Abstract
This article argues that the pressures on the NHS, which should be seen not as a consumer-led organisation but as a social organism, are at least in part caused by too much emphasis on right-based morality in the form of respect for autonomy. Trying to counter the trend and control costs with goal-based morality or utilitarianism misses important aspects of decision-making. Utilitarianism does not help us make wise choices about the kinds of healthcare that should be offered by the NHS. The case is made to resurrect duty-based morality, in re-imagined and humbler versions of natural law and virtue ethics, to play its part alongside respect for autonomy and attention to goals.
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