Ethical theories and principles are helpful in approaching ethical issues and decisions. Importantly, however, is the fact that ethical theories are guides that are essential only in providing meaning for moral experiences. In healthcare, ethical decisions are guided mainly by two classical ethical theories: deontology and teleology, or more specifically, one form of teleology known as utilitarianism.
Deontology is identified as a classical theory based on moral obligation or duty. Moral obligation is known as the duty of acting in a specific way in response to moral norms (Rosenstand, 2012). This theory suggests that the moral rightness or wrongness of an action is determined by the principle or the motivation on which the action is based. From the deontological perspective, the consequences of a specific action neither drive ethical decisions nor serve as guides for ethical justification.
Utilitarianism, on the other hand, is a form of teleology. Teleology is the ethical theory which determines rightness or wrongness solely based on an estimate of the probable outcome (Saunders, 2010). Unlike deontology, utilitarianism is based on usefulness or utility rather than moral obligation or duty. According to utilitarianism, the rightness or wrongness of human actions is determined by an assessment of outcomes. The utility of an action is decided on the basis of whether that action would bring about the greatest number of good consequences and the least number of evil consequences and, by extension, a greater good than evil in the world as a whole.
Based on the case study, a deontologist perspective suggests that taking a humans life even when it involves saving other lives is wrong and remains unjustifiable to the deontologist because the action violates the moral duty to preserve life and to avoid killing. To the utilitarian, however, preserving lives of the people who will be infected with the HIV even if it means taking another life in order save lives, may be justified by the greatest number of positive (good) consequences. Taking the life of this patient who is already determined to infect as many people as possible with HIV, because he can neither be arrested nor stopped will save many lives. Taking this mans life, while tragic to the utilitarian, represents fewer bad consequences than allowing him to take many lives that did not have anything to do with is an infection.
Therefore, the choice for Ken to take or not to take the patients life with the untraceable position is dependent on the ethical boundaries that limit his job. Clearly, deontologist perspective limits Ken from taking someone elses life, because it is unjustifiable and the action violates the moral duty to preserve life and to avoid killing. But if Ken considers the utilitarian perspective, which in my opinion is the best grounds to base such ethical dilemma, he will be forced to take the patients life to save the possible hundreds of lives that shall be affected including innocent individuals who might be affected in the process.
Nevertheless, even though most health care professionals consider themselves utilitarians, an understanding of the deontology is specifically necessary when ethical principles conflict. The ability to establish priorities among ethical principles or to establish the moral weight of ethical principles is fundamental to deontology. When confronted with ethical dilemmas, most professionals tend to operate from a perspective carefully derived from aspects of both major classical theoretical positions.
Rosenstand, N. (2012). The moral of the story: An introduction to ethics. McGraw-Hill Higher Education.
Saunders, B. (2010). JS Mill's conception of utility. Utilitas, 22(1), 52-69.
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