Med Ethics Final Exam Questions Essay

1 Explain briefly the main features of a utilitarian ethical theory and discuss some of the objections to it. Explore the nature of the moral guidance utilitarianism would give for one of the particular ethical issues in medicine we have discussed in the course. Do you find the utilitarian approach to this problem persuasive? Why or why not?

John Stuart Mill, the man who suggested the idea of Greatest Happiness Principle is well known for his contributions to the ethical theory of utilitarianism. Utility, a main theme of this theory suggests that “actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness”. Therefore, the important aspect is not the action but rather the consequence of the action. The action itself may be for the good of someone but only under certain circumstances. When looking at an action we must weigh the consequences to determine which has the higher benefit, or would produce the most happiness. Although the action may cause a slight bit of unhappiness, it outweighs the unhappiness. We can look at this with the common example of someone who is dependent on a ventilator in the hospital. Let’s call her Betty. Betty is near death and has minimal brain function. A man has just arrived in the Emergency Department after a motorcycle accident and needs a kidney to survive. When looking at the principle of utility, removing Betty’s kidney and giving it to the man who arrived would be acceptable. It would be acceptable because if the kidney was not given, both patients would more than likely die, causing the most unhappiness. But, Betty’s good kidney could save the man’s life creating the most happiness for the most amount of people in this situation, under the circumstances. Each person’s interests are looked at in situations objectively and decided on which action would produce the greatest happiness. Bentham, another contributor to utilitarianism identifies happiness as pleasure. He looks at the highest mathematical weight of pleasure versus pain to determine the best action to take. Both regard happiness as an intrinsic good, or essential good.
The theory of utilitarianism can have a wide variety of objections, especially coming from the principle of justice. In the case above, one person’s life was being taken for the happiness of other people, which would not be considered morally acceptable. Mill agrees that his theory lacks justice but also believes that there would be no way to distribute the happiness evenly under these circumstances, believing that utilitarianism is still the best moral theory available. Another objection to utilitarianism is that of how to measure happiness. Who determines what action produces greater happiness? MacIntyre criticizes utility and considers it fiction. Some also say that utilitarianism contains too much calculating. The time spent calculating what the right action may be takes away from the action itself. Debating over the right action could possibly have no benefit, taking the case above and having both the patients die.
Let’s look at a case and determine the best action based on utility. In class we discussed the case of who should receive the epinephrine for a bee sting. We have five people who all need one doses of epinephrine to survive and one person who needs five doses to survive. We only have five doses of epinephrine. Who should receive the epinephrine? All utilitarian’s would agree that the five people should all get one dose of epinephrine because it benefits the most people, or yields the greatest amount of happiness. With this action, the one person would be left out and die. I believe that the utilitarian perspective is persuasive because, given the circumstances it benefits the most people. Yes, it would stink to be the only person without the epinephrine, but saving five out of six lives rather than one out of six seems more acceptable. In this case, and in many there is no way to

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