What ethical theories and principles are used to reason about medical ethics, and how do they shape the conclusions?
Applying ethical theories to medical ethics: utilitarianism, Kantian ethics, the sanctity of life and quality of life, and the four principles of biomedical ethics (autonomy, beneficence, non-maleficence, justice).
The ethical frameworks used in SQA Advanced Higher RMPS Medical Ethics. Covers utilitarianism, Kantian ethics, the sanctity of life and quality of life debate, and the four principles of biomedical ethics (autonomy, beneficence, non-maleficence, justice), and how each shapes conclusions on medical issues.
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What this key area is asking
Medical Ethics is studied as applied ethics: real issues reasoned about with ethical theories and principles. Before the issues themselves, you need the toolkit. You must be able to apply utilitarianism and Kantian ethics, the contrast between the sanctity of life and the quality of life, and the four principles of biomedical ethics (autonomy, beneficence, non-maleficence, justice), and show how each framework shapes the conclusion on a medical question. This dot point sets out the frameworks; the next three apply them to abortion, euthanasia and organ transplantation.
Utilitarianism and Kantian ethics
The two theories often pull in opposite directions on medical issues: utilitarianism is flexible and outcome-driven; Kantian ethics is rule-driven and resists trade-offs that use a person as a means. Naming which framework is in play, and what it would conclude, is the core analytical move.
Sanctity of life and quality of life
This contrast is the deepest division in medical ethics, and it explains why reasonable people reach opposite conclusions on the same case. A strong answer uses it to diagnose disagreement, then evaluates whether either position can be held consistently across the hard cases.
The four principles of biomedical ethics
The principles are powerful because they are common ground: a religious and a secular thinker can both ask what autonomy, beneficence, non-maleficence and justice require. The difficulty, and the source of the hard cases, is that the principles do not rank themselves: when autonomy conflicts with non-maleficence (a patient refuses life-saving treatment), or beneficence with justice (one patient's best interest against fair allocation), judgement is needed.
Religious and secular approaches
Medical ethics is debated by both religious and secular thinkers. Religious approaches often stress the sanctity of life, the stewardship of a God-given life, and duties grounded in scripture or tradition; secular approaches more often weigh autonomy, consequences and quality of life. At Advanced Higher you must represent both fairly and evaluate them, rather than assuming either is correct, because the marks reward weighing competing positions.
Worked example
Try this
Q1. How does a utilitarian approach to a medical issue differ from a Kantian one? [2 marks]
- Cue. Utilitarianism judges by consequences (greatest wellbeing for the greatest number); Kantian ethics judges by duty and universal rules, treating people as ends, not merely means.
Q2. Name the four principles of biomedical ethics. [2 marks]
- Cue. Autonomy, beneficence, non-maleficence and justice.
Exam-style practice questions
Practice questions written in the style of SQA exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
SQA AH (Medical Ethics)20 marksHow useful is the distinction between the sanctity of life and the quality of life for resolving medical ethics issues?Show worked answer →
A strong essay explains both positions, applies them to medical issues, and judges how far the distinction settles the debates.
Explain the sanctity of life: human life is intrinsically valuable and (in religious versions) sacred, given by God, so it should not be intentionally ended, which tends to oppose abortion and euthanasia. Explain quality of life: the value of a life depends on its character, capacities and the wellbeing of the person living it, so when quality is very low, ending or not prolonging a life may be justified, which tends to permit euthanasia and some abortions. Apply both to a case such as a terminally ill patient in great suffering, showing how each yields a different conclusion. Evaluate: the distinction is useful because it names the deepest division in medical ethics and explains why people disagree, but it is not decisive, since each position faces hard cases (the sanctity view with intolerable suffering, the quality view with who decides and on what scale), and many real judgements blend the two. Conclude on how far the distinction resolves rather than merely frames the issues.
SQA AH (Medical Ethics)12 marksExplain the four principles of biomedical ethics.Show worked answer →
The marks reward an accurate account of each principle and how they work together.
The four principles (Beauchamp and Childress) are: autonomy, respecting the right of a competent patient to make their own informed decisions; beneficence, acting in the patient's best interests and promoting their wellbeing; non-maleficence, avoiding causing harm ("first, do no harm"); and justice, treating patients fairly and distributing resources and care equitably. They function as a shared framework that competing theories and worldviews can use: a decision is examined by asking what each principle requires, and difficulty arises when they conflict (for example autonomy versus non-maleficence when a patient refuses life-saving treatment). A full answer explains each principle clearly and notes that the principles do not rank themselves, so judgement is needed when they pull in different directions, rather than just listing the four words.
Related dot points
- Abortion: the moral status of the embryo and foetus (personhood and viability), the rights of the foetus against those of the woman, and religious, sanctity-of-life and quality-of-life arguments.
The ethics of abortion in SQA Advanced Higher RMPS Medical Ethics. Covers the moral status of the embryo and foetus (personhood, potentiality, viability), the conflict between the rights of the foetus and the woman, and religious, sanctity-of-life and quality-of-life arguments, with how to evaluate the debate.
- Euthanasia: active and passive, voluntary, non-voluntary and involuntary, the acts and omissions distinction and double effect, autonomy and the slippery slope, and sanctity-of-life and quality-of-life arguments.
The ethics of euthanasia in SQA Advanced Higher RMPS Medical Ethics. Covers active and passive, voluntary, non-voluntary and involuntary euthanasia, the acts and omissions distinction and double effect, autonomy and the slippery slope, and sanctity-of-life and quality-of-life arguments, with how to evaluate the debate.
- Organ transplantation: consent and the opt-in versus opt-out (presumed consent) debate, the definition of death, the allocation of scarce organs, the sale of organs, and religious and ethical arguments.
The ethics of organ transplantation in SQA Advanced Higher RMPS Medical Ethics. Covers consent and the opt-in versus opt-out (presumed consent) debate, the definition of death, the allocation of scarce organs, the sale of organs, and religious and ethical arguments, with how to evaluate the debate.
- The problem of evil and suffering: the logical and evidential problems, moral and natural evil, and the main theodicies (free will, the Augustinian and Irenaean responses) with their evaluation.
The problem of evil in SQA Advanced Higher RMPS Philosophy of Religion. Covers the logical and evidential problems, moral and natural evil, the inconsistent triad, and the main theodicies (the free will defence, the Augustinian and Irenaean responses), with how to evaluate them.
- The skills of Advanced Higher RMPS - analysis, evaluation, sustained argument and independent research - and how the demand rises above Higher RMPS at SCQF level 7.
The skills assessed in SQA Advanced Higher RMPS and how it differs from Higher. Covers analysis and evaluation, the use of scholarship, sustained argument, independent research, and the step up from Higher RMPS to SCQF level 7 degree-style study.