Introduction
Utilitarian way of thinking and decision making presupposes consideration of all the ethical principles and aspects possible. In general, utilitarian reasoning is closely linked with making the least harmful decision independently of the actual origin of reasoning. The necessity to decide which patient will receive the heart for transplantation requires the thorough analysis of all the factors available, as well as clear reasoning on the matters of importance of these factors.
Decision Making
Act and Rule Utilitarianism
Considering the possible consequences of the choice, it should be emphasized that independently of the decision made, only one person will benefit (regardless of the families of the patients), hence, the heart should get a person who needs it most. (Stein, 2001) As the decision should be taken quickly, the best solution would be to give the heart to a person who would endure the least without a new one. Hence, all the medical risks of dealing transplantation for other patients should be considered. If the risks of post-surgical complications are equal, the transplantation should be performed for a person who has the least time before the heart can be transplanted.
The rule principles are not applicable here if you consider the happiness of the patients only. However, considering the happiness of all the persons who are involved into the case (relatives, friends, colleagues), the entire social survey will be required in order to define who has the larger amount of friends and well-wishers.
Two-level
The solely intuitive approach is not suitable for the medical practice, as clear choice parameters are required for the report. However, a critical reflection level of the utilitarian approach presupposes the clear definition of the selection bias. This is the general rule of providing the clear solution of the case. On the one hand, it should be stated that it is impossible to bring pleasure to everyone, as there are three patients, and one heart only. (Scarre, 1996) On the other hand, considering the principle of “the Greatest Happiness”, the solution will depend on the usefulness of a person for the society, as well as the amount of people who wait for the recovery of a person. In accordance with Mill’s concepts, the highest value is placed on mental pleasure but not a physical one. Additionally, subjective pleasures have lower rank in comparison with the common satisfaction, hence, friendship and proper work should be valued the most. Applying all these factors to the case, it should be emphasized that the only factor that needs to be considered is the successful outcome of the surgery.
Negative Concept
Regardless of the fact that the negative concept of utilitarianism requires producing less harm. In fact, it is almost impossible not to produce harm leaving two persons without a heart for transplantation. Moreover, it is not in doctor’s competence to decide who will make more good or harm to society. Though, considering the aspect of causing less harm, particular selection criteria should be created. Hence, a politician, actor or any other public person will have more chances to get the heart in comparison with a person who is not known to a wide audience. Younger will have more advantages in comparison with the older, as older generally have less time in life (their end is closer), hence, more chances should be given to younger. Successful businessmen will have more advantages in comparison with unsuccessful, or a simple worker, as businessmen creates additional working places. Among expert and beginner, the favor should be given to expert, as he/she produces more high quality goods, and does not violate the safety rules, thus, he/she does not endanger the lives of the others. (Rosen, 2003)
The negative concept, if applied to solely medical point of view, should be closely related with the consequences of the surgery. Hence, the heart should be given to a person who has the highest compatibility with the donor. A recipient with higher chances for success should be given more favor, as in the case of successful surgery at least one person will be saved, in the case of failure, at least one will die, and the other two will have to wait for another opportunity, while their chances for successful surgery will decrease steadily. Another factor that may be considered is the time that is available. A patient with lesser time left should have more advantages in comparison with those who will be able to wait for some time. In general, this is close to the aspect of higher credibility of successful outcome, nevertheless, for providing the better and the more effective solution, both aspects of medical reasoning should be applied.
Conclusion
Finally, it should be stated that in spite of the effectiveness of the utilitarian reasoning, it better suits for solving some global aspects like abolition of slavery, human rights development etc. However, solving medical dilemmas and problems should be performed from the medical point of view, while the utilitarian and other philosophical aspects need to be taken as the background.
References
Rosen, F. (2003). Classical Utilitarianism from Hume to Mill. London: Routledge.
Scarre, G. (1996). Utilitarianism. London: Routledge.
Stein, M. S. (2001). Utilitarianism and the Disabled: Distribution of Life. Social Theory and Practice, 27(4), 561