Deontology & Utilitarianism: Critical Perspectives

Capital punishment is defined as the death penalty, as a punishment for a person convicted of committing a heinous crime. This form of punishment is usually reserved for crimes such as murder, but the application of the death penalty varies widely. Execution is most often carried out by medical methods, using a combination of IV drugs. There are quite a few things that can go wrong with this procedure, especially if the individuals administering lethal injection aren’t properly trained. This means that health care providers, including doctors and nurses, have been required to participate in administering lethal injections. This paper will discuss the ethical dilemma regarding health care providers participating in administering the lethal injection from the philosophical viewpoints of deontology and utilitarianism, present arguments in light of both, and proceed to touch on further ethical theories such as virtue ethics as well as feminist ethics. The paper will also seek to highlight critical perspectives regarding both theories.

Utilitarianism is known as a consequentialist ethical theory, it insists that consequences must be taken into account when considering action. For Utilitarianism, the most prominent consequentialist theory, the highest good is happiness. It is not the happiness of the individual decision-maker; it is the happiness of everyone potentially affected by one’s decision that counts. Utilitarianists strive to produce the greatest amount of happiness possible for everyone concerned. Utilitarianism yields a simple formula, to select that action which, on balance, will produce the greatest amount of happiness for the greatest number of people.

According to Utilitarianism, it would be acceptable to sacrifice the happiness of a few people in order to maximize the overall happiness for the collective. I feel Utilitarianists would advocate for the nurse or health care provider to participate in administering a lethal injection on a criminal. For Utilitarian, the fact that this action would prevent the criminal from committing future crimes in society, especially deterring the criminal from committing murder, it would then be acceptable to have the nurse perform this action. I feel most people in society would prefer this choice. Thus, protecting society and producing the best results for the greatest number of people involved. I feel the taking of one life by administering a lethal injection would be ethical under Utilitarianism, as it would prevent the taking of another innocent life, should this criminal re-offend in the future. Ultimately, having the nurse administer the lethal injection and taking such measures is for the protection/ health of citizens in society and would promote social utility.

Looking at this from a critical point of view, I feel it is a disadvantage for Utilitarian to balance happiness over harm to improve satisfaction for everyone else. It makes it to easy to advocate for health professionals to participate in lethal injection and put someone to death using this balancing principle. Just because the majority of a population thinks something would be right, does not make it ethical. The most serious criticism of utilitarianism is that, in principle at least, it could sanction actions generally thought to be immoral.

Deontologists conceive of morality as a system of moral duties, principles, rules, or imperatives. The task of the moral agent is to discern what his or her duties are, and to act consistently with and in the spirit of those duties. The morality of an action is based upon good intent, which is defined by its loyalty to a rule or set of rules. Kant believed duties were absolute and called them a categorical imperative. A categorical imperative can be seen as a test when faced with a decision, formulate the rule or maxim on the basis to which you are proposing to act. Then ask yourself if it would be reasonable if anyone and everyone acted on the basis of this same rule in any situation, it would be acceptable to then ‘universalize’ this rule. It would then be judged to be morally right. Deontology solely focuses on the rightness or wrongness of actions and does not look at the rightness or wrongness of consequences of the action.

When examining if deontology would approve of health care providers participating in giving a lethal injection for the purpose of the death penalty, I feel it could go both ways. First of All, if the nurse was employed by a correctional facility whose procedure and policy was to have the nurse or physician-administered all lethal injections, then it would be their duty to administer the injection. Therefore, it could be seen as good and morally right to participate in administering a lethal injection on prisoners/criminals in a correctional facility. You could justify the maxim in this situation by saying, ‘to only administer a lethal injection on a criminal in a prison.’ This could be seen as universally acceptable and the nurse administering the injection would not be seen as wrong for his or her actions, but rather that he or she followed the duties or set of rules put in place. It could be argued that the nurse would participate in administering the lethal injection to ensure it was done properly with the least amount of suffering. This could be viewed as the maxim or universal law and judged as morally right.

On the other hand, I believe some deontologists would not support health care providers administering lethal injection and deem it as a morally wrong action. The nurse participating in giving the lethal injection could be viewed as inhumane, cruel, and unacceptable. As it undermines human dignity and is a violation of human rights. As Sobstyl states, deontology is often seen as following the golden rule and respecting the inherent dignity of each person. For most deontologists, killing is wrong and participating in the same under any circumstances.

Some deontologists may argue that it is a violation of medical ethics, that it conflicts with the regulatory body's code of ethics, and goes against the nature of the relationship between nurse and patient or physician and patient. It could be viewed as immoral when the obligation or duty of the provider to maintain the integrity of their profession is considered.

As a nurse, you are to refrain from causing death, especially deliberately, even when legally permitted. Therefore, refraining from participating in administering the lethal injection would be viewed as the right thing to do. It is seen as a violation of the nursing code of ethics and I feel this would be accepted as the maxim or universal law. The death penalty is killing, and murder is always wrong. The act of participating in killing is a universal law and is always wrong in my eyes.

Virtue ethics views moral life as having less to do with rules or principles for determining the right action than with habits and dispositions. The emphasis is on moral character: not on actions or decisions as such, but rather on the kind of person one is and should be. Virtues are those habits and character traits the perfection of which enables us to realize and fulfill our natures. A virtue is a positive character trait that gives a person the inclination to act, think and feel in a morally good way. Virtues consist of honesty, compassion, diligence, and loyalty to name a few.

I believe virtue ethics would not advocate for the nurse or healthcare professional to participate in administering of a lethal injection. Entering a health care professional is “entering a moral community’, of which the values and certain characteristics have been long established and practiced. This is true in the case of nursing. Nurses are trained to establish morals and virtues to contribute to the overall good of society and our patients. For this reason, it would be morally wrong or unjust to have the nurse participate in administering a lethal injection regarding virtue ethics.

I feel virtue ethics is the only non-flawed theory of ethics. I believe virtue ethics would ultimately find that a nurse participating in a lethal injection would be wrong. Nurses are required to demonstrate virtues of caring, respect, dignity, honesty, and trustworthiness. Participating in a lethal injection can be viewed as wrong because it harms people and goes against nurses committing themselves to act virtuously. Because virtue ethics is an approach that focuses on a character with the assumption that a person of good character will behave in ways that’s are consistent with their character. It is appropriate for then for nurses to make choices that enhance well-being. Therefore, it would be unethical for the nurse to administer a lethal injection.

Feminist ethics is based on the understanding that society remains patriarchal in many ways. The interests and perspectives of men are often privileged and those of women are muted, sometimes in ways that are subtle and taken for granted as if they were “natural”. Feminist ethics does not seek to understand the differences in how men and women seek to remedy ethical dilemmas, rather, feminine ethics purses disparity between treatment or understanding of sexes(prejudices) in our culture and in ‘institutional policies such as those we follow in health care settings. Feminist ethics looks at the links of masculinity with power or even unjust treatment and femininity with powerlessness, emotion, and sound judgment. Feminist ethics raises women's values that may have been historically oppressed. It attempts to balance the power between women and men.

I believe feminist ethics would feel it is wrong and unethical for a health care professional to participate in administering lethal injection. Most men utilize standards of justice to solve dilemmas, where women would be more likely to use care, compassion, and the well-being for others to solve ethical dilemmas. The criminal justice system and the idea of the death penalty seem to be an old way of thinking created with traditional masculine views and ideas. I believe feminine ethics would view the death penalty as patriarchal and would want to break down and reduce the injustices and promote the well-being of all. Therefore, the feminist approach would not agree with participating in the lethal injection, as it is based on the male voice and downplays the female voice, overshadowed by the male perspective.

As a nurse who has previously worked in a correctional facility, I myself do not agree with a nurse participating in a lethal injection. When I worked in the prison as a nurse, I had obligations to promote health, and healing and focus on rehabilitation to support criminals in time of need. My role as the nurse was go offer non-discriminatory health care and to advocate for their health and social concerns. I cared for the prisoners when they were ill, became disabled or needed mental health counseling and support. I feel the death penalty is truly unethical, inhumane, and cruel. Furthermore, I believe a nurse should never participate in a lethal injection as this goes against the nursing code of ethics.

The RPNC Code of Ethics articulates the ethical principles and values that guide all members of the Psychiatric Nursing profession. It sets out the framework for professional responsibility and accountability while promoting high ethical standards in practice and providing a benchmark for Registered Psychiatric Nurses to use for self-evaluation. (RPNC code of ethics). No nurse should ever participate in the taking of someone’s life and I feel this goes in accordance with all nursing codes of ethics. Nurses are healers, not executioners.

The easiest thing sometimes is for nurses to just follow the written rules. Unfortunately, in nursing, we face ethical dilemmas about what the right and best actions are in all kinds of areas. Everything is subject to rules, regulations, and protocols and at times these will be wrong. As nurses, we will then be called to make a choice. We will have to do our best to make the ethical choice, whether it be following the code of ethics or by following one of the ethical theories as mentioned in this paper. Luckily, I do not work in a province or country that utilizes the death penalty or lethal injection. However, this does exist in various areas of the world and I will run across other ethical dilemmas in the career that will require me to assess the situation and make the best ethical choice. As medical professionals, we must do our best to choose intelligently and wisely.