latter. The comparative predicate "is better than", however, is an evaluative one and has something to do with human values, intentions, and goals. Based on the considerations above, medical practice and research may be viewed as deontic disciplines that necessitate appropriate methods of inquiry termed medical deontics in preceding sections. The deontic character of medicine is exemplified by demonstrating that prototype diseases are deontic-social constructs. They are delimited as out-to-be-treated categories of states of affairs on the basis of common morality that requires the members of a society to charitably act in humanitarian emergency situations.

This completes Part IV consisting of 3 chapters and 30 pages.