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Ethical Analysis of the Dalkon Shield Policy
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According to John Stuart Mill, the Greatest Happiness Principle holds that actions are right if
they tend to promote happiness and wrong if they tend to produce the reverse of happiness, explaining
happiness in hedonistic terms as pleasure and absence of pain (Riley, 2013). In attempting to address the
ethical dilemma facing the Robins Company and the U.S. Agency for International Development
concerning the Dalkon Shield, Mill's framework would consider the overall happiness produced against
the suffering caused by it. The proponents of this policy argued that utilization of the Dalkon Shield in
population control programs would save lives by preventing childbirth-related deaths and reducing child
starvation in poor countries. By such reasoning, AID policy was supposed to enhance overall happiness,
therefore adhering to Mill's principle. However, the device had the tendency to kill and further cause
serious health problems, which fundamentally raises a question of the utility of the device. The imposition
of such risks, especially after they were determined to be unacceptable within the domestic market,
suggests a lack of consideration toward equal consideration of everybody's happiness, which is one of the
central elements in Mill's ethical system. The happiness derived from the potentially reduced childbirth
mortality and starvation does not morally offset the direct harm, inclusive of life-threatening conditions
and even death, that was imposed on women using the shield. Thus, according to Mill's principle, one
would have to consider the actions of Robins Company and AID to be ethically wrong, as they probably
decreased net happiness due to their cause of major suffering and injustice to a defenceless population
(Riley, 2013).
On the other hand, the central point of Kant's ethical framework is the categorical imperative,
which makes actions necessarily universalizable and handles humanity, whether in one's own person or
another, as an end in itself rather than as a means to an end (Kerstein, 2019). This would systematically
criticize the actions of the Robins Company and AID. By continuing to distribute a dangerous device,
even when its dangers became known and occasioned its withdrawal from the domestic market, policy
treated the recipients as means—but not as ends in themselves—merely as a means to broader
demographic ends. This is an instrumentalization of individuals that clearly violates regard for their
inherent worth or dignity, as Kant would have it. Moreover, Kantian ethics would reproach the fact that
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there is no universalizability in the application of the policy: what is wrong to be done in one context
(domestic) cannot be ethically permissible in another (international) under the same laws of morals.
Distribution of the Dalkon Shield for these reasons is, hence, unethical in a Kantian view: such
distribution does not respect the inherent rights and dignity of all those concerned, making them merely a
means to the ends of demographic goals, not ends in their own right.
Of the utilitarian framework of John Stuart Mill and the deontological ethics of Immanuel Kant,
the Kantian approach makes a stronger case against the policy pursued by the Robins Company and the
U.S. Agency for International Development with the Dalkon Shield. His categorical imperative requiring
actions to be of universal application and to treat all human beings as ends in themselves clearly points
out the moral failures of the policy. That the Robins Company continued to market in less economically
developed countries a device it knew to be harmful and withdrew from its domestic market fairly clearly
exploits these populations only as a means to the end of population control, which clearly violates the
principle of universalizability. It cannot be ethically justified to have placed a known harmful device in
vulnerable populations under the guise of reducing childbirth-related deaths and starvation. This surmises
discrimination on the basis of geography and economic conditions—that lives in poorer regions are less
worth safeguarding and having free choice over health decisions.
Moreover, the utilitarian argument would hold its application may save more lives on the net by
reducing the risks of childbirth, but that definitely falls apart when brought up against immediate and
serious harms caused by the device—harms that have included life-threatening infections, loss of
reproductive capacity, and even death. Such negative consequences cause deep unhappiness and suffering
to many people; therefore, they violate Mill's Greatest Happiness Principle, which is aimed at maximizing
happiness and minimizing suffering. The practical negative impacts on the lives of individual women and
their communities likely outweigh any abstract benefits that might be projected forward by these policy
proponents.
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References
Kerstein, S. (2019, April 13). Treating Persons as Means. Stanford Encyclopedia of Philosophy.
https://plato.stanford.edu/entries/persons-means/
Riley, J. (2013). Greatest Happiness Principle. International Encyclopedia of Ethics.
https://doi.org/10.1002/9781444367072.wbiee762
