Deontology vs. utilitarianism: Understanding the basis for the moral theories in medicine

Abstract

We live in a society that functions with a system of morals that seeks to determine what is right or wrong. Each society is ruled by moral codes that guide people’s action to minimize the risk of sliding into structural dysfunction. To understand the importance of human values within which the society can live and operate in a harmonious state, many great philosophers such as Immanuel Kant and Bentham Jeremy have presented moral theories based on the principles of deontology and utilitarianism, respectively. These two ethical major streams of thought influence ethical decision-making. In utilitarian principles, outcomes justify the means or ways to achieve it and as such the focus is on the consequences of an action, whereas in deontological ethics, obligation to duty is what matters irrespective of the outcome. In medicine, deontology is patient centered, whereas utilitarianism is society centered. Practically, these two moral thoughts seem contradictory but each has its own advantages and disadvantages, which may occasionally intertwine to reach a midpoint level in a critical situation. In a well-resourced setting, the deontology approach to healthcare issues seems more practicable than the utilitarian approach because the duty of care is more focused on the individual and not necessarily on the society. As every rational being thinks of him- or herself as an end, doctors must act in such a way that they treat humanity and their patients always as an end and never simply as a means. The moral worth of a clinician’s action in patients’ management therefore depends exclusively on the moral acceptability of the rule of obligation to duty, that is, “cause no harm” irrespective of the consequences. This article highlights the fundamentals of deontology and utilitarian principles as moral theories in medicine with basic examples.

Keywords

• deontology
• medicine
• moral theories
• utilitarianism