Abstract
Utilitarianism focuses on the optimization of personal well being in ways that seems to make the practice of medicine irrelevant to the well being of the practitioners, unless given external incentives such as money or honor. Care based on indirect incentives is considered inferior to care motivated internally. This leads to the paradox of utilitarian care. Following Nozick's conceptual Pleasure Machine it is argued that in addition to the promotion of personal well being, people care about fulfilling their well being in a world which is real, just, good, and beautiful. Complete mechanization of social and personal life in accordance with a strict utilitarian regime is also incompatible with the kind of world people desire, even if it promises more fulfillments in terms of personal well being. This explains the so-called Taurek-Parfit paradox, according to which sometimes ethics seems “to count the numbers” and sometimes not. The very pursuit of utilitarianism does not contribute to any personal life plan. The helping professions make the world a better place for us to live in, even though they do not necessarily bear directly on the well being of any individual other than the recipients of care. This resolves the paradox of utilitarian care.
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References
Aberth, J.: 2000, From the Brink of the Apocalypse: Confronting Famine, War, Plague and Death in the Later Middle Ages. New York: Routledge.
Adams, R.M.: 1976, ‘Motive Utilitarianism’, Journal of Philosophy 73, 467–481.
Barilan, Y.M.: 2003, ‘Autonomy and Phenomenology of the Self: Between Analytic Philosophy and Dada’, Personalist Forum 14.
Bernstein, M.H.: 1998, On Moral Considerability: An Essay on Who Morally Matters. Oxford: Oxford University Press.
Brandt, R.: 1972, ‘Rationality, Egoism and Morality’, Journal of Philosophy 69, 681–697.
Brandt, R.: 1979, A Theory of the Good and the Right. Oxford: Oxford University Press.
Brooks, G.: 2002, The Wonder Years: A Novel of the Plague. New York: Penguin.
Butler: 1897/1726, ‘Fifteen Sermons Upon Human Nature’, in: L.A. Selby-Bigge (ed.), British Moralists. Vol. I. Oxford: Clarendon.
Campbell, J.: 2001, The Liar's Tale: A History of Falsehood. New York: Norton.
Cohen, G.A.: 1993, ‘Equality of What?’, in: M.C. Nussbaum and A. Sen (eds.), The Quality of Life (Oxford: Clarendon).
Darwell, S.: 2002, Welfare and Rational Care. Princeton: Princeton University Press.
Dennett, D.: 1995, Darwin's Dangerous Idea: Evolution and the Meaning of Life. New York: Simon and Schuster.
De Vigny, A.: 1826/1889, Cinq Mars: A Conspiracy Under Louis the 13th. Boston: Little Brown.
Elster, J.: 1983, Sour Grapes: Studies in the Subversion of Rationality. Cambridge: Cambridge University Press.
Foot, P.: 1978, Virtues and Vices. Oxford: Blackwell.
Frey, R.G.: 2000, ‘Act Utilitarianism’, in: H. LaFollette (ed.), The Blackwell Guide to Ethical Theory (Oxford: Blackwell).
Gibbard, A.: 1986, ‘Interpersonal Comparisons: Preference, Good and the Intrinsic Reward of Life’, in: J. Elster and A. Hylland (eds.), Foundations of Social Choice Theory (Cambridge: Cambridge University Press), pp. 165–194.
Graeber, D.: 2001, Toward an Anthropological Theory of Value. New York: Palgrave.
Griffin, J.: 1986, Well-Being: Its Meaning, Measurement and Moral Importance. Oxford: Oxford University Press.
Harris, J.: 1975, ‘The Survival Lottery’, Philosophy 50, 81–87.
Hayborn, D.M.: 2001, ‘Happiness and Pleasure’, Philosophy and Phenomenological Research 62, 501–527.
Heschel, A.J.: 1951, Man Is Not Alone: A Philosophy of Religion. New York: Farrar, Straus & Young.
Jonsen, A.R. and S. Toulmin: 1988, The Abuse of Casuistry: A History of Moral Reasoning. Berkeley: University of California Press.
Kaufman, W.: 1961, The Faith of a Heretic. New York: Doubleday.
Lyons, D.: 1965, Forms and Limits of Utilitarianism. Oxford: Oxford University Press.
Moore, G.E.: 1909, Principia Ethica. Cambridge: Cambridge University Press.
Nozick, R.: 1974, Anarchy, State and Utopia. New York: Basic Books.
Nygren, A.: 1932, Eros and Agape: A Study of the Christian Idea of Love. London: S.P.C.K.
Overvold, M.C.: 1980, ‘Self-Interest and the Concept of Self-Sacrifice’, Canadian Journal of Philosophy 10, 105–118.
Parfit, D.: 1978, ‘Innumerate Ethics’, Philosophy and Public Affairs 7, 285–301.
Parfit, D.: 1979, untitled. Philosophy and Public Affairs 8, 393–397.
Parfit, D.: 1984, Reasons and Persons. Oxford: Oxford University Press.
Pellegrino, E.D.: 2000, ‘Decisions to Withdraw Life-Sustaining Treatment: A Moral Algorithm’, Journal of the American Medical Association 283, 1061–1063.
Railton, P.: 1984, ‘Alienation, Consequentialism and the Demands of Morality’, Philosophy and Public Affairs 13, 134–171.
Rawls, J.: 1971, A Theory of Justice. Cambridge: Harvard University Press.
Rogers, A.K.: 1933, The Socratic Problem. New Haven: Yale University Press.
Scheffler, S.: 1993, The Rejection of Consequentialism. rev. edn. Oxford: Clarendon.
Schneewind, J.B.: 1998, The Invention of Autonomy: A History of Modern Moral Philosophy. Cambridge: Cambridge University Press.
Sidgwick, H.: 1901, The Methods of Ethics. London: Macmillan.
Smart, J.J.C. and B. Williams: 1973, Utilitarianism for and Against. London: Cambridge University Press.
Stocker, M.: 1976, ‘The Schizophrenia of Modern Ethical Theory’, Journal of Philosophy 73, 453–466.
Summer, L.W.: 1996, Welfare, Happiness and Ethics. Oxford: Oxford University Press.
Taurek, J.M.: 1977, ‘Should the Numbers Count?’, Philosophy and Public Affairs 6, 293–316.
Trianosky, G.W.: 1978, ‘On the Obligation to Be Virtuous: Shaftesbury and the Question, Why be Morel?’, Journal of the History of Philosophy 16, 289–300.
Williams, B.: 1973, Problems of the Self. Cambridge: Cambridge University Press.
Williams, B.: 1981, Moral Luck. Cambridge: Cambridge University Press.
Williams, B.: 1985, Ethics and the Limits of Philosophy. Cambridge: Harvard University Press.
Williams, B.: 2002, Truth and Truthfulness. Princeton: Princeton University Press.
Wolf, S.: 1982, ‘Moral Saints’, Journal of Philosophy 1982, 419–439.
Wuthnow R.: 1991, Acts of Compassion: Caring of Others and Helping Ourselves. Princeton: Princeton University Press.
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Barilan, Y.M. Towards a dialogue between utilitarianism and medicine. Med Health Care Philos 7, 163–173 (2004). https://doi.org/10.1023/B:MHEP.0000034322.60058.01
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DOI: https://doi.org/10.1023/B:MHEP.0000034322.60058.01