Introduction
There is a fundamental difference between the Kantian theory and consequence act utilitarianism. Kant’s theory is a deontological framework in that it states that the morality of an action or decision is a function of the actor’s motivation rather than the consequences’ goodness or badness (Johnson & Cureton, 2022). In contrast, the act consequentialism form of utilitarianism is a teleological framework in that it assesses the morality of an action by the consequences’ goodness (Johnson & Cureton, 2022). In other words, while the Kantian approach focused on the intent to determine whether an action is morally justified, act consequentialism focuses on the consequences.
Deontological Framework
The first framework that Dr. Gomes may consider for deciding is deontology. In the Kantian framework, the rightness of one’s action does not depend on the goodness of outcomes (Johnson & Cureton, 2022). Moreover, the deontological framework that Kant pursues deems the sense of moral worth, goodwill, and, most importantly, moral duty as vital aspects for deciding on the ethics of action (Johnson & Cureton, 2022). Thus, Dr. Gomez needs only to consider the ethical aspect of her action as applicable to the act of harvesting the homeless man’s organs.
However, to evaluate the situation and make a moral decision, Dr. Gomez needs to ask more concrete questions. Kant’s theory underlines the autonomy of will and rational human nature for making morally good (ethical) decisions (Johnson & Cureton, 2022). Therefore, deontology proposes to consider two questions in making such decisions. The first question asks the agent to consider how any sane adult would rationally act (Johnson & Cureton, 2022). Dr. Gomez may consider what others would do, which is to check the man in and get him the required injection. While she may believe that her oath not to harm applies only to the patients that have officially been checked in, any rational adult would argue that this is only a matter of technicality. As soon as the homeless man is checked in, he becomes a patient, and preventing that in itself goes against reasonable moral standards of conduct.
Having established that the first question prohibits Dr. Gomez from performing this act, the second question should be asked. Specifically, one must question whether the proposed action respects others’ goals or treats them as mere instruments (Johnson & Cureton, 2022). This question stresses humanity and respect – avoiding using people as a means to achieve one’s ends. Dr. Gomez’s actions, in this case, contradict this principle too since she intends to use the homeless man as an organ source – as a tool. According to Kantian theory, Dr. Gomez is not morally justified in her intended action.
Utilitarian Framework
The second approach that Dr. Gomez may consider is applying a utilitarian point of view. In the act consequentialism framework, the value of the action’s consequence determines its rightness (Johnson & Cureton, 2022). Therefore, in this case, Dr. Gomez must consider the consequences that her actions would bring for either party. Further, act consequentialism asserts that an act is ethically justified if its good outcomes are maximized (Sinnott-Armstrong, 2021). In other words, if an agent’s decision resulted in a certain amount of ‘bad’ but was outweighed by the beneficial consequences it brought, it is morally right. Therefore, the fundamental question that Dr. Gomez must ask in this framework is whether the good of consequences outweighs the bad.
Sometimes, this approach is interpreted as the maximum good being done where more people benefit, but that is not entirely correct. The bigger numbers do not automatically increase worth: if a small number of people loses incomparably more than a larger group gains, it may not be justified. In this case, either a homeless man loses his life, or five patients lose theirs. For the act to be justified in such a scenario, the sacrifice of the smaller group must increase the benefits to the greater group significantly more than any other alternative (Sinnott-Armstrong, 2021). There are no alternatives as the patients would most certainly die if appropriate organ transplants are not received. Additionally, Dr. Gomez does not see homeless people as being less worthy of life than others, so the question becomes that of numbers: one life versus five. In the act consequentialism framework, saving five lives for one brings four lives a net benefit. Therefore, Dr. Gomez should make the exact opposite decision to harvest the organs under this framework.
Conclusion: Choosing a Better Approach
Overall, the Kantian framework would do a better job of guiding Dr. Gomez in making the decision. Kant’s theory provides two points of reference: with other rational thinkers and that of humanity. Thus, Dr. Gomez may compare her intended action with a broader perspective and consider the respect shown to either party. She can decide to treat the homeless man as a person equally deserving of respect and humanity and not as an involuntary organ donor. In contrast, act consequentialism only asks to weigh the outcomes, presenting a limited perspective. This framework leads Dr. Gomez to consider a wrong decision by using technicality as an excuse for not treating the homeless man as a patient. The main medical ethics principles are “autonomy, beneficence, non-maleficence, and justice” (Andrade, 2019, p. 2). While these principles are in a moving balance, there is an ethical difference between killing and letting die highlighted by the Kantian approach, where killing is not permissible (Andrade, 2019). Medical professionals should not base their decisions on how many patients they can sacrifice to improve overall outcomes but on the individuality and integrity of each human being.
References
Andrade, G. (2019). Medical ethics and the trolley problem. Journal of Medical Ethics and History of Medicine, 12(3), 1–15.
Johnson, R., & Cureton, A. (2022). Kant’s moral philosophy. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (2022). Metaphysics Research Lab, Stanford University.
Sinnott-Armstrong, W. (2021). Consequentialism. In E. N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy (Fall 2021). Metaphysics Research Lab, Stanford University.