7.1.1  Two important ethical theories

In this study session you will learn about two of the most relevant ethical theories for your professional practice as a Health Extension Practitioner. These are called utilitarianism and deontology.

Utilitarianism considers an action as morally right if its outcomes or consequences are good for the greatest number of the population. It focuses on ‘the greatest good for the greatest number’. This theory disregards individual rights and considers the welfare of the greatest majority to be the most important factor. For example, it might be necessary to drain a particular pond because it is the breeding ground for mosquitoes – although this might be difficult for the farmer on whose land it is situated (Figure 7.2). In this situation the welfare of the greatest number of people is more important than the rights of the individual farmer.

Figure 7.2  Draining a mosquito breeding ground may be difficult for the farmer but be good for the health of everybody in the community. (Photo: Ali Wyllie)

Deontology, on the other hand, considers the way that things are done rather than focusing just on the consequences. This type of ethics holds at its core the respect for fundamental rights, such as the right to truth, privacy and the fulfilling of promises (Figure 7.3). Deontology considers the rightness or wrongness of an action. For instance, someone who believes that lying is always wrong, even if a lie might accomplish some good for individuals and society, is following the principles of deontology – although they may never have heard of the theory.

Figure 7.3  It is always important to be clear and truthful about health issues such as the use of contraception. (Photo: Ali Wyllie)

  • Imagine that a healthworker tells a mother of ten children that if she takes oral contraceptive pills they will be 100% effective in preventing another pregnancy, and that the pills have no side-effects. Is this approach an example of utilitarianism or deontology?

  • The healthcare provider has given wrong information (lying) because there is no 100% effective contraceptive which is without side-effects. However, using contraception has a great benefit to the health and wellbeing of the mother in particular and her family in general. Therefore, the approach taken by the healthworker is an example of utilitarianism, because it contains a lie (so it cannot be deontology), but it may yield a benefit to the woman, her partner and her ten children.

7.1  Ethical issues in healthcare work

7.2  Ethics in practice