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Second, when we punish for the wrongs consisting in our violation of deontological duties, we (rightly) do not punish all violations equally.
There is an aura of paradox in asserting that all deontological duties are categorical to be done no matter the consequences and yet asserting that some of such duties are more stringent than others.
One well known approach to deal with the possibility of conflict between deontological duties is to reduce the categorical force of such duties to that of only "prima facie" duties (Ross 1930, 1939).
This depends on whether "prima facie" is read epistemically or not, and on (1) whether any good consequences are eligible to justify breach of prima facie duties; (2) whether only such consequences over some threshold can do so; or (3) whether only threatened breach of other deontological duties can do so.
The restriction of deontological duties to usings of another raises a sticky problem for those patient-centered deontological theories that are based on the core right against using: how can they account for the prima facie wrongs of killing, injuring, and so forth when done not to use others as means, but for some other purpose or for no purpose at all?
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More than two millennia later, the German philosopher Immanuel Kant argued for a deontological (duty-based) view when he claimed that human beings have direct moral duties to other human beings who are morally autonomous entities and thus have moral standing but not to nonhuman organisms, which are not morally autonomous.
To take a stock example of much current discussion, suppose that unless A violates the deontological duty not to torture an innocent person (B), ten, or a thousand, or a million other innocent people will die because of a hidden nuclear device.
87% (42 respondents in total) of physicians believe that it is an ethical and deontological duty to admit to the patient that a mistake has been made.
At an international level, there is a general consensus among bioethicists, physicians and organizations representing patients, that it is the ethical and deontological duty of physicians to inform patients when harmful medical errors occur.
This was also found to be the case in 87.5% of the survey replies given by professional health care providers who consider it to be, first and foremost, an ethical and deontological duty to disclose medical errors to patients.
Like other softenings of the categorical force of deontological obligation we mention briefly below (threshold deontology, mixed views), the prima facie duty view is in some danger of collapsing into a kind of consequentialism.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com