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Utilitarianism: Pleasure or Preference?

Spend much time in discussion of ethics and you’ll likely hear standard objections to various utilitarian theories. In their single-minded drive to maximize some version of the good (e.g., desirable conscious states like pleasure), utilitarian theories are said to run afoul of situations that seem morally dubious, if not abhorrent. Perhaps on utilitarian grounds it is morally permissible, or even obligatory, to kill an innocent person if that quiets a rampaging mob who thinks she is guilty, and there isn’t enough time to persuade them otherwise.
Perhaps it’s incumbent on a surgeon to harvest the organs of a healthy UPS delivery guy visiting his hospital, if that can save the lives of a dozen patients who will soon die otherwise.
Defenders of utilitarianism have responses to such Philosophy 101 objections. Rampaging mobs seeking innocent blood are uncommon, and anyway killing the innocent likely sets a bad precedent that would bring about more overall bad than good. On utilitarian grounds, it’s likely better in the long run to spare the lives of innocents even if that means short-run unappeased mob damage. Hospitals where people are killed for their organs would quickly cease to exist as word spread of disappearing UPS drivers. Having no hospitals would leave us all worse off and thus make the counterexample a nonstarter for our actual world.
Such thought experiments are often artificial to the point of being limited in their use. They may pump intuitions at the cost of being irrelevant to real life.   
In response, skeptics often press the “just-so” elements at risk for utilitarian views that especially favor maximizing desirable conscious states. Take someone who deeply enjoys shaving off people’s eyebrows and just so happens to have easy access to a person unsupervised in a coma. The coma patient will suffer no lasting physical damage, no felt harms (arguably, no harms at all) from their boundaries being crossed, and they’ll be none the wiser should they eventually wake up with the eyebrows grown back. No witnesses are around to see the trespass and tell the patient what happened. The boundary crosser won’t suffer any long-term guilt or other negative psychological ramifications from his fetish. It will all be his own little secret, and so more net pleasure occurs than if he didn’t shave the patient’s eyebrows. 
So, must utilitarians claim it’s ok for this encounter to occur? There is only net pleasure and no damage otherwise. I sense most readers will balk. Surely something has gone wrong that utilitarians aren’t accounting for, such as the coma patient’s lack of opportunity to consent to the encounter, which they most likely would not consent to if they were alert. We can’t help but wonder how the utilitarian misses ways in which the boundary crosser disrespects the recipient of his intended action in ways that a pleasure/pain calculus can’t fully explain. 
A utilitarian may dig in his heels and respond that consent matters, of course. A world in which consent was regularly ignored would likely be worse overall than one where it was regularly honored. Consent is also valuable largely because it helps people promote the good in ways they see fit through voluntary interactions. But consent is only relevant for agents capable of giving it, namely conscious agents. The comatose patient can’t give consent, but neither will they suffer from this inability, so what is the problem other than maybe a stubborn allegiance to some allegedly intrinsic value or inherent rightness consent itself has? The utilitarian may argue such intrinsic value or rightness is mysterious at best. If one is bothered by such an example, perhaps the best thing to do on utilitarian grounds is ensure that coma patients are supervised or the doors to their rooms are locked. 
That’s it?! Are those of us still bugged by this boundary crossing merely registering feelings of ickiness that have nothing to do with serious moral evaluation? Should we grow up and realize there can’t be wrongs where there are no harms, no clear setbacks of interests? 
As it happens, utilitarianism need not commit to the permissibility of the boundary crossing in this or many other instances. This is because one can defend preference-satisfaction utilitarianism (“preferentism” for short). Unlike “hedonic” utilitarian views that focus on maximizing some form of desirable conscious states like pleasure, preferentism looks to maximize the satisfaction of agents’ (informed) preferences. 
Preferentism improves matters by taking seriously the content of each agent’s preferences, including strong preferences not to be infringed on in certain ways, such as eyebrow boundary crossing. Unlike “occurrent” states such as conscious pleasure, preferences can be stable dispositions individuals have (or are presumed to have) even if they are not readily able to access conscious awareness. 
Almost all of us likely have strong preferences not to be subject to non-consensual boundary crossings because we value our bodily integrity and privacy more than giving strangers rude pleasure. The coma patient may only need a slightly stronger (real or presumed) preference to not be so crossed than the crosser’s preference to cross. If so, and all else equal, preferentism forbids him from crossing even if he would get a lot of pleasure from it and the victim would suffer no pain. 
Do we have good reason to, well, prefer preferentism over rival utilitarian views on grounds besides its ability to avoid an uncomfortable result such as this case? A sequel to this essay will explore some of the strengths and issues with preferentism, and its structure as a utilitarian approach more generally.

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