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By Karmyn Jones
Medicine is the sum of knowledge about disease and illness. It also focuses on feelings, experiences, anxieties, and the fears of patients. In Principlism, doctors are expected to intervene for the patients best interest, representing and acknowledging autonomy. However, in Personalism, the focus on preserving life is the first priority. Considering autonomy under a personalist approach would be unsuitable. The personalist approach supports life under any circumstance, but allows the withdrawal of treatment only if there is no possibility of life in the future.
Health professionals are often expected to make difficult ethical decisions which they are not necessarily trained for. A good health professional respects the wishes of the patients. This means respecting their autonomy, giving patients the right to determine their own treatment. Infirmity is the overall state of being weak in body or mind especially during old age or illness. Those with mental infirmity should be treated the same as those with physical infirmity.
Both Personalism and Principlism believe people should be treated with the patient’s best outcome in mind, however principlism allows the patients to make decisions about their own treatment. In a principlistic system, the patient should be able to choose their course of action and it should be respected. Under a personalistic approach the patient should be treated with all the available resources until there is no chance of future life. In this case, health professionals would cease treatment.
While Personalism’s underlying definition is extremely ethical, in my opinion, Principlism is more ethical when considering most situations within medical ethics. Principlism is based on the four principles: autonomy, nonmaleficence, beneficence, and justice. The two that cause me to believe Principlism is more ethical are nonmaleficence and autonomy. Nonmaleficence calls upon the physician to do no harm. In some medical cases, continuing treatment is doing more harm to the person than if treatment were to cease. Also, under a personalist system, autonomy would not even be considered. The patient should have the right to make decisions regarding their health.
In “Born Free '', McGinn implies under a principlist approach that an impaired person is less of a person based on their cognitive function. Therefore, an impaired person doesn't deserve to be treated with the same dignity and respect as an unimpaired person. Personalism is based on the idea that there are no non-personal beings. The two approaches differ in this sense. McGinn implies that personhood is based on function. This would mean an imapaired person is less of a person only because they are impaired. Personalism represents the opposite. In the case of Team Hoyt and Annette, Principlism would allow the euthanization of an impaired adult person because they would be considered less of a person, but Personalism would never allow the euthanization of an imapired person under any circumstances because all humans are personal beings who deserve the same respect no matter what.
Relationships of giving and receiving, dependence, contribute greatly to our own good and allow us to live a full flourished life. They are essential to developing into independent practical reasoners. In the case of a parent raising a child, the parent is providing knowledge to the child in order for them to create their own practical judgments. For example, a parent must teach their child to act for their own desires rather than what everyone else believes or what they themselves (the parent) believes. This is the distinction between caring for children and caring for those with disabilities. Both young children and some people with disabilities lack the ability to create their own practical judgments, so caring for them can be similar. The difference is that children are being raised to eventually create their own judgments, but some people who have severe disabilities are unable to ever create their own judgments.
Macintyre points out that in vulnerability and dependence dolphins and humans are extremely alike. Dolphins generally live long lives, but they are vulnerable to disease and death under many circumstances. Macintyre states that dolphins are especially enhanced when they have social relationships and groups to depend on. Human flourishing and surviving is similarly enhanced by dependence and social relationships.
Macintyre argues that dependence and acknowledging one's dependence is absolutely essential to living a full, successful human life. By nature, we are all dependent creatures, so at some point throughout life, everyone is completely dependent on another person. Macintyre states that independent reasoners that understand acknowledged dependence are able to help others who are vulnerable, and in turn cause human flourishing. The act of giving and receiving should never be calculated. For example, if someone was taking care of an elderly person, they would likely give more than they would ever receive from that specific person, but they could receive more from others who they give less to. Because of this, what we give to others should not be calculated to determine what they owe us.
Karmyn Jones is a McConnell Scholar in the class of 2026. She is studying neuroscience and political science at the University of Louisville.