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Hedonistic Calculus

As a way to understand the hedonistic calculus, consider " A Convenient Truth (Links to an external site.)Links to an external site. " by Peter Singer. The following hedonistic calculus analysis uses Bentham’s categories to assess the best course of treatment for Ashley, the subject of Singer’s article. To apply the hedonistic calculus to the situation and evaluate its consequences, you would use a 10-point scale where 0= low for pleasure and 10= high for pain. Review this analysis before applying hedonistic calculus on another case study with your group.

Intensity: How intense is the pleasure or pain?

· Ashley will have to endure anaesthesia, surgery, healing and there will be post-operative pain. Pain or comfort will be assessed by non-verbal means (e/g/grimacing) or body movements (writhing etc.) Value =5

· Monthly discomfort and potential skin excoriation from bleeding: Ashley is 9 years old and will presumably go through puberty and menses for approximately 50 years. This monthly occurrence will be preceded by swollen breasts until menopause. We do not know if she is deformed which would further complicate her ability to be cleaned and well positioned for the rest of her life. Value =9

· Ashley will not have periods but could have other untoward side effects from hormonal treatments to diminish her weight and height (e.g. acne, hirsutism, baldness from growth stunting hormones). Value=6

· Ashley will feel comfort and love from her family and will have her basic physiologic Maslow’s hierarchy of needs met (food, shelter, clothing, safety). Value=0

· Her parents will derive pleasure from being able to carry her more easily and also not have to institutionalize her until they are unable to care for her. Value=0

Duration: How long will the pleasure or pain last or exist?

· Ashley probably has a normal lifespan but her mental condition is never expected to improve. She will be dependent on others for physical, emotional, spiritual, and intellectual care for her entire life. Value=10

· Other developmentally and severely retarded children with a mind of a 3 month old have expressed themselves so we do not know if the mental status will change over time with new medications, brain imaging, or miracle cures. 3 month old babies can smile and laugh. Value=3

Certainty or uncertainty: How sure can we be that happiness will follow from our action?

· Surgery will definitely remove her breasts and uterus. However, she could die during the operation. Value=10

· Her minimized height/weight will definitely result from meds. Value=5

· Her parent’s ability to carry her based on less weight is true. It is probably better for the child too since she will not be able to perform active exercise. Value=1

· Eating, urinating and defecating are easier in this situation if there is less body weight and it is easier to put a catheter in or conduct an enema. Value=0

Propinquity or remoteness: How far or near in space, time?

· Her parents and family desire to keep her within the family unit. Value=0

· The family’s evaluation of the situation is that this will certainly be in the best interest of the child and their ability to provide lifelong care more easily. Value=2

Fecundity: How big are the chances it will be followed by a similar pleasure or pain?

· The chances are that other medical problems could occur; we don’ t know but assuming the severe mental incapacity is the major problem, it cannot get worse unless more unknown neurological disability like seizures occurs and this is not predictable. Value=2

· The family will probably be happy with their decision because I assume they had protracted discussions with the ethics committee and within their family unit. Value=2

· If regrets occur, this would be painful emotionally and maybe spiritually for the family and the medical team. The medical ethical committee might also have regrets later. Value=8

Purity: How big are the chances that it will not be followed by the opposite sensation (pain after pleasure or pleasure after pain)?

· For Ashley, the chances are that the removal of her uterus and both breasts will not be followed by more pain or disability physically if she recovers adequately. However, the hormonal treatments could be followed by more pain if they cause side effects or the need for other surgeries in the future. Value=8

· From the parent’s perspective, they are likely to have feelings of guilt, anger, regret, shame, frustration and by venturing into unknown territory, they may inadvertently cause more pain for their daughter and their family; also they may still eventually institutionalize her, we don’t know. Value=8

Extent: How many people will be affected by the decision?

· Ashley, mom, dad, brothers/sisters, the medical team that cares for the child for life, the psychological counselors that support the family, the bioethics committee. Other severely mentally disabled children could also be affected by this decision due to the publicity and open blogging about it. Value=2

Conclusion: By this calculus, Peter Singer's position on this issue is confirmed: unless they proceed with the surgery and hormone treatments, there will be more pain than pleasure for Ashley and her family.

Hedonistic Calculus Assignment

As a group, select a case study from the archive of columns by the  New York Times Magazine’s Ethicist (Links to an external site.)Links to an external site. . After reviewing the case study, apply the hedonistic calculus to the situation and evaluate its consequences in the following categories, using a 10-point scale where 0= low for pleasure and 10= high for pain.

Intensity: How intense is the pleasure or pain?

Duration: How long will the pleasure or pain last or exist?

Certainty or uncertainty: How sure can we be that happiness will follow from our action?

Propinquity or remoteness: How far or near in space, time?

Fecundity: How big are the chances it will be followed by a similar pleasure or pain?

Purity: How big are the chances that it will not be followed by the opposite sensation (pain after pleasure or pleasure after pain)?

Extent: How many people will be affected by the decision?

Instructions

· Work together with your group in your group forum.

· Provide a URL for or actual copy of the case from The Ethicist that your group used to develop a hedonistic calculus.

· Summarize key decision points in the case and provide your group’s recommendation for the most ethical course of action based on your application of the hedonistic calculus.

· Be sure to test your recommendation against the hedonistic calculus. Ideally your recommendation should come as a result of working the calculus.

· Conclude with a reflection on the process and evaluate the usefulness of the hedonistic calculus as a tool for moral decision making.

· Select one member of your team to submit the final product as a Microsoft Word document to the Hedonistic Calculus assignment drop box.