The trolley problem is helpful to illustrate the difference between utilitarian and deontological ethical frameworks.

You are on a bridge overlooking a track on which there is a runaway trolley. The trolley is headed toward five people tied to the train tracks and unable to move. You are standing next to a lever and if you pull the lever, the trolley will divert to another track were a single person is tied down. The utilitarian will pull the lever and intentionally kill the one person in order to save the five. In a second scenario, the trolley is still headed toward five people tied to the track. This time, however, there is no lever, but there is a very large man who, if pushed onto the tracks, will stop the trolley. For a strict utilitarian, this shouldn’t make any difference; it would, though, for a deontologist. Pushing the man onto the track would be using him as a means to an end, so a deontologist would not push the man.

There is a famous story from World War II that vividly demonstrates how a clash between deontology and utilitarianism can lead to situations in which agonizing decisions need to be made. Since the start of the war, the British had been working to crack the secret code that was used to encrypt German communications. This was part of the all-out war effort as the British believed that they would only be able to rebuff a German invasion if they had an advanced warning of where the Germans would attack. The British were successful in cracking the German code, but after they had succeeded in doing so, they intercepted a German communication giving orders to bomb the city of Coventry in the UK. Churchill was thus faced with the choice of whether to scramble the British Air Force in an effort to save Coventry but, in doing so, reveal to the Germans that their code had been compromised or do nothing. Churchill ended up deciding to keep the message a secret and leave the people of Coventry to their fate. The town was decimated, and 554 people were killed. Churchill’s decision could be justified using a utilitarian framework, as the fact that they were able to crack the code and keep it a secret may have been an integral part of the Allied victory. A deontologist, however, would view the decision with dismay as the people of Coventry were clearly used as a means to an end — a fact that, no doubt, weighed heavily on Churchill’s mind.

From 1932 to 1972, the U.S. government sponsored the Tuskegee Syphilis Study to better understand the clinical course of untreated syphilis among 400 African American men. The men were misled, and not informed of the true purpose of the study and therefore did not consent to participate in the research and were not given treatment even after it was determined, in 1947, that penicillin could cure the disease. A utilitarian framework could be used to justify this research on the assumption that the knowledge generated would help more than the 400 people harmed during the study. A deontological approach would consider the study as having used these men as a means to an end, and would determine that the actions of the researchers was not justified. Indeed, in 1972 an Advisory Panel concluded that the Tuskegee Study was “ethically unjustified”, citing that the knowledge gained was limited as compared to the harms and risks experienced by the subjects and their families.

Most science and risk communication efforts are intended to persuade the audience to change their thinking and/or action. However, at some point you can cross the line from persuasion into manipulation. Utilitarian ethics would tell us that manipulation could be justified if its benefits outweigh its harms. Deontology, however, would tell us that any interchange in which we purposely obstruct someone from making their own rational decision would not be justified. The problem is that the line can be hard to identify. If you lie or withhold information in order to force your audience to make a specific decision, then this would clearly not be justified under a deontological framework. However, what about using emotion as a tool to sway your audience? This 1987 Grim Reaper-themed AIDS campaign from Australia uses fear to convince people to take steps to mitigate the spread of AIDS. Is that OK?

Childhood vaccination is mandatory in several European countries with financial penalties for non-conformance and there are few non-medical exceptions. This policy can be justified under a utilitarian framework given that it has been shown to reduce the incidence of vaccine-preventable diseases, such as measles. What would a deontologist think about this situation? Perhaps a case could be made that every possible effort should be made to communicate and compromise with parents who will not vaccinate their children prior to removing their right to choose. The urgency to communicate is particularly great given that forced vaccination could be viewed as akin to physical assault, and thus could constitute a significant harm in and of itself.

The varying approaches that different jurisdictions have taken about making masks mandatory during COVID-19 demonstrates the push and pull between the utilitarian and deontological frameworks. Some areas have made masks mandatory in public spaces because they view the cost of forcing people to wear masks as being outweighed by the benefit of preventing the spread of COVID-19. Other jurisdictions are concerned that their citizenry may view such authoritarian policies as an unacceptable transgression on the decision-making power of individuals, and have, instead, relied on communication to elicit voluntary compliance. Interestingly, the clash between these two perspectives seems to be less keenly felt in highly integrated societies as citizens in such societies tend to perceive decisions made for the good of community as also being good for themselves, and thus not as an egregious transgression on their autonomy. This demonstrates how ethics can vary not only by issue but also by context and audience.