A Utilitarian Approach To a Dilemma

Huntington’s disease is a dominantly inherited disease that often strikes people in middle age (onset of symptoms is between 30 – 50 years of age). A less common form of this disease begins in adolescence or during childhood. It is a fatal disease and has no cure. This disease progresses to the point where the carrier depends entirely on others, resulting in full-time care, and eventual death. It is common for carriers to commit suicide. There are available tests to determine if one carries this disease. Such was the case of Maria, a 17-year-old pregnant girl who went to her physician for genetic testing and counseling. Maria went to see her physician, Dr. Berkman, in the company of her mother, Sue, and boyfriend, Tom. Knowing the history of this disease (Maria’s father and aunt were both diagnosed with this disease), Maria desired to know the fate of her child.

Dr. Berkman explained to Maria that a definite diagnosis of her baby would mean she was a carrier of this disease too. The test result showed that the fetus had the disease. Maria decides to have an abortion as she did not want her unborn baby to suffer the way she sees her father suffer. Maria’s father is in the end stage of this disease while her aunt committed suicide after learning she also had the disease. Maria’s mother, Sue believes the fetus should have the opportunity to live. Maria and Sue both look to Dr. Berkman to resolve the issue. This assignment examines the conflict between Maria’s decision to terminate her pregnancy and Sue’s optimism that the child could live a good life before the onset of symptoms.

The ethical question this dilemma raises is “what is the right thing to do?” How should Dr. Berkman approach this situation? Is it ethically justified to have an abortion because the fetus is a carrier of the Huntington's disease? Applying the utilitarian framework to this issue According to Robertson, Morris, & Walter (2007), ‘utility’ is the degree of the relative happiness or satisfaction of a group. In the utilitarian approach, decisions are dependent on the greatest amount of benefit obtained for the greatest number of individuals. Utilitarianism determines the most moral action as one that produces the best or least harm in any circumstance. It focuses on the overall good of society, rather than on the individuals within it. Utilitarianism is also known as the consequentialist approach since the outcomes determine the morality of the decision taken Applying the utilitarian approach to this case According to Candee & Puka (1984), the steps include i.

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Identifying the parties involved to determine who wants what. The people involved are Maria, who desires an abortion for fear of having a child who would suffer in the same way her father is suffering. The baby whom we could assume has a right to life. Dr. Berkman, who must decide what the best option is. The question, is, does the fetus have an equal right to life as an adult?. Consider alternatives available. In this case, the alternatives include advising Maria against having an abortion or encouraging Maria to have an abortion. iii. Predict the results of each action. The possible result of carrying the pregnancy to full term and delivering the fetus is that the baby could live a normal life before the onset of symptoms. Moreover, even after the onset of symptoms, people could deal with this disease in different ways.

Alternatively, the baby will live a life full of uncertainty and anticipation of the disease before the onset of symptoms. After the onset of symptoms, the baby will have a poor quality of life and would become a burden to loved ones. The possible result of having an abortion is preventing harm and suffering to the child. Is there a balance between quality of life before the onset of the disease and after the manifestation of the disease? Also, Maria might be saved from the stress of having to take care of her sick child. Another point to consider as a possible result of this action is saving the child the stress of caring for Maria when her symptoms start manifesting (she is a carrier of the disease). Determine the chance of each result occurring.

From the predicted results, the best outcome if the fetus is carried to term is that the baby will live a normal life before the onset of symptoms. The question asked is how long will this be? What if the child has the juvenile form of this disease and symptoms begin to manifest much earlier? The only outcome. if an abortion is carried out, is the child will be free from suffering. What if the child lives a fulfilled life for a long time before the onset of symptoms? Does termination not deny the child of this outcome? Assign a value to each result. Can a fetus assess the value of life? Is there a comparison between living a life filled with the severe symptoms and loss of function that accompanies this disease, and not living at all? The fetus still has its entire life ahead to live.

What if the fetus is not carried to term due to other circumstances, for example, a motor accident? Another approach is comparing the life of a person living with the Huntington’s disease with that of a person living without the disease. The value and quality of life of a person living with this disease are considerably lower than that of a person living without the disease. The loss of body functions and complete dependency later in life diminishes the quality of life of such an individual. From Maria’s viewpoint, avoiding the pain and suffering her unborn child will experience and taking away the burden of care that would be on her presents more value to her and the fetus. Another perspective, that of the society must be considered. What if the child starts behaving irrationally and begins to pose a threat to others?

Alternatively, the burden of care will be the responsibility of the society peradventure Maria dies? Determine utilities of parties involved. Combine the values of each option. If the value the child will give to living life despite carrying this disease is high, one might argue in favor of carrying the pregnancy to term. We all would die, and passing away from disease is just a way death comes. How much time will such a person live healthy to justify the assumption that this life is worth living? Besides, on-going research for a cure for this disease has begun. What if the baby is lucky and this cure comes out before the suffering? Abortion will be a more appealing option if the value the child will give to living a life of pain is low, plus the disadvantages to Maria and the society. The problem here is adequately estimating the quality of life. It is also difficult to predict the quality of life for another person. A healthy person does not directly equate to a happy person, neither does a sick person necessarily equal an unhappy person. Although the severity of symptoms involved in this disease can be overwhelming, some persons might be grateful for life and for the opportunity to have loved ones around them.

Other limitations of this approach are that its choices are based on happiness, other goods such as human life, freedom are not considered. It uses a personal approach to make decisions (decisions are based on individual perceptions). The utilitarian viewpoint is rational about the occurrence of harm in medicine. It sees some harm as unavoidable, and although regrettable, justifies this by the greater good of a more significant number of others. It bases decisions on predicted outcomes; the limitation to this is that it is not easy to predict future results. According to Robertson, Morris, &Walker (2010), the utilitarian approach appears to lack empathy and an appreciation of an individual’s unique plight. The principle states “the end justifies the means” is a weakness of this approach. For example, allocating medical resources to a patient while denying another whom is felt has a limited chance of survival is supported by this approach

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