Utilitarianism may be useful to those deciding overall health care policies, but it offers an unhelpful and even immoral guide for individual health care workers.’ Discuss. Issues regarding life, health and death in health care raise very sensitive ethical questions regarding what the right course of action is. It is easy for individuals to philosophically discuss what they believe the right ethical course of action to be.
However in genuine situations when real decisions have to be made for actual people, it becomes not just a conceptual argument, but also a matter of life and death that will affect our very own lives. Therefore it is easy for people who have clear ethical ideals, to change their minds regarding ethical decisions when it is themselves or their family being affected by the decision in front of them. There are three major approaches to moral theorizing; these are agent centered, act centered and consequence-centered approaches. One such consequentialist ethical theory that can be used to make health care decisions is called utilitarianism, which this essay will focus on.
In this essay I will discuss utilitarianism and then bioethics individually and then discuss how they could relate and do relate to each other in an ethical system. I will then discuss what is involved and needed for health care workers to try to make a right decision and the problems involved in making an ethical decision with the principle of utility. Finally I will use practical examples, which highlight the problems of utilitarianism and how alone it is an immoral guide for individual health care workers.
Utilitarianism? Consequentialist moral theories place the emphasis on the good. It is the reflection of human behavior based on the consequences of a human action. Consequentialist theories are therefore teleological, which means they are focused on the end or the “telos” of a human action. Utilitarianism is one of the most prevalent examples of consequentialist thought. Utilitarianists believe that we can determine our required conducts by focusing on the end result of are behavior.
The main proponents of modern utilitarianism are Bentham (1748AD-1832AD) and Mill (1806AD-1873AD). Utilitarianism is a set of ideas, which promote “the greatest happiness for the greatest number”; Bentham thought the notion useful for a guiding principle for governmental effectiveness. Bentham took a quantitative position described rightly by Thomas Carlyle as a “pigs philosophy”, in other words if the good life is simply increasing the quantity of pleasure then there is no difference between a human being and a pig in the mud. Mill however adopted a qualitative position, which most bioethicists accept, as Mill says,
“The creed which accepts as the foundation of morals, utility, or the Greatest Happiness Principle, holds that actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure, and the absence of pain; by unhappiness pain and the privation of pleasure.”1
In recent times new version of utilitarianism has been proposed called act and rule utilitarianism. Act utilitarianism justifies pacific acts in terms of the utility of those acts, that is the doing of the act which produces the most happiness. Rule utilitarianism try’s to bypass the criticisms that can be made of act utilitarianism where any act can be justified and instead introduces considerations of utility when we contemplate the rules that we are going to use. This is not useful for deciding pacific acts but is useful for deciding certain rules.
At first glance it looks to be a very appealing ethical theory that could be used to solve the intricate problems, which are encountered in the field of bio-ethics. Its straightforward application and simplicity of having one criterion for right action make it looks like a very practical and useable theory. Utilitarianism is unbiased and does not take sides because it treats everyone as one and no more than one. Utilitarianism also has an apparent rationality when making moral decisions; it refers to a calculative model to decide what is really best, therefore this theory appeals to reason and is not just based on deliberative judgment referring to individual opinion. These points seem appealing when looking at the outer coat of the theories clothing, however underneath the mask lies a sinister character.
Bioethics? Advancements in healthcare, new fertilization and reproduction techniques, development of modern contraception and the availability of abortions have all caused ethical problems in healthcare. Tough decisions, such as whether to turn off a life support machine for patients who will not regain consciousness, need to be made and are made everyday, the question of bioethics is how these decisions should be made. As well as these technological breakthroughs there has been the concern of the power expressed by doctors and scientists. These decisions are not just technical decisions based on available data made by doctors and the elite but decisions that affect people and therefore some believe patients and the community should be involved with issues that directly affect them.