In practical ethics, two arms of thoughts exist in decision-making: Utilitarian and deontological. In utilitarian ethics, outcomes justify the means or ways to achieve it, whereas in deontological ethics, duties/obligations are of prime importance (i.e., end/outcomes may not justify the means).

In the utilitarian approach, decisions are chose based on the greatest amount of benefit obtained for the greatest number of individuals. This is also known as the consequentialist approach since the outcomes determine the morality of the intervention. This approach could lead to harm to some individuals while the net outcome is maximum benefit. This approach is usually guided by the calculated benefits or harms for an action or intervention based on evidence. A few examples of utilitarian approach in medical care include setting a target by hospitals for resuscitation of premature newborns (gestational age) or treatment of burns patients (degree of injury) based on the availability of time and resources.

In contrast to the utilitarian concept, deontology is ethics of duty where the morality of an action depends on the nature of the action, i.e., harm is unacceptable irrespective of its consequences. This concept was introduced by a philosopher, Immanuel Kant and hence widely referred as Kantian deontology. The decisions of deontology may be appropriate for an individual but does not necessarily produce a good outcome for the society. The doctor-patient interaction or relationship is by nature, deontological since medical teaching practices inculcate this tradition, and when this deontological practice is breached, the context of medical negligence arises. This tradition drives clinicians to do good to patients, strengthening the doctor-patient bond. The deontological ideologists (doctors and other medical staffs) are usually driven to utilitarian approach by public health professionals, hospital managers, and politicians (utilitarian ideologists). 

Kant’s Deontology is based on rationalizing universal principles of behavior (not an agent’s intentions, as some others have incorrectly stated). Killing (other moral agents or anyone) is always morally wrong because, if everyone did it, no moral agent would be left alive to act. This is not an argument from consequences. It is an argument from the absurdity of universalizing the counter-principle to the one we are proposing. Kant believed we could rationally determine our moral principles regardless of their consequences, essentially by logic and reason alone.

Kant affirmed all of the virtues popular in previous Virtue Theories from the Classical period throughout the Middle Ages, but as he did so often, attempted to provide epistemological foundations for those virtues by a single principle of reason and logic. Lying is always bad because it cannot be universalized, therefore honesty is always good. Good will or intentions are always good because they can be universalized, while bad will or intentions cannot. We can reason that charity is always good, while theft is always bad, based on their ability to be universalized or not.

In epistemological terms, Kant is usually considered a Rationalist because he believed that reason ultimately provides the epistemic justification for true beliefs. He carries his epistemological rationalism over to the moral justification of virtuous behavior and lack of moral justification for vices in order to provide a stronger philosophical foundation for traditional Virtue Ethics. Deontology is a moral theory based on reason and logic about which behaviors are morally permissible and which are not. Its logical structure is parallel to the dual modal structure of possibility and necessity in ontology and metaphysics. The entire notion and language of inalienable (human) rights and privileges is based on Kant’s Deontology.

Mill was also looking for the epistemic justification for ethics, but he starts from a very different view of epistemic justification. Mill was an Empiricist, which means that he viewed empirical methods as those which provide the epistemic justification for true beliefs. So rather than reason and logic alone, Mill tries to find an explanation for ethics in the Renaissance of scientific methods. This different epistemological approach provides Mill with a moral theory which looks completely different from classical and medieval virtue theories.

Mill could have opted for a completely naturalistic causal description of moral behavior, but for some reason, like Kant he is also interested in providing a method for determining good behavior. Both Mill and Kant are considered Moral Realists, meaning that they believe moral propositions can be true or false. So it could be that Mill didn’t opt for a completely causal explanation because he thought it might lead to a sort of Moral Skepticism or Amorality (something like the idea that we can only study ethics as that of what people believe and do about ethics without affirming or denying any particular moral propositions). Mill might have also thought, along with a good majority of philosophers, that ethics has an inextricably prescriptive component (which is often argued to be both normative and intentional).

Whatever the motivations or reasons, Mill’s Utilitarianism has two components, a descriptive one and a prescriptive one. The descriptive component can be considered the causal explanation of moral goods (where the cause of moral goods is to be studied empirically), while the prescriptive component can be considered as a sort of weighing of the effects of moral behavior (where the moral behavior is the cause to be studied empirically).

By Chelsea Kim 1 year ago . Marked as helpful (455). Marked as unhelpful (470)