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The focus of moral principles on behavior is the major difference between principles and virtues. Moral principles designed for medical professionals are a standard for how practitioners should act and what they should do regarding treatment and in relationships with their patients. Moral virtues, in contrast, are the beliefs that a medical professional holds regarding the kind of person they should be. Moral principles are a starting point for ethical behavior, and, while far from being exhaustive, can help teach the relevant proper moral behavior.
Appropriate behavior arises from the intersection of moral virtues and moral principles, and the correlation between the principles and the virtues is how those principles are able to teach those moral behaviors. Moral virtues and principles are generally the beliefs and actions supported by the general population. However, community support is not enough to designate a behavior, virtue, or belief as “moral”. Moral virtues require the background support of moral reason. If a principle is to be considered moral, it must teach morally valuable behavioral traits.
Community morals must be backed by reasons as to why they are moral. This can cause a dilemma if the general beliefs of a community do not agree with a practitioner's personally held belief. For example, if a particular community's legal system does not allow abortions but a medical professional feels that one is morally indicated for a particular patient, he or she may be held to be immoral by principle but moral in virtue. Simply because an action fails to meet the community morality does not make such an action universally immoral.
This specific example is of course controversial and does not attempt to make a statement on the morality of abortions, but simply to make a point about the difference between community standards and an individual's beliefs. Moral dilemmas can also arise from too-strict adherence to standards that have been built from moral principles. Moral principles are a guideline and a starting point for standards, but they cannot and should not be applied universally. A good example of over-applied standards affecting moral virtue is the principle of impartiality.
Most medical standards and codes of ethics hold impartiality to be the correct course of behavior; these codes hold that a medical practitioner should treat all of his or her patients the same and to keep a professional distance with all patients. However, in practice, maintaining this distance is not always practical or even desirable, especially for long-term care. A principle of impartiality in a situation where such a distance is not ethical can cause a dilemma for the practitioner, as he or she must then decide whether to obey personal moral virtues or professional moral principles.
The previous example is a sample of how the gap between practical ethics and theoretical ethics, of which principles are a type, can lead to dilemmas in medical practice. Principles should only be used as a starting point for developing standards of behavior. These principles need additional data and information in order to cover the true ethics implications of a situation in treatment, and they need flexibility enough to deal with the changing reality of medical treatment. As stated above, no principle can possibly cover every treatment scenario.
The resultant dilemmas can be dealt with
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