One for many

It has been a stressful afternoon at your office, and you are 20 minutes behind schedule. The palatal expander for sensitive little Elizabeth will not seat fully, and she loudly whines every time you try to seat the appliance. You just learned that your senior assistant left early because her son got on the wrong school bus, and there is only standing room in your reception area. Above all of this, you can hear a hacking cough out there that recurs about every 10 seconds. Your receptionist tells you it is young Seth. His typically contentious mother entered the crowded reception room, announcing that although Seth did not go to school today, she wanted him to keep his appointment so that you could repair a broken bracket. “I want it repaired because I don’t want him losing any treatment time!” There is no question that you will not be able to accommodate him for at least a half-hour. It is the flu season and you are concerned that the healthy people in the room, as well as your staff, will be exposed to his illness. But there is no place to sequester him until he can be seated. You can feel your pulse rise because Seth’s appointment should be rescheduled, yet you want to avoid a scene in the waiting room.

Utilitarianism represents an act that provides the most good or the most favorable welfare for the greatest number of people. It is an estimation of future benefits as a consequence of an action, and it is therefore labeled as consequentialist. Utilitarianism is often contrasted with deontological ethics, which defines ethical behavior as a duty; that is, ethical behavior that is simply “the right thing to do.”

The Chinese government’s reaction to the coronavirus crisis is an example of utilitarianism. There are reports that the government has staged a “mass roundup” of people who have been exposed to the virus but have not yet tested positive. Some have been forced to board buses with infected people, exposing all on board to certain contamination. The entire group is then housed in community facilities with insufficient medical care to treat the virus, not to mention any preexisting chronic conditions. The intent is to protect the 11 million people in Wuhan, China, who are not affected by the disease, yet the minority that are exposed or infected might perish.

Utilitarianism includes 2 forms. Act utilitarianism justifies an action that is intended to produce overall good, well-being, or happiness and is unbound by moral rules. The Chinese government’s objective was to contain the epidemic by protecting the majority at the expense of the few, even if the effort contaminates or kills some in the process. Act utilitarianism can be criticized from several perspectives, one of which is that innocent people can be harmed to generate benefit for others; this might include any action—regardless of severity—to achieve such benefit. Rule utilitarianism also brings the greatest good for the greatest number of people, but in doing so, respects established moral rules or principles. These rules are considered universally right and moral, and they are followed without exception. For example, faced with the edict “Do not kill,” a rule utilitarian would not condone killing anyone, even to protect many from a potentially lethal threat. Despite an apparent similarity between rule utilitarianism and deontology, they are differentiated by the reason that rules are to be followed; the former is to benefit the many, and the latter because it is a righteous duty to act.

Your response to Seth’s condition should involve a prompt, private discussion with his mother to communicate your concern about exposing others to potential harm by the transmission of his illness. You should assume a compassionate, gentle, utilitarian approach toward the problem of inconveniencing one to spare many from the unhappiness of illness. Sometimes that is the burden of leadership.

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May 12, 2020 | Posted by in Orthodontics | Comments Off on One for many

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