The foundations of right-based thinking

From duties to rights

The last chapter distilled from deontological ethical theories a duty-based approach to the ethics of research on humans, which stated that doctors owe a duty of care to their patients, and must therefore act in their best interests. This duty has traditionally bound doctors to behave ethically, but it has also created an ethos of paternalism in which the doctor has been thought to know best, gives orders, and is unassailably right in his decisions. Another kind of deontological ethics not yet discussed is based on people's rights. Rights can be a useful counterbalance to the duty-based moralist's tendency to be paternalistic.

Ian Kennedy argues: ‘Historically, those who enjoy (in all senses of the term) power have insisted on the language of duty to express the relationship between the powerful and the rest’ (1988, p. 391). People who are responsible for others have duties towards them. But although the language of duty can be invoked positively, as a way of determining how that responsibility will be carried out so that the good of all is served, it can also be used as a means of retaining power to the detriment of those purportedly being served. Just because a doctor believes he knows what is best for his patient, and just because he feels that he is doing his duty by his patient, it does not follow that what he proposes should happen.