Health Care Analysis

, Volume 11, Issue 3, pp 229–244

Utilitarian Theories Reconsidered: Common Misconceptions, More Recent Developments, and Health Policy Implications

  • Afschin Gandjour
  • Karl Wilhelm Lauterbach

DOI: 10.1023/B:HCAN.0000005495.81342.30

Cite this article as:
Gandjour, A. & Lauterbach, K.W. Health Care Analysis (2003) 11: 229. doi:10.1023/B:HCAN.0000005495.81342.30


Despite the prevalence of the terms utilitarianism and utilitarian in the health care and health policy literature, anecdotal evidence suggests that authors are often not fully aware of the diversity of utilitarian theories, their principles, and implications. Further, it seems that authors often categorically reject utilitarianism under the assumption that it violates individual rights. The tendency of act utilitarianism to neglect individual rights is attenuated, however, by the diminishing marginal utility of wealth and the disutility of a protest by those who are disadvantaged. In practice, act utilitarians tend to introduce moral rules and preserve traditional rules. At the same time, the tenability of rule utilitarianism is limited because it ultimately collapses into act utilitarianism or a deontological theory. Negative utilitarianism is a viable utilitarian variant only if we accept complete aversion to suffering, ie, if we disregard any forgone opportunities to increase pleasure. Finally, the adoption of preference utilitarianism requires us to accept the subjectivity of individual claims which may be perceived as unfair.

act utilitarianismdeontological theorynegative utilitarianismpreference utilitarianismresource allocation in health carerule utilitarianism

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Afschin Gandjour
    • 1
    • 2
  • Karl Wilhelm Lauterbach
    • 1
  1. 1.Institute of Health Economics and Clinical EpidemiologyUniversity of CologneCologneGermany
  2. 2.Institut für Gesundheitsökonomie und Klinische EpidemiologieUniversität zu Köln, GleuelerKölnGermany