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Utilitarian theories reconsidered: common misconceptions, more recent developments, and health policy implications
Afschin Gandjour1, Karl Wilhelm Lauterbach
1Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany. gandjour@igke.de
Summary
Utilitarianism in healthcare is diverse, with various theories like act, rule, negative, and preference utilitarianism. Understanding these nuances is crucial, as some forms may not violate individual rights as commonly assumed.
Area of Science:
- Bioethics
- Health Policy Analysis
- Moral Philosophy
Background:
- The terms "utilitarianism" and "utilitarian" are frequently used in health care and health policy literature.
- Authors may lack awareness of the diverse utilitarian theories, their principles, and implications.
- Utilitarianism is often rejected due to assumptions about violating individual rights.
Purpose of the Study:
- To clarify the diversity of utilitarian theories.
- To examine the principles and implications of different utilitarian approaches in healthcare.
- To address the common misconception that utilitarianism inherently violates individual rights.
Main Methods:
- Literature review and conceptual analysis of utilitarian theories.
- Examination of the relationship between utilitarianism and individual rights.
- Analysis of the practical implications and tenability of various utilitarian variants.
Main Results:
- Act utilitarianism's neglect of individual rights can be mitigated by factors like diminishing marginal utility of wealth and the disutility of protest.
- Rule utilitarianism faces challenges, potentially collapsing into act utilitarianism or deontology.
- Negative utilitarianism is viable only with complete aversion to suffering.
- Preference utilitarianism introduces subjectivity in individual claims, potentially perceived as unfair.
Conclusions:
- A deeper understanding of utilitarianism's variants is needed in health policy and bioethics.
- Certain forms of utilitarianism, particularly act utilitarianism, can be reconciled with individual rights.
- The limitations and conditions for adopting different utilitarian theories require careful consideration.