Exploring The Ethical Theories

Consequentialism is an ethical theory based on whether or not a decision made or an act carried out is deemed right or wrong based on the outcome having a positive end result. Utilitarianism and Hedonism are types of consequentialism. Utilitarianism is concerned with what is best for the greater good, for instance, whether a particular act is more beneficial for the masses rather than just benefiting one individual.

Exploring The Ethical Theories

There are two types of Utilitarianism: Act and Rule Utilitarianism. Act Utilitarianism involves each individual act being carefully examined. For example, if a decision is to be made, the consequences have to be evaluated, and the chosen option should be of maximal benefit. However, Rule Utilitarianism evaluates the consequences by adopting a certain set of rules, such as ‘Do not kill’ or ‘Do not lie.’ Whether an act is right or wrong is generally based on these rules (Fletcher et al., 1995, as cited in Hendrick).

Hedonism is one’s own pursuit to seek pleasure and to avoid pain. Bentham and Mill are described as hedonistic utilitarians because they defined utility in terms of pleasure and happiness. Mill and Bentham’s ideas were widely respected due to the notion that they reduced moral judgments and suffering while increasing happiness (Hendrick, 2000).

If the outcome of an act is positive in the long-term, but the route taken to achieve the positive outcome involved some forms of dissatisfaction or emotional unrest, it can be seen as justifiable because the end result is positive. However, if the outcome is negative, the act would not be justifiable (Rumbold, 1999). For example, if a person, who is a mother, father, or a loved family member, is in receipt of a very invasive treatment, such as chemotherapy used to treat cancer, the treatment would cause dissatisfaction and emotional turmoil. Yet, the end result would or could be the individual’s wellness and overall happiness, as the patient would or could be cured. This would also be for the greater good for the said patient’s family members, as well as the patient.

There are other scenarios to help understand consequentialism on a much larger scale. If a deceased person’s organs were donated, that one person could have suffered at some point before their death, yet many people would have gained life from the death because their organs enabled others to sustain life. This scenario can go further too. Consequentialism would look at who would benefit from the donated organs the most and what would have the greatest outcome, although consequentialism does not guarantee an outcome.

Deontology

The definition of deontology in the Oxford Dictionary is “The study of the nature of duty and obligation” (Oxford University Press, 2019). Deontology is absolutist, in that something is wrong or right regardless of the consequences. Immanuel Kant was well-known and widely influential for his ethical views surrounding the theory of deontology. The morality of an act does not justify the actions taken during the time period it takes to reach the end result of that particular act. According to Thompson et al. (1994), when referring to Kant, “It is not the end result of an act that makes it right or wrong, but rather the moral intention of the agent” (Thompson et al., 1994, as cited in Bartter). If an act is to be carried out, it must be done within what is ultimately right. For instance, an act propelled by emotions that goes against a moral code of conduct is wrong, even if carried out for the greater good. If an individual commits theft and steals food to feed the poor and hungry, it is wrong regardless of the good consequences the result would bring. Kant theorized that if a person is going to make a decision, it should be one that everyone should be able to follow, no matter the circumstances, beliefs, or culture; it should be one that can be applied universally and not one where exceptions are permitted depending on the situation.

There are criticisms of the deontology theory. Deontology is considered too absolutist. David Seedhouse (1988) argues that the rights and wrongs of this ethical theory are too firm and not sensitive to people’s moral judgments. Deontology states that it is wrong to lie in any context of a situation. There could be situations that arise in a healthcare setting that justify an untruth to be told. This could be a case where a family has been involved in a catastrophic car accident, involving the fatalities of some family members. If one of the surviving family members were to ask about a relative after the accident and this relative was deceased, but the truth would cause the surviving family member severe distress, which would prolong the need for emergency treatment, it would be in the best interest of the survivor not to be told this information until they were in a more stable condition. There is no direction on how decisions should be made when a lie is being told to protect a person. It also presumes that as a society, people all live by the same righteous moral code of conduct. In reality, life and people’s life experiences cause different judgments, and therefore people make different decisions. An example of this could be two patients needing a liver transplant, one a chronic alcoholic and another with non-alcoholic fatty liver disease (NAFLD). This could influence who was to receive the first available donated organ. However, under the rules of deontology, the first person on the organ transplant list should receive the organ, whereas in the NHS, the donated organ is matched to the patient who would benefit the most from the transplant (British Liver Trust, 2018).

Postmodern Ethics

Postmodern ethics are a set of rules that take into account people’s social surroundings, their environment, psychological state, and show respect and acceptance for a person’s political views, religion, sexual orientation, ethnicity, and culture. Postmodernism also questions facts, and the theory is open to the idea that things can change. Postmodernism is not absolutist; there is no absolute truth. Although it is accepting of all beliefs, it also speaks out against ruling regimes some religions may have. Pre-modernism was based on God and religion and what was morally right or wrong, according to the Bible. Modernism was based on scientific facts that had been researched and is a very biomedical model.

Principlism

Principlism is based on ethics that include autonomy, beneficence, non-maleficence, and justice. In healthcare, autonomy allows a patient to make a decision about their treatment without a healthcare professional influencing their decision-making. Although the healthcare professional would still provide information and advice. Under the modern theory, which is a biomedical model, the healthcare professional would be presented with a patient’s ailments and treat the illness with a prescription of whichever medication may be needed to solve the ailment; the patient would either comply or not. Whereas, with autonomy, an example could be a young person under the age of 16. A healthcare worker or doctor would have to safeguard the patient as well as respect their autonomy (Singleton & McLaren, 1995, as cited in Bartter). However, a parent or court can override the decision of any person under 16 years of age if deemed appropriate to do so. A general practitioner should provide the young patient with all the adequate information they need to make an informed choice regarding medical treatment. It is only when the underage patient makes a decision that the general practitioner disagrees with that the patient’s autonomy will be overridden (Care Quality Commission, 2017). Beneficence is the production of positivity and to be beneficial to others; it is often considered to be the moral compass that must be upheld by healthcare workers (Naidoo & Wills, 2015).

Conclusion

In conclusion, the exploration of ethical theories, including consequentialism, deontology, postmodern ethics, and principlism, provides a comprehensive understanding of diverse perspectives in ethical decision-making. Consequentialism, represented by Utilitarianism and Hedonism, focuses on the outcomes of actions, emphasizing the greater good or the pursuit of pleasure. Deontology, rooted in the moral philosophy of Immanuel Kant, posits that the morality of an act is determined by the moral intention of the agent, irrespective of the consequences. While deontology is criticized for its absolutist nature, it underscores the importance of universalizable ethical principles. Postmodern ethics embrace diversity and change, challenging absolute truths, while principlism provides a balanced approach in healthcare ethics, considering autonomy, beneficence, non-maleficence, and justice.