Multiple myeloma is a cancer of plasma cells in the bone marrow. Plasma cells are white blood cells that produce antibodies to fight infection. In people with multiple myeloma, abnormal plasma cells accumulate in the bone marrow and produce too many antibodies. This can lead to problems such as anemia, kidney damage, and bone lesions (Padala et al., 2021). When giving treatment, doctors can borrow from different theories such as act utilitarianism and Kant’s Humanity Formula of the Categorical Imperative. Act utilitarianism is a consequentialist ethical theory that holds that the best action is the one that produces the best for the greatest number of people (Savulescu et al., 2020). The Humanity Formula of the Categorical Imperative, as formulated by Kant, states that one must never treat others merely as a means to an end but always as ends in themselves. When it comes to delivering treatment plan information, act utilitarianism recommends the option with great positive results, while Kan’s Humanity Formula of the Categorical Imperative prefers working with the patient’s treatment plan choice.
Recommendation Centered on Act-Utilitarian’s Perception
Due to the fact that doctors are highly trained professionals, it makes sense that they would be fearful of revealing information about the side effects of chemotherapy to their patients. However, from a strictly utilitarian perspective, it is more important to promote the biggest benefit for most individuals. In short, if the doctor withheld information about the patient’s chemotherapy side effects, then Marcia suffered these side effects; the harm would have been greater than if he had been honest with her from the outset. Indeed, there are always cases where withholding information may seem like the best course of action, such as if a patient has a condition that makes them particularly susceptible to serious side effects.
There are several reasons why an act utilitarian would recommend that Dr. C tell Marcia about the side effects of chemotherapy for treating multiple myeloma. First, act utilitarian believe that the morally correct action is the one that leads to the maximum benefit to the largest number of individuals (Savulescu et al., 2020). In this case, informing Marcia about the potential side effects of her treatment could help her make a more informed decision about whether or not to undergo chemotherapy. Second, act utilitarian similarly believe that humans have the duty to promote happiness and minimize suffering (Savulescu et al., 2020). Telling Marcia about the potential side effects of her treatment could assist her in avoiding stress related to financial constraints if she decides to go ahead with chemotherapy. While it may seem like hiding the side effects from Marcia would be best for her happiness in the short term; eventually, she would find out and likely be even more upset.
Concerning act-utilitarian objection, it is important for doctors to be honest with their patients about the potential side effects of treatment plans, but it is not always necessary or practical to disclose every last detail. In some cases, doing so could cause more harm than good by causing undue stress or panic. There is a delicate balance that must be struck between providing accurate information and preserving the patient’s emotional wellbeing. Specifically, Dr. C would have provided enough information to enable the patient to make an informed decision without confusion or future regret. Additionally, I think it would be wise for Dr. C to treat Marcia by subjecting her to chemotherapy without mentioning its side effects, such as contracting leukemia after twenty years. Depression due to chemotherapy’s negative impacts on information disclosure could lead to Marcia’s health deterioration, thus causing her early death due to a weakened immune system. Due to this, it would be good for the doctor not to tell the truth, which is contrary to act-utilitarian.
Recommendation Based on Kant’s Concept
Apart from act utilitarian, there is Kant’s Humanity Formula of the Categorical Imperative concept. In the metaphysics of morals, Kant proposes the Humanity Formula of the Categorical Imperative, which states that one should always act in such a way that they treat humanity (Bojanowski, 2018). Applying this formula to whether or not to disclose potentially life-threatening side effects of chemotherapy treatment to Marcia, Kant would say that Dr. C has a duty to inform her of these risks (Bojanowski, 2018). To do anything less would be to treat her as a means to her own ends (in this case, getting her to agree to treatment) rather than as an end in herself. In this case, that means ensuring that Marcia understands the risks and benefits of chemotherapy before making a decision about treatment.
In objection to Kant’s concept, it is likely that Marcia would not have wished to subject herself to a treatment that may cause her to develop leukemia twenty years later. Therefore, regardless of disclosing the truth to the patient, she would have rejected chemotherapy treatment. The fear of communicating the threatening chemotherapy side effects would prevent Marcia from seeking proper treatment, thus dying early, as compared to when she was not informed about leukemia, thus accepting the chemotherapy plan.
Moreover, chemotherapy is a demanding treatment, and the side effects can be quite severe. Apart from leukemia, other side effects of chemotherapy include extreme fatigue, nausea, vomiting, and hair loss, as well as cognitive impairment or even organ damage (Nho et al., 2020). Disclosing the truth will mean that all these negative effects of chemotherapy were to be revealed to Marcia. Informing Marcia about these potential chemotherapy side effects and that failure to undertake it then she would die early can be frightening. Due to these terrifying side effects, Marcia may choose to end her own life out of losing hope following her condition.
Bojanowski, J. (2018). Thinking about cases: Applying Kant’s universal law formula. European Journal of Philosophy, 26(4), 1253-1268.
Nho, J. H., Kim, S. R., Park, M. H., & Kweon, S. S. (2018). Symptom clusters and quality of life in breast cancer survivors after cancer treatment in a tertiary hospital in Korea. European journal of cancer care, 27(6), e12919.
Padala, S. A., Barsouk, A., Barsouk, A., Rawla, P., Vakiti, A., Kolhe, R., Kota, V., & Ajebo, G. H. (2021). Epidemiology, staging, and management of multiple myeloma. Medical Sciences, 9(1), 3.
Savulescu, J., Persson, I., & Wilkinson, D. (2020). Utilitarianism and the pandemic. Bioethics, 34(6), 620-632.