Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia.
KIE: The utilitarian and deontological approaches to ethical analysis are illustrated by Candee and Puka, using the case of a newborn with Down's syndrome and duodenal atresia who was allowed to die at Johns Hopkins Hospital in 1971. They discuss divergent steps in the moral reasoning process for each approach; analyze the utility of alternative medical treatments--surgery, passive euthanasia, and active euthanasia--from the child's, parents', and society's perspectives; and consider the rights claims and moral obligations involved. Fletcher faults Candee and Puka on several points in their analysis, including their failure to consider the consequences of alternative decisions on members of the clinical team.