DECISION MAKING IN VALUE ISSUES

TEOLOGICAL (CONSEQUENCE-ORIENTED) THEORIES

Judge the rightness and wrongness of decisions based upon outcomes or
predicted outcomes. Those following consequence-based theories would decide
what is right also maximizes some good. The right thing to do then, is the good
thing to do. The purest form of this line of reasoning is act utilitarianism.

Utilitarianism is where the decision is based on listing the possible alternatives

for action, weighing each in regard to the amount of pleasure or utility it provides,
and selecting the course of action that maximizes pleasure. To a utilitarian, the
good resides in the promotion of happiness or the greatest net increase of
pleasure over pain.

The basic formulation for act utilitarianism can be captured in the principle that
one ought to act as to produce the greatest balance of happiness over
unhappiness, everyone considered utilitarian systems are referred to as
teleological theory, taken from the Greek word telos, which means end. The basic
concept is that the right act is that which brings about the best outcome.

Rule Utilitarianism holds that action can be deemed to be right if it conforms to a

rule that has been validated by the principle of utility. The principle of utility
requires that the rule bring about positive results when generalized to a wide
variety of situations. Rules forbidding the abridgement of speech or the forceful
housing of military in private hones might qualify as suitable, even if under certain
rare situations they might bring about a decrease in happiness or pleasure.

Agape is defined by Joseph Fletcher as a general goodwill or love for humanity.

He holds that human need to determine what us or is not ethical. If an act helps
people, it is a good act. If it hurts, it is a bad act. He provides six guidelines for
making ethical choices:
Compassion for people as human beings
Consideration of consequences
Proportionate good
Priority of actual needs over ideal or potential needs
A desire to enlarge choice and reduce chance
A courageous acceptance of the need to make decisions and the equally
courageous acceptance of the consequences of our decisions

DEONTOLOGICAL (DUTY-ORIENTED) THEORIES

The basic rightness or wrongness of an act depends upon its intrinsic nature
rather than upon the situation or the consequences. An act is in itself would
either be right or wrong. It could not be both.

Groundwork of the Metaphysic Morals by Immanuel Kant

The consequences of an action were essentially relevant. We are rational beings
and a central feature of this rationality was that principles derived from reason
were universal. An action could be known to be right when it was in accordance
with a rule that satisfied a principle he called a “categorical imperative”.
By categorical, he meant they do not admit exceptions. An imperative is a
command derived from a principle. These imperatives have 3 elements:
1. Universal application
2. Unconditionally
3. Demanding an action
Example : the unconditional duty of a lifeguard to enter the water to save a
drowning man.
People have absolute value based upon their ability to make rational choices. One
such maxim relevant to health ethics is “We must always treat others as ends and
not as means only”.