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Utilitarianism
Utilitarianism
Unlike principlism, predicated on the inherent value of a set of accepted principles, utilitarianism is a consequentialist approach that aims to do the greatest good for the greatest numberโto maximize utility.32,33 One advantage of utilitarianism is that it does not require the intellectual exercise of accepting four, and only four, principles as the bedrock of ethical action. Still, a utilitarian approach that requires the physician to dispassionately create the most good (or cause the least harm) over all else necessarily creates secondary questions, including perspective (doing the most good for whom?), paternalism (who decides on what is the most good?), and possible ethical conflicts (utilitarianism embodies the idea that the end indeed justifies the means). Other concerns regarding utilitarianism include the demandingness objection (the concept that pure utilitarianism may be too demanding to be adopted on a practical level),34 and the risks of unjust distribution, as doing the greatest good for the greatest number may consistently marginalize minority groups.