Kant's ethics poses two great problems that lead many to reject it:
1. Unlike the proportionality that comes out of the utility principle, the categorical imperative yields only absolutes . Actions either pass or fail with no allowance for a "gray area." Moreover, the rigid lines are often drawn in unlikely places. For example, lying is always wrong--even the "polite lie."
2. Moral dilemmas are created when duties come in conflict, and there is no mechanism for solving them. Utilitarianism permits a ready comparison of all actions, and if a set of alternatives have the same expected utility, they are equally good. Conflicting duties, however, may require that I perform logically or physically incompatible actions, and my failure to do any one is itself a moral wrong.
It is not always clear what the outcome of an action will be, nor is it always possible to determine who will be affected by it. Judging an action by the outcome is therefore hard to do beforehand.
It is very difficult to quantify pleasures for cost/benefit analysis (but since this only has to be done on a comparative scale, this may not be as serious an objection as it at first seems).
The calculation required to determine the right is both complicated and time consuming. Many occasions will not permit the time and many individuals may not even be capable of the calculations.
Since the greatest good for the greatest number is described in aggregate terms, that good may be achieved under conditions that are harmful to some, so long as that harm is balanced by a greater good.
The theory fails to acknowledge any individual rights that could not be violated for the sake of the greatest good. Indeed, even the murder of an innocent person would seem to be condoned if it served the greater number
Mr Wilkinson is a 77-year-old who lives with his wife and son. He is terminally ill with cancer of the lung with liver secondaries. Over the last few months he has deteriorated, he has also lost a lot of weight. It has now been decided that Mr Wilkinson should be admitted for assessment and pain control.
He is currently taking co-codamol for pain relief but it is felt by the nursing staff that his pain relief would be better met through use of morphine. However, Mr Wilkinson has stressed that he does not want to start taking morphine having heard terrible stories about people who have taken it.
The ward staff express their concerns to you that they feel Mr Wilkinson is in pain and that he looks uncomfortable. The staff have asked him on several occasions but he always says he's ok. During previous respite admissions, Mr Wilkinson has told nursing staff that he does not want to be drugged to death, He feels the Lord will receive him when he is ready.
One week after his admission, he deteriorates. He becomes semi-conscious - he is dying. During periods of consciousness he becomes very agitated, screaming at times - especially when moved.
The nursing staff on the ward are very distressed by this. The wife and son are asked if they would agree to morphine or sedation being given to the patient. They refuse.
The next day the son appears ambivalent about the decision to withhold morphine.
Both the Consultant and nursing staff feel that morphine should be given. The junior doctors and staff feel that the wishes of the family should be observed as they are worried about a complaint.