Ethical theories are a significant part of the healthcare profession. They help healthcare providers overcome challenges and conflicts that arise in the profession. These difficulties and conflicts stem from competing personal, organizational, professional and societal values through which healthcare professionals are required to make critical decisions. Ethics determine the standards through which healthcare providers ought to act in such situations. Ethical theories can be categorized as consequentialism, non-consequentialism, and age centered theories. Consequentialism theories focus on the consequences of the ethical decisions made while non-consequentialism theories focus on the intentions that drive specific ethical choices on particular situations (Barber,2016). These theories have a broad application in different disciplines including the healthcare. Example of consequentialism theories is the utilitarianism theory and the principlism theories. This paper critically discusses the strengths and weakness of these two theories as they apply to ethical decision making in healthcare.
The utilitarianism theory is among the most common approaches in making ethical decisions. The theory instructs that ethical decisions should weigh the consequences of the actions on if it does more good or harm for the majority of the people. In other words, utilitarian approach directs that decision should result in more good over harm for the affected people.
One of its strengths is that it does not dictate complex rules when used to make ethical decisions. It merely requires one to take the option which results in the least harm to the people affected. When applied in the healthcare setting, the theory gives a medical professional the power to decide what is best depending on the circumstance. The utilitarianism approach provides a solution when one is faced with a situation where a decision has to make on choosing one option of the other especially when the best alternative available is morally wrong. According to Mack (2004), the theory lays a strong emphasis on impartiality and unselfishness as it does not require one to refer to the precedent actions on if they worked for the decision or not
The straightforwardness of the unitarianism theory is another of its best strengths. In the healthcare sector, the theory can be applied in making ethical decisions in situations that require minimizing pain and maximizing pleasure even when the decision is morally wrong. It focuses on benefiting the majority while agrees with common sense making its principles fair and widely accepted. Utilitarianism theory is accepted widely in the society. It dictates the ethical decisions made by an individual must behold his point of view and interests to promote the happiness of others, making the theory very practical in real life. The strengths of the theory have been very applicable in balancing the costs and benefits in health care.
However, despite its strengths and wide acceptance, utilitarianism theory also has several weaknesses. It is difficult to define happiness as it varies between different individuals. Also, the theory bases its ethical decisions on the consequences of action to be taken. However, it is difficult for an individual to evaluate all the consequences that may arise from a particular action accurately. The theory also does not put into considerations the integrity as personal responsibilities for the actions.
It is possible that wrong motives can be influenced to lead to everyone’s happiness as required by the theory. The theory is criticized for lack of respect for the rights of others. It only considers the happiness of the majority while simply ignoring the right of the minority even though they might be justified. The theory also ignores the significance of duty as there are instances which an action can be right or wrong different from the purpose of the happiness of the majority which the theory applies.
Principlism is also a consequential theory widely applied in the healthcare sector. The theory is based on four principles that include autonomy. The second principle is the non-maleficence, the third principle is beneficence, and the fourth principle is justice. Principles provided by the principles theory are less general several other theories in making ethical decisions but can be applied in the rules, cases, and virtues in the healthcare profession.
Bulger, (2007) notes that the theory was developed for the healthcare profession following the ethical issues that arose on the field at the beginning of the medical history. Practitioners were required to take an oath to ensure that they observed the four principles. The autonomy principle is based on making decisions that are relevant to the profession by rationally evaluating their options putting into consideration the facts and the consequences of the ethical decisions they would make. This principle makes it the sole responsibility of a health practitioner to collaborate with other decision makers who include the patients to ensure that decisions made are healthy and well being.
The principle further requires the healthcare provider to educate the patients on the ethical issues on hand to ensure that they make informed decisions, especially with the treatment or healthcare. Also, the principle ensures that human rights and dignity are protected. Beneficence focuses on compassion derived from the desire to do well and improve the wellness of others. The theory approaches beneficence as the basis of morality and human nature principles(DeMarco, 2005). Using this principle, the healthcare providers have a responsibility to consider the pain experienced by the patients in their decisions.
The theory replaces the moral theory and rules with principles that are one of the greatest weaknesses of the principlism theory. Hence, The theory misses several moral problems that are common in the healthcare environment. This makes the theory either misleading or impractical in such situations. The principles provided by the theory are not thorough guidelines that should guide a medical practitioner on making ethical decisions but rather collection or related matters that can be considered when making ethical decisions. Unlike utilitarianism, the theory does not expressively straightforwardly guide a health care professional on the approach to make an ethical decision when faced with such a situation. Clouser, & Gert(1990) argue that the principles also presented by the theory have a systematic relationship with each other on the sequence through which they should apply when solving an ethical problem. Critics have argued that the theory is therefore confusing as the principles often conflict with each other contradicting the theory.
Both the utilitarianism and the principlism theories are very applicable in the healthcare sector. However, the theories have several weakness and strengths when applied in making ethical decisions. The utilitarian theory is simple, straightforward and requires no past precedents on similar applications that worked successfully.
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DeMarco, J. P. (2005). Principlism and moral dilemmas: a new principle.Journal of medical ethics, 31(2), 101-105.
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