Utilitarian Bioethics
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Utilitarian Bioethics is a very controversial branch of Utilitarian ethics that espouses directing medical resources where they will contribute most to the sum of the number of happy people in the world. It is implicitly used in some healthcare planning decisions, such as the use of Quality Adjusted Life Years (QALYs). It is also implicitly inherent in the concept of triage, which is at present is seen by most as ethically justifiable only in extreme emergency situations.
As with much of utilitarianism, Utilitarian Bioethics is internally coherent only if one takes as proven the concept that the economic distribution of resources is a zero-sum game. Then, it makes sense to evaluate society as the aggregate of each person's total future economic value, their chance of survival from the present, and the cost of keeping them alive indefinitely. If we end up with too many people whose cost of medical maintenance outweighs their total future economic value (because they are terminally ill, are no longer productive, and have no reasonable chance of becoming productive in the foreseeable future), then it may be economically efficient to encourage them to voluntarily self-terminate in order to end their own suffering and to free up scarce medical resources. That is, there are only so many healthy people who can take care of the sick (and do all the other things that keeps civilization running), and if there are simply too many unproductive sick people, then providing care for them will inevitably be detrimental to the healthy. To put this more bluntly, every nurse who spends their days caring for a terminally ill Alzheimer's or cancer patient, or for a comatose vegetable, is one more nurse who will not be taking care of a sick baby or a 12-year-old gunshot victim. See opportunity cost.
Therefore, the upsides of Utilitarian Bioethics include increased medical expenditure on other patients with a higher chance of survival (and thus their chances would improve of a return to a productive, happy, healthy status). This would ideally lead to an overall net decrease in suffering, as terminal patients voluntarily exit and curable patients are more often saved.
"Downsides" include: potential justifications for physicians to kill patients, the uncertainty in measuring 'happiness', and the possibility of classification of many disabled or old people as "nonpersons".
- Arguments in favor of forms of Utilitarian Bioethics include:
- Peter Singer, Practical Ethics, Cambridge Univ Pr (Pap Txt); ISBN 052143971X; 2nd edition (February 1993)
- Udo Schüklenk, 2001 (http://sunsite.wits.ac.za/bio/intro1.htm)
- Arguments against Utilitarian Bioethics include:
- Betty Alfred, 1999 (http://www.tell-us-your-story.com/_disc69r/0000000d.htm)
- Dean R. Koontz, One Door Away from Heaven, Bantam Books; ISBN 0553582755; (October, 2002)