Deontological theory (duty)
The word "deonto" means "duty" in Greek. A person using a deontological theory would consider the basic duties and rights of individuals or groups and act in accordance with those guidelines. You would make a decision based on what you consider your moral obligations or duties. Your action will be guided by a set of moral principles or rules. The work of the philosopher Immanuel Kant who lived in the 18th century is used in reference to deontology because he believed that every person has an inherent dignity and is entitled to respect. In one of his categorical imperatives, Kant says that we must not treat others exclusively as a means to our ends.
For example, refer back to Case 7 in which you must decide whether to tell a
patient the truth or to lie. If
you believe that truth-telling is a sacred duty
that you hold dear, then you would not be able to lie to the patient and tell
her that her daughter was alive. If you did tell her a lie, that would be using
the patient as a means to your desired outcome, however honorable it might be.
In this case you are trying to achieve a better medical outcome. In this theory
you do not consider the ends or the outcomes, but rather the means that you
achieve them. In this case you might not be able to treat the patient, or you
could discuss with the physician your feelings prior to entering the patient's
room to avoid having to go against your duty of truth-telling.
This case is a good example of how conflict can arise within the health care system. If the nurse was using a utilitarian form of decision-making, the decision would have been based on achieving the best medical outcome for the patient, no matter what means are used, including not being truthful. If the physical therapist is making a decision based on a perceived duty to the patient to treat her with dignity and respect, then the decision would be not to tell a lie. If the theoretical grounding of each person's decision-making approach can be discussed, fewer conflicts may arise since we would have a better understanding of the basis of a person's actions. While conflicts will continue, there may be a greater willingness to reach a compromise on behalf of the patient's welfare, and in most cases these resolutions must be made in a brief period of time.