Risk and Luck in Medical Ethics
January 2003, Polity
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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
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.
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