LAUSR

Contemporary medicine has unique challenges that render principlism inadequate as a sole paradigm for medical ethics education. Shortcomings of this ethical system include the often contradictory nature of the principles, difficulty with integration and internalization of the principles, and the inadequate treatment of moral relativism. Principlism has also contributed to the rise of consumerism in medicine by making autonomy “chief among equals” of the principles. The ethics of Immanuel Kant is offered as a potential helpful addition to medical trainee ethics curricula. Kant’s Categorical Imperative to “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” respects patient autonomy and dignity while simultaneously offering an ethical foundation for the relationship between the patient and the physician. The concept of autonomy is discussed, specifically how Kant’s idea of autonomy is very different from that in contemporary medicine, and is in fact more nuanced and helpful for the ethical development of physicians. By focusing on intentionality as opposed to outcomes, Kant’s philosophy also is applicable to the “blame and shame” medical culture, establishes a deeper sense of duty for the physician, and is clinically helpful for patient and peer interaction.