Consequentialism, Deontology, Ethics, and Virtue

We are all presented with ethical/moral questions in our life. The actions or behavior we choose can impact both our life and the life of others. The fundamental question is: as an individual person (including corporations) of our society how should one act?

The term deontology comes from the Greek words for duty (deon) and science (or study) of (logos). Deontology deals with what we ought to do (deontic theories). The deontic theory views morality as comprised of duties and rights. Deontologism is a rule based approach that defines moral action by axiom, such as “treat others as you would like to be treated.” Therefore a deontic theory is bound to rules, not material interest or experience. Within this view, moral duty is derived from reason where moral decisions are based on one’s duty and the rights of others.

Consequentialism theories (aretaic theories) deal with the kind of person we should be. The question in consequentialism of whether an action is ethically right depends on the consequences of that act. The result of ones action and not duty or rights define what one ought to do. Consequentialism is the analysis of the expected benefit of the results for a given course of action. Through empirical means consequentialism seeks the most desirable ends good for mankind. In summary, consequentialism looks at the result of one’s chosen action as the norm for how one ought to act.

Virtue ethics looks at the character of a person. Virtue ethics has its classical roots in Plato and Aristotle. A similar focus on character is also found in Chinese philosophy. Virtue ethics philosophy in its return to the table of discussion puts much effort in distinguishing itself from consequentialism and deontology. Virtue is defined in terms of desirable characteristics such as: prudence, justice, courage, and temperance.

These three philosophical ethic models are distinguished by their respective normative bases. In deontology, it is to follow the rules presupposed by moral absolutes. In consequentialism, it is the results of action that define right behavior. The virtual ethics model focuses on good characteristics. There are other philosophical views that are less present. Of the three presented the first two make up the majority of current debate. Also, these three approaches represent the normative ethics branch of ethics in philosophy. Although the models have different criteria for analysis the results can be and often are the same, however, not always. The current normative ethic models are concerned with how one ought to act. The reality of course is that most people do what they do regardless of any philosophical ethics model. That is, presented with an ethical situation, we choose a course of action based on our experience and knowledge without thinking about an underlying ethical model.

Consider as an example the new generation of Hepatitis C medications. The new medications have significantly reduced side effects and much greater efficiency eliminating the virus for a cure. One pharmaceutical company has a newly approved medication that they are offering for sale in the U.S. at $1,000 per pill, that amounts to about $84,000 for a 12 week treatment. The propriety of charging that much has come into question. On the one hand, the action appears to be within the law and in business that should be the end of it. Looking at consequences is another story. Treating all three to five million people believed to be infected would amount to a cost of more than $250,000,000,000. The concerns from a bio-ethical view include the likely impact on equality of treatment and the potential harm to those that do not have the resources for treatment. Also, without mitigation on cost the national fisc will be negatively impacted.

Outside of the manufacturer, one option being considered is to only provide coverage for the medication to patients in the more advanced stages of the illness. The pharmaceutical company has stated they would provide the medication for free or significantly reduced cost for those in need that can not afford the cost. It is not clear to me how the story will end. My question is, what would you, the reader, consider to be an ethical solution to this example of high cost medication?