Welcome to Teleological Approaches to Moral Decision Making
Welcome to your study notes for Unit AS 7: Foundations of Ethics with Special Reference to Issues in Medical Ethics. Don't worry if ethical theories feel a little abstract at first! Once you grasp the central idea—that outcomes matter—everything will start falling into place.
In this chapter, we will explore two major teleological ethical theories: Utilitarianism (developed by Jeremy Bentham and John Stuart Mill) and Situation Ethics (developed by Joseph Fletcher). We will also learn how these theories apply directly to real-world medical issues like abortion, euthanasia, and human embryo research.
1. Understanding Teleological Ethics
What does "Teleological" mean?
The word comes from the Greek word telos, meaning "end", "purpose", or "goal".
In teleological ethics:
• The focus is on the consequences: An action is not inherently right or wrong on its own. Instead, it is judged purely by its outcome or result (the "end" it achieves).
• Flexibility over rigid rules: Unlike rule-bound ethical theories, teleological approaches allow people to look at the unique circumstances of a situation.
• The ends justify the means: If an action produces the best possible result, that action is considered morally right.
Key Contrast: Teleological vs Deontological
Common Exam Pitfall: Make sure you do not confuse these two terms!
• Teleological ethics: Consequence-based / outcome-based (e.g., "Lying is acceptable if it saves someone's life").
• Deontological ethics: Duty-based / rule-based (e.g., "Lying is always wrong, regardless of the consequences").
Quick Review Box:
Teleological = Focuses on the telos (end/consequence). Good results make an action right!
2. Theory 1: Utilitarianism
Utilitarianism is a teleological theory founded on the Principle of Utility, also known as the Greatest Happiness Principle: "The greatest good for the greatest number."
A. Jeremy Bentham and Act Utilitarianism
Jeremy Bentham believed that all human beings are motivated by two basic forces: pain and pleasure. He famously stated that mankind is placed under the governance of "two sovereign masters: pain and pleasure."
Bentham put forward Act Utilitarianism, which evaluates every individual act on its own merits to see how much overall pleasure or pain it causes.
The Hedonic Calculus
To measure the quantity of pleasure or pain an action will produce, Bentham created a tool called the Hedonic Calculus. It consists of seven distinct criteria:
1. Intensity: How strong is the pleasure or pain?
2. Duration: How long will the pleasure or pain last?
3. Certainty: How likely is it that the pleasure or pain will actually occur?
4. Propinquity (Remoteness): How soon will the pleasure or pain happen?
5. Fecundity: What is the likelihood of the sensation being followed by more of the same feeling (more pleasure following pleasure)?
6. Purity: What is the likelihood that the pleasure will NOT be followed by the opposite feeling (e.g., pleasure followed by pain)?
7. Extent: How many people are affected by the action?
Memory Trick (P-R-I-C-E-D-F):
Purity, Remoteness (Propinquity), Intensity, Certainty, Extent, Duration, Fecundity.
B. John Stuart Mill and Rule Utilitarianism
John Stuart Mill agreed with Bentham's general principle of utility, but he worried about Bentham's purely quantitative approach (measuring only the "amount" of pleasure). Mill introduced a qualitative distinction between pleasures:
• Higher Pleasures: Intellectual, artistic, and spiritual pleasures (e.g., reading philosophy, enjoying music, learning). Mill considered these superior.
• Lower Pleasures: Physical and sensory pleasures (e.g., eating, drinking, sleeping). While necessary, they are of lower value.
Mill famously wrote: "It is better to be a human being dissatisfied than a pig satisfied."
Rule Utilitarianism
Rather than calculating every single action from scratch (like Bentham's Act Utilitarianism), Mill suggested that society should follow general rules that have been shown over time to produce the greatest happiness for the greatest number (e.g., "Do not lie" or "Do not murder").
Key Takeaway for Utilitarianism:
Bentham focuses on the quantity of pleasure (Act Utilitarianism + Hedonic Calculus). Mill focuses on the quality of pleasure (Higher vs Lower pleasures + Rule Utilitarianism).
3. Theory 2: Situation Ethics
Situation Ethics was developed in 1966 by the Christian theologian Joseph Fletcher in his book Situation Ethics.
The Core Principle: Agape
Fletcher argued that morality should not be based on rigid legalistic laws or chaotic lawlessness. Instead, it must be guided by a single absolute standard: Agape.
Agape is unconditional, selfless Christian love—the love that seeks the best for others without expecting anything in return.
Important Exam Tip: Situation Ethics is NOT "anything goes" (antinomianism). Fletcher positioned Situation Ethics as a middle way between Legalism (rigid rule-following) and Antinomianism (having no rules at all). The one unchanging boss in every situation is Agape.
The Four Working Presuppositions
Before making a moral decision, Fletcher states we must accept four starting points:
1. Pragmatism: The proposed action must be practical and work in the real world.
2. Relativism: There are no fixed, absolute rules. Every decision is relative to love (agape).
3. Positivism: Faith and commitment to love come first; reason is then used to work out what love requires.
4. Personalism: People come first, not rules or laws.
The Six Fundamental Principles
Fletcher also outlined six rules of thumb to guide decision-making:
1. Love only is always good: Only love has intrinsic moral value; actions are good only if they produce love.
2. Love is the only norm: Love replaces all traditional ethical rules and commandments.
3. Love and justice are the same: Justice is simply love distributed fairly among people.
4. Love is not liking: Agape is a matter of the will, not an emotional preference; it applies even to our enemies.
5. Love justifies its means: Any action (even one usually considered wrong) is justified if it leads to a loving outcome.
6. Love decides there and then: Decisions must be made situationally, based on the immediate facts, not in advance.
Key Takeaway for Situation Ethics:
Fletcher replaces rigid laws with the single guiding rule of Agape (unconditional love). People come before rules (Personalism).
4. Application to Medical Ethics (AS 7 Focus)
In Unit AS 7, you are required to apply teleological theories directly to medical scenarios. Here is how they approach key dilemmas:
A. Abortion
• Utilitarian Perspective: Weighs the total pleasure and pain produced. If a pregnancy threatens the life, mental health, or economic well-being of the mother and family, an abortion might produce the net balance of happiness over suffering (considering duration, intensity, and extent of pain).
• Situation Ethics Perspective: Considers what the most loving thing (agape) to do is for everyone involved. If carrying a pregnancy to term causes immense suffering, agape may justify abortion (putting the mother's personhood first—Personalism).
B. Euthanasia
• Utilitarian Perspective: Focuses on the quality of life and the duration/intensity of physical suffering. If a terminally ill patient is experiencing unbearable, unending pain with no prospect of recovery, ending life may maximize utility by ending suffering for the patient and relieving distress for the family.
• Situation Ethics Perspective: Fletcher would ask whether keeping a person alive on machines serves love or merely legalism. If extending life prolongs agony, voluntary euthanasia or the withdrawal of treatment can be the most loving and compassionate act.
C. Human Embryo Research
• Utilitarian Perspective: Evaluates the potential future benefits against the destruction of early-stage embryos. The research could lead to cures for debilitating diseases (e.g., Parkinson's, Alzheimer's), creating vast happiness for millions of people (Extent and Fecundity). Therefore, the overall utility justifies the research.
• Situation Ethics Perspective: Guided by Pragmatism and Personalism. If research on microscopic embryos can heal living, suffering human beings, love justifies the means to achieve that compassionate end.
5. Exam Skills & Pitfalls for AS 7
1. Applying the Hedonic Calculus
Examiner Warning: In the exam, do not just list the 7 criteria of the Hedonic Calculus! You must explain how they apply to the specific medical scenario in the question. For example, mention how the duration of suffering in terminal illness or the extent of people helped by embryo research affects the calculation.
2. Clarifying the Thresholds
Keep the decision-making criteria distinct:
• Utilitarian Threshold: The net balance of pleasure over pain (the greatest good for the greatest number).
• Situation Ethics Threshold: Whether the action serves the end of Agape (unconditional love).
3. Section B: "Other Aspects of Human Experience" (OAHE)
In Section B of the AS 7 exam, higher mark bands require you to engage with Other Aspects of Human Experience. This means drawing on relevant historical or contemporary real-world examples, legal debates, or wider societal issues beyond standard textbook examples to evaluate how teleological theories work in everyday life.
Quick Summary Checklist:
✓ Can you define telos and distinguish teleological from deontological ethics?
✓ Can you explain Bentham's Act Utilitarianism, sovereign masters, and the 7 Hedonic Calculus criteria?
✓ Can you explain Mill's Rule Utilitarianism and the distinction between higher and lower pleasures?
✓ Can you list Fletcher's 4 Presuppositions and 6 Fundamental Principles of Situation Ethics?
✓ Can you apply both theories to Abortion, Euthanasia, and Embryo Research?