Summary of Cases and Theories
The first case, In re MB, presents a situation in which the hospital decided to perform a cesarean section contrary to the patient’s decision. The doctors acted based on Utilitarian principles, which aimed to achieve the most favorable outcome. The second case, the death of Emma Gough, presents a situation in which the patient, Emma Gough, refused blood transfusions after giving birth to a twin and severe blood loss due to her religious beliefs, which led to her death. In this example, the doctors acted based on the principles of Divine Command theory, which prioritizes the autonomy of each individual’s decisions.
Motive utilitarianism and divine command theory will be applied to both case studies through the lens of determining morality in specific actions within the framework of God’s commands and character. Thus, motive utilitarianism is a concept that considers the validity of a motive. Consequently, divine command theory is a theory based on the belief that the essence of morality, as well as the concepts of good and evil, justice and injustice, and other relevant aspects, directly depend on the commands and prohibitions emanating from God (Zomorodi & Foley, 2009). The basis of utilitarianism is the pursuit of plans aimed at maximizing happiness, well-being, and satisfaction, while minimizing adverse consequences and potential risks.
Motive Utilitarianism
One of the most critical elements of utilitarian motives is the social significance of the moral imperatives it proposes. Starting from the psychological and anthropological properties of human nature, from the desire for pleasure and happiness inherent in all people (Bingham, 2011). Classical utilitarianism formulates the idea of the social and political purpose of moral philosophy, in which the highest goal of moral activity is not the personal benefit of the subject of moral life, but the pursuit of everyday happiness.
Case 1
Utilitarianism, for reasons, lies in the fact that the refusal of a cesarean section was motivated by the fact that this is a risky decision and may subsequently harm the child. That is, in this case, by refusing to perform a cesarean section, the team of specialists made a decision that minimized the harm to the health and life of the child.
Case 2
According to the basic concepts of utilitarianism, the wrong decision in this case led to the patient’s death. The specialists’ motive was to provide the patient with an autonomous existence; however, this motive proved erroneous and led to fatal consequences (Kogetsu et al., 2018).
Divine Command Theory
The theory of divine command often appeals to the principle of “good” in what God says, even if it seems terrible to some people. However, it should be understood that conscience is not an impeccable source of moral truths; by definition, God is a just judge and legislator (Burkhardt et al., 2018). Consequently, the decisive role of applying this theory to the provided cases is played by the observance of the autonomy of decision-making, which medical professionals should respect.
Case 1
According to Divine Command Theory, doctors are obligated to respect the wishes of a patient in a serious physical condition. However, in such a situation, various indirect methods should be used to inform the patient about the consequences of their decision. Therefore, the patient will act more carefully and thoughtfully.
Case 2
In the second case, also based on Divine Command Theory, respect for the patient’s decision should prevail, and the medical team should respect the decisions made by patients, as they are often based on their own values and beliefs.
Conclusion
To conclude, both of these theories aim to highlight different aspects of the importance of life. For Motive Utilitarianism, this manifests as creating the most favorable outcome, as the patient may be in a state of affect, which can lead to incorrect decisions. On the other hand, relying on the Divine Command theory, medical staff should respect the patient’s autonomy in making decisions regarding treatment methods. In this case, the priority task is to provide a comprehensive picture of the situation so that the patient can act accordingly.
References
Bingham, S. (2011). Refusal of treatment and decision-making capacity. Nursing Ethics, 19(1), 167-172.
Burkhardt, M., Nathaniel, A. & Walton N. (2018). Ethics and issues in contemporary nursing. Nelson Publication.
Kogetsu, A., Ogishima, S., & Kato, K. (2018). Authentication of patients and participants in health information exchange and consent for medical research: A key step for privacy protection, respect for autonomy, and trustworthiness. Frontiers in Genetics, 9(1), 167.
Zomorodi, M. & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line’. Journal of Advanced Nursing, 65(8), 1746-1752.