Introduction to ethics

by David Stone

Ethics and morality concern the decision we make about whether something is right or wrong: first about how we make such decisions and secondly about how we carry them out in practice.

Why are ethics important?

Today’s healthcare professionals are capable of remarkable feats, many of which would have amazed their predecessors. But such advances in technology carry with them a hidden danger. It is all very well being able to say ‘yes’ to the question ‘Can we do this?’ But we also need to pause and ask the question ‘Should we do this?’ The reason is that just because we have the ability to do something does not necessarily mean that doing it is right.

At some stage in our lives, all of us will be affected by decisions that relate to the issues of giving or receiving healthcare. Questions of what is right and wrong arise all the time. This is what makes medical ethics such an important subject.

The problem is that people in our society have very different ways of working out what is right and wrong. They have individual ideas about how to apply moral principles.

Take a subject like abortion. One person’s ideas about morality may lead them to conclude that abortion can never ever be justified. But their next-door neighbor’s moral framework may lead them to see abortion as entirely acceptable.

The study of ethics enables us to examine these different points of view. We can then assess the competing claims of the different moral systems. This is very important, because individuals within our society use a great variety of different systems.

Frameworks for decisions

How do people go about deciding what’s right and wrong? We need to recognize that people are often under great pressure when they make decisions. Consequently they often don’t think about the morality of a situation too carefully. They go with the flow and do what feels right at the time. But the rest of us are justified in asking whether this really is acceptable.

Most of us are aware of a strong sense of right and wrong about what other people do. Especially when they do it to us! Everyone who offers healthcare to their fellow human beings should do so on the basis of principles they have thought through carefully. They need to apply these principles consistently and not allow them to change to suit their mood at the time.

Just because we can do something dos not necessarily mean that doing it is right.

Anything goes…

Perhaps we should just learn to accept our differences. Instead of worrying about how to sort oot our disagreements, why not just ‘live and let live’? But is this right?

By taking this view there are no absolute standards that we all need to agree on. But it does not take much thought to realize that such ethical relativism is nonsense. If there really are no absolutes, then the absolute statement ‘there are no absolutes’ cannot be true! If we conclude that we are to tolerate everything, what happens when we try and tolerate intolerance?

This isn’t just a philosophical game with words. The relativist’s view of morality isn’t true in the real world either. Despite the many differences that undoubtedly exist between cultures, a common core of morality is found right across the human spectrum (e.g. most cultures disapprove of the taking of innocent life).

It’s true that the way moral principles are expressed may vary quite widely (e.g. what exactly is ‘innocent’ life?). But we find that the underlying principles themselves are remarkably similar.

It just feels right…

Where do such principles come from? Let’s start by thinking about someone who suggests that moral statements are simply an expression of an inner feeling (a view known as emotivism). For example, asked to justify a statement like ‘killing people is wrong’, they might respond that ‘it just feels wrong’.

For these people, moral statement are no more than an expression of how people feel. Morality becomes a matter of subjective taste rather that any absolute standards.

The problem with this view is that most people do seek to justify what they believe to be right and wrong by appealing to their ability to reason rather than their feelings.

Let’s look at this question the other way round for a moment. A person had killed somebody else. Very few of us would consider ‘I did it just because I felt like it’ to be an adequate excuse. There may indeed be extenuating circumstances, but we would expect them to be based on reason not feeling.

A further point to make here is that feelings can be dangerously misleading. After all, we often find ourselves in situation where, although we may feel like stealing someone’s else bar of chocolate, we know that the right course of action is to go and buy our own!

Feelings are important, but are not by themselves an adequate basis for morality.

What do people value?

Lets imagine that you’re in charge of a hospital department with limited resources. You have to make a series of life or death choices between different pairs of patients. There are no alternatives: you must come to a decision that will mean that one patient survives while the other is allowed to die.

  • An old man of 80 OR a young boy of 10
  • A millionaire OR a person on social security benefit
  • Someone who will probably walk again OR someone who will always be in a wheelchair
  • Someone who will need to take painkillers for the rest of their life OR someone whose life will be relatively free of pain
  • A married woman aged 30 with a husband and three children OR a single woman aged 30
  • Someone with a history of criminal offences OR someone with an unblemished record
  • Someone who looks attractive OR someone who is ugly
  • Someone who is unlikely to have a sexual relationship in the future OR someone who can look forward to an active sex life
  • Someone who is likely to go back to work and earn their own living OR someone who will always be dependent on welfare benefits
  • Someone who says “I really want to get better” OR someone who doesn’t seem to care whether or not they recover

Can you analyze why you have made the choices in the way that you have? How easy was it? Your answer to these questions will tell you something about what you value and how you go about deciding what is right and wrong.

It’s the way things are…

At the other end of the spectrum, many people believe that morality is a matter of reasoning issues out. They say that it’s simply a matter of thinking things through properly. Then we would all arrive at the principles of right and wrong that are build into the nature of things. This is known as the deontological approach to morality.

Of course, the problem here is that even when we try and think things through carefully, people often end up disagreeing.

And anyway, we don’t all think things through ‘properly’. All sorts of unreasonable fears and attitudes influence the way we think about right and wrong. Even when we know what we ought to do, we don’t always go on and do it.

Moral philosophers may be content with the way they think about right and wrong. But those who want to use a system of ethics need to be concerned with what that system actually does. In the real world we’re often forced to choose between principles: what are we to do then?

Does the end always justify the means?

Read more : Introduction to Ethics part 02