Using Kantian Ethics in Medical Ethics Education


Since ancient times, humanity has been seeking for an answer on how to act properly in moral terms. What behavior can be considered appropriate, what we should and should not do – the questions of that kind remain debatable to this day. There are two main reasons why a universal reply is impossible in the given case. First, behavior cannot be discussed in the abstract, but only in the context of a particular situation, which actually determines the relevance of certain deeds. Second, the same behavioral pattern is not necessarily seen identically by different people, as the perspective on what is proper and improper varies from person to person.

In one concern, ethics is expected to streamline the multiple views by developing rulebooks to rely upon under certain circumstances. By contrast, ethics, similarly to any field of knowledge, comprises several theories that embody the opinions of their authors, who would not readily agree. Therefore, a more relevant question is not how to act, but which of the theories under the review is apparently the best according to its reason. The categorical imperative by Kant actually offers the most reasonable perspective because it relies upon categories that are relatively strictly determined rather than abstract notions difficult to measure.

Aristotle’s Doctrine of the Mean

Theoretical Framework

Aristotle’s postulates are believed to have laid the foundation for the notions that are still topical in modern ethics as well as social sciences. One of his best-known concepts in the mean, the intermediate state between excess and deficiency, which he saw as the essence of any virtue (Fisher, 2018). Simply put, the sensible middle between two extremes is the most desirable behavior, while those extremes are both vicious.

Fisher highlights that it is not enough to identify two opposing extremes and find the intermediate between them to describe a virtue. According to him, Aristotle insisted that a certain action could only be considered virtuous when done “in the right way, at the right times, and so on” (Fisher, 2018, p. 60). In other words, it is only possible to decide what is sufficient, deficient, or excessive in a specific situation and not speculatively. That means a random person cannot be generous or courageous by themselves, but judging by what behavior is reasonable under the given circumstances.

Practical Application

With consideration of the above, a solution to any ethical dilemma needs to be built around the objective. For instance, the aim of performing as a lifeguard at a beach lies in rescuing holidaymakers in an emergency. Such a mission requires the readiness to act immediately, notwithstanding fear, but reasonably, so that no essential point is occasionally neglected. This behavior can actually be regarded as sufficient boldness in case a lifeguard sees a surfer drowning. Notably, he should reach him as soon as possible, keep him above the surface, and transport him to land.

By contrast, defining the objective is no more than an initial step to an appropriate decision because situational factors may change the degree of a certain trait to be considered sufficient. Thus, if a surfer is not simply drowning but being pulled underwater by a shark, rescuing him bears a threat to the lifeguard. In this case, the question is where to draw the line between boldness, which stands for an intermediate, hence a virtue, and reckless courage, which is a vicious extreme.

The reasonable solution grows more apparent if it is remembered that deficiency is also a vice. For a lifeguard, simply observing a drowning one and hoping that they survive without help is even more than just deficient boldness. It is a complete lack of courage, in other words, cowardice, which Aristotle would apparently not accept in ethical terms. Therefore, the philosopher would most probably say that the lifeguard has to attempt to rescue the surfer anyway. However, he should not self-sacrifice in case that would give the surfer but not himself a chance to escape the shark, as such behavior is an example of reckless courage.

Mill’s Greatest Happiness Principle

Theoretical Framework

As is seen from its name, the greatest happiness principle establishes that the morality of a certain action correlates with its contribution to happiness. In the simplest terms, an act that promotes happiness is moral, while one that results in unhappiness is not. An ideal moral society is the one where “every person’s happiness is equally desirable” (Ogan, 2018, p. 72). Needless to say, how utopic this sounds, considering that the happiness of different people can collide.

Mill, however, did not mean that everybody has to care about everybody else’s happiness. According to him, any individual desires their own happiness to the degree they believe to be achievable, and the aggregation of those desires of everyone in the general happiness (Ogan, 2018). This allows assuming that a moral action is one that factors positively into the general happiness through that of a particular individual.

Practical Application

It would apparently be most relevant to enlist all possible solutions to a dilemma as well as their consequences and then regard them through the lens of general happiness. Thus, in the above-mentioned situation, where a lifeguard sees a surfer who a shark is attacking, the options for him to choose from are as follows. He can do nothing and hope that the surfer will rescue himself, which would contradict his professional duty but keep his life safe. The surfer may actually survive without exterior help but also may not. Alternatively, he can try to save the surfer, in which case there are three possible outcomes: they both survive, they both die, or only one of them survives.

The most favorable variant is where no one dies; however, it is not guaranteed. If both die, the general happiness will decrease dramatically, as the nearest and dearest of two people, who will weep for them, are probably numerous. If only one dies, the number of those who will turn unhappy is smaller. However, it does not seem possible to calculate the exact number of people who will or not be happy in each hypothetical case.

It would be reasonable here to remember the point regarding the personal happiness of everyone that is integral to the general and performs as a more reliable touchstone. Every living person desires his or her own happiness, but not a dead one. Therefore, the surfer’s death will reduce the number of those who want to be happier, hence increase the general happiness, and so will actually do the end of both. However, remorse of conscience in case of no action can make the lifeguard unhappy, due to which the general happiness will diminish. The conclusion is that trying to save the surfer is the correct decision, as it allows for a growth of happiness, whatever may be the outcome.

Kant’s Categorical Imperative

Theoretical Framework

Categorical imperative, the central concept of deontological ethics by Kant, is initially known in three formulations, two of which are intertwined enough to be united into one. That one describes the categorical imperative as the universal moral law, which all human beings are to follow and which derives from their own maxims (Donaldson, 2017). To put it very simply, a way to estimate the morality of a certain deed is to imagine what would happen if everybody did the same.

Another formulation is frequently referred to as that of humanity since it postulates the prevalence of universal respect and dignity over subjective motives. It looks as follows: “Act in such a way that you treat humanity […] never merely as a means to an end, but always at the same time as an end” (Donaldson, 2017, p. 841). In other words, an individual should not regard other people as tools for achieving his or her own goals, but remember that any person has an unconditioned intrinsic value. Neither should he or she be treated as a means, whether by himself or herself or somebody else.

Practical Application

The notion of the universal law is apparently very close to that of duty. An optimal decision, in these terms, is the one that will not have catastrophic consequences if it becomes compulsory for all. From this point of view, the lifeguard from the above example is morally obliged to do all in power to rescue the surfer from the shark. Unless he does, the universal law derivable from his behavior will state that nobody must help somebody else in an emergency, which will soon put humanity at the risk of extinction. The unconditioned value of an individual is another reason why the lifeguard must not surrender. Kant would probably claim that it is entirely irrelevant to doubt whether or not a person should be rescued, notwithstanding the circumstances.

Along with that, the unacceptability of treating and using people as means is another critical point. If the lifeguard is bound to self-sacrifice to enable saving the surfer, he will literally become a tool for somebody else’s survival. Besides, not only the surfer is intrinsically valuable as a human being, but the lifeguard as well. Due to this, he should not consider his own life to be less important and risk it readily.

To highlight that applying the categorical imperative to the given dilemma makes it even tougher is to say nothing. Whichever decision of the lifeguard seems to violate either of the principles embodied in the two formulations. Nevertheless, it is possible to follow both sequentially rather than simultaneously. Such an approach premises the need for helping another person, due to which the lifeguard must not completely neglect his duty. Instead, he should estimate the real possibility of rescuing the surfer and decide whether there is any point in risking.


Although applying three different theories to the dilemma under the review leads to generally the same solution, they are not equally reasonable. The doctrine of the mean by Aristotle is based on the difference between a mean and an extreme, which can hardly be categorical. Mill’s principle of greatest happiness does not provide a solution to a conflict of happiness of different people, which makes it even vaguer. Meanwhile, Kant’s categorical imperative warrants its name, operating with categories, hence offering clearer recommendations.


Donaldson, Ch. M. (2017). Using Kantian ethics in medical ethics education. Medical Science Educator, 27, 841-845. Web.

Fisher, J. J. (2018). A plausible doctrine of the mean. The Review of Metaphysics, 72(1), 53-75.

Ogan, T. V. (2018). John Stuart Mill’s utilitarianism: A critique. International Journal of Piece and Conflict Studies, 5(1), 65-76.

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