Deontology is an ethical theory, which states actions should be performed according a previously ranked set of values (Johnson, 1996). It states that some rights must not be violated even if it may produce the greatest overall good. It sees rightness as something intrinsic, rather than extrinsic, to the action performed. It is generally attributed to the philosophy of Immanuel Kant on categorical imperatives. Deontology urges that actions or means to actions must themselves be ethical. It upholds ethical norms and truths to be universally applicable. Immoral actions are those, which are wrong in themselves and of themselves. Deontology requires that all people act with the view that their act be a universal pattern or norm of behavior. Immanuel Kant also maintains that people arrive at moral conclusions on what is morally right or wrong through rational thought. Deontology insists that the means must justify the end (Johnson).
Utilitarianism, on the other hand, is an ethical theory or moral principle, which states that the moral act is one, which produces the greatest amount of benefits over harms for everyone involved (Andre, 2010). The end or means is not as important as the projected maximum benefits for those involved. This is the more frequently used method by most people for the purpose of achieving the greatest amount of good or preventing the greatest harm. This thinking guides most businesses and business analysts, lawmakers and scientists. Jeremy Bentham established the principle of utilitarianism, which seeks the greatest good for the greatest number. John Stuart Mill is also credited for it (Andre).
A nurse confronts a situation on how to advocate for a patient, Mrs. Rita Trosack, who must decide whether she and her husband should opt for abortion or continue with her pregnancy. She is three months pregnant and her doctor diagnosed her unborn child with Tay Sach's Disease, a genetic and still-incurable deformity. This is an actual case.
A nurse has been assigned to the care of Mrs. Rita Trosack, at a high-risk obstetric clinic. Rita is 43 years old, married for 6 years. This is her first pregnancy. Both of them are Caucasian. Rita's medical history reveals that her father had a sibling who died at an early age for unknown causes, attributable to Tay Sach's Disease. On the other hand, Peter's medical history shows that his father had two siblings who also died at an early age for causes unknown at that time. These were also attributed to Tay Sach's. This duplicate condition means that both Rita and her husband are carriers of the Tay Sach's gene. This explains why their still-unborn child is afflicted with it.
Tay Sach's Disease is a neurological condition, characterized by nerve damage. The damage begins from the womb. Symptoms usually appear when the child is 3 to 6 months old after birth. The disease progresses and, in most cases, the defective child dies at 4 or 5. Research says that there is a 25% risk of passing the gene to every pregnancy among couples who are both carriers. Genetic screening is recommended before high-risk couples begin a family.
Rita and Peter are inconsolable upon learning the condition of their child. They go through the stages of denial, blame and compromise. But abortion is not an option to them because of their Catholic belief. Furthermore, another pregnancy is likely to be defective. Current knowledge about Tay Sach's Disease states that their only would-be child will be defective right in the womb and when born. He is expected to develop other symptoms, including blindness, dementia and paralysis, until a likely death at an early age. Rita and Peter will have to shoulder the immense and expected expenses and frustrations of caring for a child who will be physically, mentally and emotionally defective and dependent, with no visible chance of a cure.
The Deontologist's Side
A deontologist claims that a person is bound by duty or constraints not to do certain things, which are morally wrong per se, more than to produce an effect perceived as good (Johnson, 1996). These constraints are agent-relative rather than agent-neutral. An agent-relative moral constraint requires a person to fulfill a duty even if by violating it will prevent consequent violations of the same duty by others. Lying is never permissible to a deontologist. An agent-neutral belief may argue that one lie may be bad, but more will be worse if one lying is not allowed. One wrong can minimize the total amount of wrongs if allowed. Deontology is opposed to consequentialism or utilitarianism, which considers the effects of an act more than the act itself (Johnson).
Deontology holds that it is impossible to predict the outcomes of a single act with absolute certainty (Johnson, 1996). At the moment, the only thing that a person making a decision can be sure of is whether what he is doing is ethical or not, according to categorical imperatives. Furthermore, the person is responsible only for his own actions, not those of others (Johnson). Abortion is considered inherently evil or wrong because it takes the life of a human being. This takes precedence over the incurable defects and certain death in the child of the Trosacks. There is no question that the unborn child is a human being and the value of the child's life is greater than the intended elimination of the defects and the miserable consequences expected. The end does not justify the means, which is abortion. Not only is abortion is murder, which is forbidden by the Catholic faith of the Trosacks. It is also inherently evil and, therefore, morally forbidden.
The Utilitarian's Side
Universal moral truths or premises exist, as those truths are difficult or impossible to ascertain (Andre & Velasquez, 2010). In comparison, the benefits or harms produced by a certain act are more easily measured. A person, therefore, should not rely on abstract principles to determine his choice. He should, instead, choose concrete ways of determining the basis for a decision or act. A utilitarian rejects morally untenable outcomes upheld by deontologists. A consequence of greater or more harms is less desirable than only one. The person should then choose ends rather than the means in determining whether an act is morally correct. Utilitarianism offers a clear and concrete way of deciding after considering a number of choices. It chooses the one, which promises the greatest number of benefits to the greatest number of persons and at the least cost. It asks about the effects and the general balance between good and evil. If a given act, which is considered inherently wrong, will produce maximum good to the greatest number, it ought to be done (Andre & Velasquez).
A utilitarian will disagree with the Trosacks in proceeding with the pregnancy, which is medically certain to produce a series of sufferings on the couple and the offspring. They will all suffer uselessly. Each day, the couple will see the progressive deterioration of their child until it dies without enjoying life. A sure cure for Tay Sachs is not in sight and extremely difficult if not impossible because it is genetic. It can only be prevented if carriers will decide not to procreate. But with conception, the child is doomed for destruction. Utilitarianism will nip sure suffering in the bud. It perceives the total and predicted amount of suffering in all concerned as justifying the termination of pregnancy. It is comfort, not a crime, for the entire family to save them from useless suffering.
Taking a Side
The Trosacks' decision to proceed with the pregnancy is an extremely difficult one because of the certainty of Tay Sachs. But it is much more difficult for them to abandon their faith and their true feelings about the pregnancy and abortion just to prevent a…