This Is Bioethics. Udo Schüklenk. Читать онлайн. Newlib. NEWLIB.NET

Автор: Udo Schüklenk
Издательство: John Wiley & Sons Limited
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Жанр произведения: Медицина
Год издания: 0
isbn: 9781118770733
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an intensive care unit might well demand that an elderly patient is removed from a scarce intensive care bed to make space for a younger patient with equal likelihood of successful care. All other things being equal this would lead to a maximization of quality adjusted life years and so result in a perfect utilization of scarce health care resources. Many people would consider it unethical to physically remove a patient who is still alive, and who would still benefit from clinical care, from intensive care in order to make room for a younger patient who is competing for the same resource. The act‐utilitarians, defending the removal of the elderly patient, might respond to this by saying that all they are aiming for is to make the best out of a bad situation, and that the bad situation is not of their own making.

      2.18 Preference utilitarianism is an influential variety of modern‐day utilitarianism. The preference utilitarian aim is to maximize the satisfaction of the preferences or interests of all those affected by an action. It is partly based on the acknowledgment that not everything we do is based on the utilitarian twin‐objectives of reducing pain and suffering and maximizing happiness. As John Harsanyi puts it, ‘preference utilitarianism is the only form of utilitarianism consistent with the important philosophical principle of preference autonomy. By this I mean the principle that, in deciding what is good and what is bad for a given individual, the ultimate criterion can only be his own wants and his own preferences’ (Harsanyi 1977, 645). Preference utilitarians hold that individuals are likely the best judges of whatever it is that is in their best interest. The rightness of a proposed course of action then is determined by how much it contributes toward maximizing the satisfaction of autonomous individuals’ preferences, desires or interests. An important condition here is that not all of an individual’s preferences matter, because satisfying any random preferences or desires an individual utters would likely not result in optimal utility. Rather we should aim to maximize the satisfaction of individual preferences and desires that are reflective of a person’s true preferences, that is ‘preferences he would have if he had all the relevant factual information, always reasoned with the greatest personal care, and were in a state of mind most conducive to rational choice’ (Harsanyi 1977, 646).

      2.20 Does this ethic meet our two action guidance and action justification criteria? As we shall see in various chapters throughout this book, it does provide us with clear action guidance, if we have the relevant data available to us. It also provides us with a moral justification for why particular courses of action ought to be followed. Among modern‐day Anglo‐Saxon utilitarians wielding significant influence in bioethics are those in public health Angus Dawson (2005), and Robert Goodin (1989), in the context of animal rights Lori Gruen (2011), and in end‐of‐life issues Helga Kuhse (1987, 1997). Peter Singer is perhaps the most high‐profile of contemporary utilitarian bioethicists (1995). We will come across views expressed by these utilitarians on a range of issues across this book. Jonathan Baron has advocated utilitarianism as the best theory for practical bioethics and defended its usefulness for a whole range of bioethical questions, including end‐of‐life issues, drug research and development, resource allocation justice and a host of other topics (Baron 2006).