How can utilitarianism be applied

Because the drug addict needed to pay for their habit. His drug addiction caused him enough misery that he had to steal to support the habit. His stealing increased the misery of his victims. You need to stop the addiction. No other option really exists. The only thing that will help is taking targetted action that stops the addiction and keeps it stopped.

Addiction — as I understand it — is horrible. Getting off the drugs is hard enough, but staying off is also a constant struggle. The real answer to this challenge is to provide services that help eliminate the causes for crime. In the case of an addict stealing to maintain their habit, the real answer is to provide ongoing drug treatment.

To conservatives, this might seem like a waste of money, but drug addiction treatment is actually cheaper than throwing people in jail.

After all, if conservatives want to stop wasting tax money, clearly the better answer is the one that costs taxpayers less. On the other hand, utilitarianism can also seem to place demands on moral actors that appear too stringent. These and other arguments against utilitarianism and replies to these objections are summarized in Moral Tribes.

For example, according to Greene, slavery is actually not permitted on the utilitarian account because, as a practical matter, it is implausible that slavery could increase net utility, though it might increase wealth. The possibility of repugnant outcomes is by no means unique to utilitarianism.

As shown in the Trolley Problem, and in evaluating the ethical implications of favoring expenditures on antiretroviral drugs for treatment over pre-exposure prophylaxis, non-efficiency based principles are often hard to interpret, irrelevant, or contradictory. They may also lead to outcomes that diverge dramatically from that of health-maximization. Cost-effectiveness analysis has the virtue of being relevant to any resource allocation decision.

Its operational definition is unambiguous maximization of health benefits for a given budget even if performing cost-effectiveness calculations is sometimes challenging.

Other principles, such as rule of rescue or the urgent need based adjudications of claims on health care resources, have expression in clinical medicine and elsewhere. However, the principles appropriate when considering the welfare of large populations differs from those appropriate for clinical medicine or for small communities and families. Utilitarianism, because it does not distinguish between identified and statistical lives is, in general, the framework best suited to the former.

We do not propose that utilitarianism is the only legitimate guide to global health resource allocation decisions. However, we do suggest that it should be the point of departure for further analysis. Because of its intrinsic ethical dimensions, efficiency is not merely one criterion among many. The promotion of human flourishing is a central goal of most ethical system. Attaining the greatest population health available with given resources is consonant with that flourishing.

Thus, decisions to diverge from pursuit of that goal to promote other ethical values should be acknowledged and justified. Wherever possible, decision-makers should quantify the tradeoff, i. This will often be possible in a rough but serviceable manner.

For example, spending incremental dollars on the male condom will almost always generate greater health benefit than spending the same money on female condoms [ 29 ].

The details of why this is true in almost every HIV epidemic type and risk sub-population are complex, but this finding was driven primarily by two factors: a the female condom is much more expensive than the male condom while conferring the same protective benefit per unprotected sex episode; and b use of a female condom often displaces use of a male condom, thus providing no additional protection.

Though potentially significant, the degree to which access to the female condom helps secure this right to autonomy is hard to quantify. Table 1 illustrates the health consequences of promoting the female condom over the male condom in high-prevalence HIV countries. This is a low estimate of the cost of the female condom and the results displayed are therefore likely tilted in favor of the female condom.

The model incorporates information on HIV transmission risk per episode; protective benefits of both types of condoms; sexual behavioral data on three sub-populations, sex workers, women with regular partners and women with casual partners; rates of substitution between male and female condoms; and other parameters affecting the cost of generating an incremental protected sexual episode.

However, in the context of the female condom it seems a difficult case to make, particularly if one is concerned about the rights and health, of those 92— additionally infected people, many of whom will be women. Article 25 of the United Nations Universal Declaration of Human Rights guarantees access to adequate medical care for all persons [ 32 ].

These legal and moral principles are not superseded by utilitarian values. But the full realization of these rights-based values will, for the foreseeable future be imperfect given health care budgets and other constraints. Therefore, efficiency concerns as expressed in utilitarianism and cost-effectiveness analysis will often be the best guide to rapidly securing those rights for as many people as possible. However, this can only be accomplished when decision makers acknowledge that the trade-offs of the type illustrated in the female condom example are real and consequential.

When competing ethical principles favor different actions, following non-efficiency based principles may increase mortality or morbidity. It is true that a small fraction of what the world spends on armaments and on ultra-luxurious or frivolous pursuits could, if re-deployed, have huge global health benefits.

But this information is of no use to the Minister of Health in a low-income country as she decides what portion of her budget should be allocated to TB drugs, versus bed nets to control malaria. The long-term social and political project of re-directing resources away from activities that undermine human flourishing and toward those that are conducive, is one of the most urgent of our era.

However, for any meaningful time horizon there will be insufficient money to pursue all beneficial activities. Trade-offs, and the problems of resource allocation will therefore persist. Utilitarianism will usually be the most reliable guide in resolving those trade-offs.

This may be in part because the types of fanciful situations concocted in the original trolley problems are now similar to actual dilemmas that must be addressed by those writing the software governing autonomous vehicles. Jamison DT. Disease control priorities, 3rd edition: improving health and reducing poverty. Musgrove P. Public spending on health care: how are different criteria related?

Health Policy. Article Google Scholar. Legislating against use of cost-effectiveness information. N Engl J Med. Hidden costs: the ethics of cost-effectiveness analyses for health interventions in resource-limited settings.

Glob Public Health. Ethical analysis in public health. Bentham J. An introduction to the principles of morals and legislation. A new ed. London: Printed for W. Pickering etc; Google Scholar. Mill JS. London,: Parker, son, and Bourn; Singer P. Practical ethics, vol. New York: Cambridge University Press; Book Google Scholar. Greene J. Moral tribes: emotion, reason, and the gap between us and them: penguin press; Russell LB.

Is cost-effectiveness analysis unfair? Medical decision making : an international journal of the Society for Medical Decision Making. A carpenter makes a judgment of when a saw is the best tool for his or her task, followed by judgments about what type of saw is best, where to apply the saw, in what manner, and for how long.

If mistakes are made about any of these judgments, including the appropriateness of using a saw, the carpenter learns from them, and attempts to ameliorate his or her performance with respect to the saw. The assumption is that the carpenter wishes to be the best carpenter he or she can be, and make the best creation or repair he or she can make. Similarly, the agent-centered prerogative is a tool that the agent can use when he or she sees fit, making judgments about the amount of weight it carries in what situations, at what times, and with what other agents.

The moral agent will learn from mistakes made with regard to use of the agent-centered prerogative, and attempt to ameliorate performance with regard to it, as the moral agent wishes to be the most morally good agent possible. With his agent-centered prerogative, Scheffler has established a positive aspect of a normative moral theory of consequentialism that proves to be beneficial to all agents who observe it.

It is the centerpiece to a moderate moral system, including permissions for individuals to pursue their interests, while simultaneously including rules that individuals are obligated to follow. This moral structure, resting in between the most rigid and lax of moralities, commanding moral demands and allowing freedoms both at once, would be of good use imbedded within the utilitarian framework discussed by Williams, Singer, Mill, and Mackie.

A utilitarian system requiring the course of action producing the greatest outcome for all, when combined with the preservation of autonomy, as could be supplied by the agent-centered prerogative, would be a largely acceptable moral theory, that would manage to be agent-friendly while exacting observance to moral obligation from its followers.

Mackie, J. Ethics: Inventing Right and Wrong. New York: Penguin Books,. Mill, John Stuart. Mark Timmons. California: Wadsworth. Scheffler, Samuel. Human Morality. Oxford: Oxford University Press, Singer, Peter. Practical Ethics. Cambridge, England: Cambridge University. Smart, J. Utilitarianism: For and Against. All rights reserved. Skip to content. As a result, in an act utilitarian society, we could not believe what others say, could not rely on them to keep promises, and in general could not count on people to act in accord with important moral rules.

An implication of this commitment is that whenever people want to buy something for themselves or for a friend or family member, they must first determine whether they could create more well-being by donating their money to help unknown strangers who are seriously ill or impoverished.

If more good can be done by helping strangers than by purchasing things for oneself or people one personally cares about, then act utilitarianism requires us to use the money to help strangers in need. Almost everyone, however, believes that we have special moral duties to people who are near and dear to us.

As a result, most people would reject the notion that morality requires us to treat people we love and care about no differently from people who are perfect strangers as absurd. This issue is not merely a hypothetical case. In a famous article, Peter Singer defends the view that people living in affluent countries should not purchase luxury items for themselves when the world is full of impoverished people.

According to Singer, a person should keep donating money to people in dire need until the donor reaches the point where giving to others generates more harm to the donor than the good that is generated for the recipients.

Critics claim that the argument for using our money to help impoverished strangers rather than benefiting ourselves and people we care about only proves one thing—that act utilitarianism is false. There are two reasons that show why it is false. First, it fails to recognize the moral legitimacy of giving special preferences to ourselves and people that we know and care about.

Second, since pretty much everyone is strongly motivated to act on behalf of themselves and people they care about, a morality that forbids this and requires equal consideration of strangers is much too demanding. It asks more than can reasonably be expected of people. There are two ways in which act utilitarians can defend their view against these criticisms.

First, they can argue that critics misinterpret act utilitarianism and mistakenly claim that it is committed to supporting the wrong answer to various moral questions. Because they do not maximize utility, these wrong answers would not be supported by act utilitarians and therefore, do nothing to weaken their theory.

Unless critics can prove that common sense moral beliefs are correct the criticisms have no force. Act utilitarians claim that their theory provides good reasons to reject many ordinary moral claims and to replace them with moral views that are based on the effects of actions.

People who are convinced by the criticisms of act utilitarianism may decide to reject utilitarianism entirely and adopt a different type of moral theory. This judgment, however, would be sound only if act utilitarianism were the only type of utilitarian theory. This is what defenders of rule utilitarianism claim.

They argue that rule utilitarianism retains the virtues of a utilitarian moral theory but without the flaws of the act utilitarian version. Unlike act utilitarians, who try to maximize overall utility by applying the utilitarian principle to individual acts, rule utilitarians believe that we can maximize utility only by setting up a moral code that contains rules.

The correct moral rules are those whose inclusion in our moral code will produce better results more well-being than other possible rules. Once we determine what these rules are, we can then judge individual actions by seeing if they conform to these rules.

The principle of utility, then, is used to evaluate rules and is not applied directly to individual actions. Once the rules are determined, compliance with these rules provides the standard for evaluating individual actions. Rule utilitarianism sounds paradoxical.

It says that we can produce more beneficial results by following rules than by always performing individual actions whose results are as beneficial as possible. This suggests that we should not always perform individual actions that maximize utility. How could this be something that a utilitarian would support? In spite of this paradox, rule utilitarianism possesses its own appeal, and its focus on moral rules can sound quite plausible.

The rule utilitarian approach to morality can be illustrated by considering the rules of the road. More specific rules that require stopping at lights, forbid going faster than 30 miles per hour, or prohibit driving while drunk do not give drivers the discretion to judge what is best to do.

They simply tell drivers what to do or not do while driving. The reason why a more rigid rule-based system leads to greater overall utility is that people are notoriously bad at judging what is the best thing to do when they are driving a car. A rule utilitarian can illustrate this by considering the difference between stop signs and yield signs.

Stop signs forbid drivers to go through an intersection without stopping, even if the driver sees that there are no cars approaching and thus no danger in not stopping. A yield sign permits drivers to go through without stopping unless they judge that approaching cars make it dangerous to drive through the intersection. The key difference between these signs is the amount of discretion that they give to the driver. The stop sign is like the rule utilitarian approach.

It tells drivers to stop and does not allow them to calculate whether it would be better to stop or not. The yield sign is like act utilitarianism. It permits drivers to decide whether there is a need to stop. Act utilitarians see the stop sign as too rigid because it requires drivers to stop even when nothing bad will be prevented.

The result, they say, is a loss of utility each time a driver stops at a stop sign when there is no danger from oncoming cars.

Rule utilitarians will reply that they would reject the stop sign method a if people could be counted on to drive carefully and b if traffic accidents only caused limited amounts of harm. But, they say, neither of these is true. Because people often drive too fast and are inattentive while driving because they are, for example, talking, texting, listening to music, or tired , we cannot count on people to make good utilitarian judgments about how to drive safely.

In addition, the costs i. Accident victims including drivers may be killed, injured, or disabled for life. For these reasons, rule utilitarians support the use of stop signs and other non-discretionary rules under some circumstances. Rule utilitarians generalize from this type of case and claim that our knowledge of human behavior shows that there are many cases in which general rules or practices are more likely to promote good effects than simply telling people to do whatever they think is best in each individual case.

This does not mean that rule utilitarians always support rigid rules without exceptions. Some rules can identify types of situations in which the prohibition is over-ridden. The rules of the road do not tell drivers when to drive or what their destination should be for example. Overall then, rule utilitarian can allow departures from rules and will leave many choices up to individuals. In such cases, people may act in the manner that looks like the approach supported by act utilitarians.

Nonetheless, these discretionary actions are permitted because having a rule in these cases does not maximize utility or because the best rule may impose some constraints on how people act while still permitting a lot of discretion in deciding what to do.

As discussed earlier, critics of act utilitarianism raise three strong objections against it. According to these critics, act utilitarianism a approves of actions that are clearly wrong; b undermines trust among people, and c is too demanding because it requires people to make excessive levels of sacrifice.

Rule utilitarians tend to agree with these criticisms of act utilitarianism and try to explain why rule utilitarianism is not open to any of these objections. Critics of act utilitarianism claim that it allows judges to sentence innocent people to severe punishments when doing so will maximize utility, allows doctors to kill healthy patients if by doing so, they can use the organs of one person to save more lives, and allows people to break promises if that will create slightly more benefits than keeping the promise.

Rule utilitarians say that they can avoid all these charges because they do not evaluate individual actions separately but instead support rules whose acceptance maximizes utility. To see the difference that their focus on rules makes, consider which rule would maximize utility: a a rule that allows medical doctors to kill healthy patients so that they can use their organs for transplants that will save a larger number of patients who would die without these organs; or b a rule that forbids doctors to remove the organs of healthy patients in order to benefit other patients.

Although more good may be done by killing the healthy patient in an individual case, it is unlikely that more overall good will be done by having a rule that allows this practice. If a rule were adopted that allows doctors to kill healthy patients when this will save more lives, the result would be that many people would not go to doctors at all. A rule utilitarian evaluation will take account of the fact that the benefits of medical treatment would be greatly diminished because people would no longer trust doctors.

People who seek medical treatment must have a high degree of trust in doctors. If they had to worry that doctors might use their organs to help other patients, they would not, for example, allow doctors to anesthetize them for surgery because the resulting loss of consciousness would make them completely vulnerable and unable to defend themselves.

Thus, the rule that allows doctors to kill one patient to save five would not maximize utility. The same reasoning applies equally to the case of the judge. In order to have a criminal justice system that protects people from being harmed by others, we authorize judges and other officials to impose serious punishments on people who are convicted of crimes. The purpose of this is to provide overall security to people in their jurisdiction, but this requires that criminal justice officials only have the authority to impose arrest and imprisonment on people who are actually believed to be guilty.

They do not have the authority to do whatever they think will lead to the best results in particular cases. Whatever they do must be constrained by rules that limit their power.

Act utilitarians may sometimes support the intentional punishment of innocent people, but rule utilitarians will understand the risks involved and will oppose a practice that allows it. Rule utilitarians offer a similar analysis of the promise keeping case.

They explain that in general, we want people to keep their promises even in some cases in which doing so may lead to less utility than breaking the promise. The reason for this is that the practice of promise-keeping is a very valuable. It enables people to have a wide range of cooperative relationships by generating confidence that other people will do what they promise to do. If we knew that people would fail to keep promises whenever some option arises that leads to more utility, then we could not trust people who make promises to us to carry them through.

In each of these cases then, rule utilitarians can agree with the critics of act utilitarianism that it is wrong for doctors, judges, and promise-makers to do case by case evaluations of whether they should harm their patients, convict and punish innocent people, and break promises.

The rule utilitarian approach stresses the value of general rules and practices, and shows why compliance with rules often maximizes overall utility even if in some individual cases, it requires doing what produces less utility.

Rule utilitarians see the social impact of a rule-based morality as one of the key virtues of their theory. The three cases just discussed show why act utilitarianism undermines trust but rule utilitarianism does not.

Fundamentally, in the cases of doctors, judges, and promise-keepers, it is trust that is at stake. Being able to trust other people is extremely important to our well-being. As a result, people would be less likely to see other people as reliable and trustworthy. While rule utilitarians do not deny that there are people who are not trustworthy, they can claim that their moral code generally condemns violations of trust as wrongful acts.

The problem with act utilitarians is that they support a moral view that has the effect of undermining trust and that sacrifices the good effects of a moral code that supports and encourages trustworthiness. Rule utilitarians believe that their view is also immune to the criticism that act utilitarianism is too demanding.

In addition, while the act utilitarian commitment to impartiality undermines the moral relevance of personal relations, rule utilitarians claim that their view is not open to this criticism. They claim that rule utilitarianism allows for partiality toward ourselves and others with whom we share personal relationships. Moreover, they say, rule utilitarianism can recognize justifiable partiality to some people without rejecting the commitment to impartiality that is central to the utilitarian tradition.

How can rule utilitarianism do this? In his defense of rule utilitarianism, Brad Hooker distinguishes two different contexts in which partiality and impartiality play a role. One involves the justification of moral rules and the other concerns the application of moral rules. Justifications of moral rules, he claims, must be strictly impartial. When we ask whether a rule should be adopted, it is essential to consider the impact of the rule on all people and to weigh the interests of everyone equally.

The second context concerns the content of the rules and how they are applied in actual cases. Rule utilitarians argue that a rule utilitarian moral code will allow partiality to play a role in determining what morality requires, forbids, or allows us to do.