created by Cardio-fast-eatass on 30/06/2024 at 22:26 UTC
14 upvotes, 7 top-level comments (showing 7)
Is there a strong argument against utilitarianism in medicine? Do we expect this may ever change in the future?
Comment by AutoModerator at 30/06/2024 at 22:26 UTC
1 upvotes, 0 direct replies
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Comment by Voltairinede at 30/06/2024 at 22:57 UTC
33 upvotes, 2 direct replies
How has utilitarianism become the dominant ethic in western medicine?
Well the first thing to ask is, is it? Why do you think so? It seems in fact that we often spend massive sums to keep particular people alive that would be unjustifiable if we were doing cold hard utilitarianism. From a story recently in the headlines, in the UK the NHS have spent £2.6m to give a hemophiliac virus therapy that has largely cured him, while normally spending £150,000 and £200,000 per patient per year for life on haemophiliacs. It doesn't seem clear what the straightforward utilitarian justification for doing either thing is (Though I'm sure you can come up with one, the point is to indicate while a utilitarian justification makes more sense than any other one), especially at a time where routine operations in the UK have bafflingly long waiting times. This sort of thing is not at all unusual, but is in fact entirely routine, the idea that we should treat people with what we can to help them, unless it costs a truly incredible sum. On the face of things this seems to not be a utilitarian principle, but a deontological one (and a virtue ethics explanation also seems to work better than a utilitarian one).
The second point is that, if you are seeking to explain why people other than Philosophers do things, you shouldn't ask Philosophers, but almost certainly some kind of scientist.
Comment by Platos_Kallipolis at 01/07/2024 at 13:02 UTC
4 upvotes, 0 direct replies
It's not. Medical practice, in the west at least, is strongly driven by respect for autonomy (hence the practice of informed consent) and justice (hence the emphasis on treating the most in need, even if it expends significant resources).
In the 70s and 80s, utilitarianism was more dominant, at least in the form of not caring about what the patient wants. But that has mostly changed, even to the point of providing non-medically indicated care just because a patient requests it.
There are still some areas where we function on something closer to a utility calculus, arguably at least. For instance, triage situations change or treatment priorities to preserve resources and save as many as possible, rather than treating the most in need. Similarly, only in the past 6 months had the US finally decided to put a stop to unconsented pelvic exams during procedures where the patient is under. That has been going on forever supposedly to train students. As a utilitarian, I don't think it is actually sorted, but one could naively claim that.
Comment by being_as_such at 01/07/2024 at 22:18 UTC
2 upvotes, 0 direct replies
Ok, to start, it is worth mentioning that *medical ethics* as an academic discipline is not itself that utilitarian. The classic textbook that med students have to read in their ethics module is Beauchamp and Childress *The Principles of Biomedical Ethics*, which recommends a “four principles” approach to medical ethics, where ethical decisions attempt to balance considerations of beneficence (do good), non-maleficence (don’t do harm, autonomy (respect the patient’s decisions) and justice (treat all people equally). Only the first of these two can be plausibly characterized as utilitarian.
Putting this aside, I do think there is something to the idea that we as a society often think about medical ethics in utilitarian ways. Here is one speculative reasons for why this might be the case.
Utilitarianism arose out of positivism (the idea that all inquiry should be carried out in the model of the natural sciences). Utilitarianism was a natural view because it treats ethics using quantitative methods. To the degree that this positivist picture still has hold on a lot of people, so does utilitarianism. This is compounded by the fact that modern scientific medicine was also born out of the positivist movement of the 19th century. And so it is not that implausible that a lot of the conceptual framework that goes into how we think about medicine is related to the conceptual framework that fits well with utilitarianism.
Again, just speculation, but maybe something worth thinking about.
Comment by [deleted] at 30/06/2024 at 23:12 UTC
1 upvotes, 1 direct replies
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Comment by [deleted] at 30/06/2024 at 23:37 UTC
1 upvotes, 1 direct replies
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Comment by bunker_man at 01/07/2024 at 05:36 UTC
2 upvotes, 1 direct replies
Just to clarify, you know doctors aren't really trying to kill you to harvest your organs, right?