Ethical Theories and Utilitarianism

Ethical Theories

  • Three main ethical theories:
    • Utilitarianism
    • Deontology
    • Principlism
  • Important concept: 'ought implies can'

Utilitarianism

  • Definition:
    • Based on the Principle of Utility.
    • "One should always act in such a way as to bring about the greatest good and the least harm for the greatest number of people."
  • Key Idea: Maximizing benefits and good for the majority.

Prominent Utilitarians

  • Key figures:
    • Jeremy Bentham (1748-1832)
    • John Stuart Mill (1806-1873)
  • Known as the classical utilitarians.

Jeremy Bentham's Views

  • Definition of Good:
    • "Good" equated with pleasure (Hedonism).
    • Introduced the "Pleasure Principle": Act to maximize pleasure for the greatest number.
  • Felicific calculus - a quantitative framework to measure happiness:
    • Positive aspects (pleasure = "hedons") minus negative aspects (pain = "delors").
    • For a situation to be deemed good, the total must be 1 or higher.
Factors in Felicific Calculus
  1. Intensity - Strength of the pleasure.
  2. Duration - Length of time pleasure lasts.
  3. Certainty - Likelihood of pleasure occurring.
  4. Propinquity - Imminence of pleasure occurrence.
  5. Fecundity - Chances of repeated similar pleasures.
  6. Purity - Likelihood of not resulting in opposite sensations.
  7. Extent - Number of people affected.

John Stuart Mill's Views

  • Definition of Good:
    • "Good" refers to happiness (Eudaemonia).
    • Happiness involves a sense of well-being, mental, and physical joy.
  • Mill's perspective:
    • Actions are right if they promote happiness and wrong if they produce the reverse.
    • Introduces the concept of higher vs. lower pleasures - intellectual over sensual.
Mill's Arguments
  • Addresses claims of hedonism, stating intellectual pleasures are superior due to dignity and morality.
  • Secondary morality can arise from the Principle of Utility (e.g., laws against theft).

Rules vs. Principles in Utilitarianism

  • Act Utilitarianism: Consider specific circumstances to determine good actions.
  • Rule Utilitarianism: Follow general rules intended to promote good, universality in actions.
    • Limits exceptions and unique circumstances.

Differences from Egoism

  • Utilitarianism focuses on the greater good, allowing personal sacrifices for others' benefit.

Example Case Study: United Airlines Flight 93

  • Ethical dilemma during 9/11:
    • 300 lives on board vs. potentially thousands on the ground.
    • Decision to crash the plane deemed utilitarian as it saves more lives.

Deontology

  • Focuses on duty and principles over outcomes.
  • Notable Proponent: Immanuel Kant.
Kant's Categorical Imperative
  • First Formulation: Act only on maxims that can become universal laws.
  • Second Formulation: Treat humanity as an end in itself, never merely as a means.

Example of Deontological Ethics

  • Case study: Lying to a patient's family regarding health status.
    • Lying could preserve familial bonds but violates categorical imperative/lies are typically wrongful.
    • Practical imperative: it treats family members merely as a means to an end.

Fundamental Principles of Deontological Ethics

  1. Autonomy & Respect - Right to self-determination, infringed only if it violates others' rights.
  2. Principle of Impossibility - Rights/duties void if impossible to fulfill (e.g., saving terminal patients).
  3. Fidelity or Right Action - Duty to fulfill obligations diligently.
  4. Equality & Justice - Provide equal treatment and duties.
  5. Beneficence - Obligation to promote good.
  6. Non-Malfeasance - Commitment to do no harm.

Principles in Professional Healthcare

  • Codes of ethics guide behavior in healthcare:
    • Based on principles of autonomy, beneficence, non-maleficence, and justice.
  • In practice, these principles are not absolute and may sometimes conflict with each other.