According to rule utilitarianism, which rule should doctors generally adopt in the transplant case to maximize the good?

According to rule utilitarianism, which rule should doctors generally adopt in the transplant case to maximize the good?

• A. Always kill the healthy donor if it saves more lives
• B. Always follow the rule to kill healthy people when it would promote the good
• C. Kill the five and spare the one
• D. Do not kill the healthy donor; follow a rule that generally protects life

Answer: (D)

In rule utilitarianism, we judge not individual acts by their immediate outcomes, but the rules we would be better off following over time. The transplant case asks us to think about what general rule would maximize welfare if everyone followed it. Killing a healthy donor to save five might look to maximize lives in a single instance, but adopting a rule that allows killing healthy people would undermine trust in doctors, deter people from donating, and destabilize healthcare. If such a rule became standard, the overall harm to society’s welfare would be far greater than any one-time gain. Rule utilitarianism therefore favors a rule that protects life and forbids killing healthy donors, because this rule tends to produce the greatest long-run good when applied broadly. So the best course is to avoid killing the healthy donor and to follow a rule that generally protects life.

In rule utilitarianism, we judge not individual acts by their immediate outcomes, but the rules we would be better off following over time. The transplant case asks us to think about what general rule would maximize welfare if everyone followed it.

Killing a healthy donor to save five might look to maximize lives in a single instance, but adopting a rule that allows killing healthy people would undermine trust in doctors, deter people from donating, and destabilize healthcare. If such a rule became standard, the overall harm to society’s welfare would be far greater than any one-time gain. Rule utilitarianism therefore favors a rule that protects life and forbids killing healthy donors, because this rule tends to produce the greatest long-run good when applied broadly.

So the best course is to avoid killing the healthy donor and to follow a rule that generally protects life.