PHI 204 - Ethical Issues in Health Care: Consequentialism, Deontology

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  • 1. Consequentialism Deontology (Biomedical Ethics) Charles Lohman
  • 2. Consequentialism
    • CONSEQUENTIALISM is about the rightness or wrongness of an action/policy based on its consequences.
      • JUSTIFICATION is based on the amount of good the actions/policies bring about.
      • UTILITARIANISM is the most familiar form of CONSEQUENTIALISM
        • UTILITARIANISM states that one should act to promote the greatest good for the greatest number.
  • 3. The Difference Between Utilitarianism and Consequentialism
    • Although UTILITARIANISM and CONSEQUENTIALISM are used interchangeably; there is a difference between the two theories.
      • UTILITARIANISTS are more concerned with the greatest good for the greatest number.
      • CONSEQUENTIALISTS are more concerned with the greatest good than with the good of the greatest number.
  • 4. Act & Rule The Two Types of Consequentialism
    • 1.) Act-CONSEQUENTIALISM is based on actions.
      • An action is right if it produces a better consequence than alternative actions.
        • For example, an act is OBLIGATORY if it promotes better consequences than any alternatives.
        • An act is PERMISSIBLE if it promotes consequences that are at least as good as any of its alternatives.
          • For example, the act of selecting one patient over the other is PERMISSIBLE, if not OBLIGATORY, because it brings about a better consequence than giving each of the patients an equal chance for treatment.
  • 5. Act & Rule The Two Types of Consequentialism
    • 2.) Rule- CONSEQUENTIALISM is based on a set of rules.
      • The set of rules are right if they lead to better consequences than alternative sets of rules.
      • Usually, the general rules will promote the best consequences in the long term.
        • For example, it would not promote the best consequences if a doctor breached confidentiality in order to tell a patient’s children that their parent has a disease that they might have inherited as well. Now, although the doctor’s action can be justified because it might prevent harmful consequences to the children, it would lead to more harmful consequences in the long term; whereas if doctors were to breach confidentiality regularly then many people would distrust the medical profession and be discouraged from seeing doctors for prevention and treatment for diseases.
  • 6. Objection to Consequentialism
    • 1.) Doing whatever promotes the best consequences may violate individuals’ interests and rights.
    • 2.) It is an impersonal theory concerned more with the aggregative question of “how much” of some good there should be than with the distributive question of “who” should have it.
  • 7. Deontology
    • DEONTOLOGY defines the rightness or wrongness of an action in terms of a duty or obligation to respect the rights and values of persons.
      • The focus is on the RIGHTS, DUTIES and the PERSON as an END-IN-ITSELF.
      • DEONTOLOGY gives the constraints on what we can and cannot do to others.
        • With DEONTOLOGY, consequences can matter, but they are not the main motivation for action.
        • DEONTOLOGY more or less addresses the objections of CONSEQUENTIALISM
          • In other words, since CONSEQUENTIALISM does not truly focus on the claims of each person who will benefit or be burdened by general decisions or policies; DEONTOLOGY does.
  • 8. Kant’s Categorical Imperative
    • CATEGORICAL IMPERATIVE is based on reason alone and reason alone tells us which action is right in every situation.
      • In other words, an action is right when it aligns with the moral law, which embodies the categorical imperative and is self legislated by rational human beings.
        • The imperative is categorical in the sense that it is unconditional and therefore allows no exceptions.
          • So it applies to all humans regardless of personal desires, plans, or interests.
  • 9. Categorical Imperative Consists of Two Formulations
    • 1.) Act only on the maxim by which you can at the same time ‘will’ that it should become a universal law.
      • A maxim is a subjective rule that guides one’s actions.
        • So it’s not the actions that are judged to be right or wrong, but the actions on the basis of the particular maxim.
    • 2.) Act so that you treat humanity, whether in your own person or in that of any other, always as an end and never as a means only.
      • This formulation is more relevant to biomedical ethics.
        • It specifies constraints on what we can do to others, prohibiting even actions that would maximize over all net benefit.
  • 10. Summed Up
    • Although CONSEQUENTIALISM and DEONTOLOGY differ, they both tell us WHAT WE SHOULD DO.
      • In this sense, they identify MORAL OBLIGATIONS.
        • In CONSEQUENTIALISM, the OBLIGATION is to promote good outcomes.
        • In DEONTOLOGY, the OBLIGATION is to respect persons as ends-in-themselves.
    • In addition, CONSEQUENTIALISM and DEONTOLOGY are the two ethical theories most frequently used to defend different positions in biomedicine.