Risk and Luck in Medical Ethics

Ethics is commonly assumed to be the one realm in which luck and risk do not intrude. It has been said that 'While one can be lucky in one's business, in one's married life, and in one's health, one cannot, so it is commonly assumed, be subject to luck as far as one's moral worth is concerned.' But although we do not normally hold people responsible for outcomes beyond their control, a serious examination of the role of luck and risk may lead us to conclude that very few outcomes are really within people's control. This is the paradox of 'moral luck'. Risk and Luck in Medical Ethics examines the 'moral luck' paradox in greater detail, relating it to Kantian, consequentialist, and virtue-based approaches to ethics. Dickenson applies the paradoxes of risk and luck to medical ethics, including timely discussion of risk and luck in the allocation of scarce health care resources, informed consent to treatment, decisions about withholding life-sustaining treatment, psychiatry, reproductive ethics, genetic testing, and medical research and evidence-based medicine. The book concludes with an examination of the relevance of risk and luck in a medical context to the study of global ethics. If risk and luck are taken seriously, it would seem to follow that we cannot develop any definite moral standards at all, that we are doomed to moral relativism. However, Dickenson offers strong counter-arguments to this view that enable us to think in terms of universal standards for judging ethical systems. This claim has direct practical relevance for practitioners as well as philosophers.