Acting in extremis

 Ethics, Philosophy, Philosophy Experiments  2 Responses »
Jan 292011
 

Michael F., in a comment here, argues, in effect, that the shipwreck scenario and transplant scenario featured in In The Face Of Death are not strictly analogous because of the extremity of the situation faced by the shipwrecked sailors:

They were at sea for something like a week before the decision was even made, delirious from hunger, thirst, lack of shelter from the elements…it’s beyond comprehension how far removed from the day to day way we have of dealing with all of these situations. And they were the only ones who could deal with the situation. No appeal to anyone except those they were sharing the boat with.

All this is absolutely right: the situation with the transplant doctor doesn’t have these features. However, there are a couple of points to make here which undermine the argument that the two situations are not parallel in the required way.

The first is that the transplant scenario does have its own element of extremity (which was added in precisely to handle the point Michael makes here): one of the patients the transplant doctor is trying to save is her own child. It is true, of course, that this is a different sort of thing than being stranded in the middle of the ocean without food and water, but nevertheless one should not underestimate just how desperate people will become if the life of their child is under threat. Certainly, I’d warrant that many mothers would happily trade places with the shipwrecked sailors if it meant their own child had a chance to live.

The second point is that there is a difference between factors that justify a particular course of action and factors which mitigate against culpability given the immorality of a particular course of action. It is true that the extremity of the situation faced by the shipwrecked sailors could reasonably be seen to mitigate against their culpability (assuming that one thinks it was morally wrong to kill the cabin boy). It is a much harder argument to make that it justifies their actions. To put it simply, we don’t tend to think that the antecedent pressures and temptations that people are under are part of the story of the rightness or wrongness of the actions they take (albeit they are part of the story of how we judge their culpability).

There is an interesting datum here: in their judgement of the case brought against Thomas Dudley and Edward Stephens for the murder of the cabin boy, Richard Parker, the Queen’s Bench Division under Lord Chief Justice Coleridge, did not accept that the extremity of the situation was even a mitigating factor:

It must not be supposed that in refusing to admit temptation to be an excuse for crime it is forgotten how terrible the temptation was; how awful the suffering; how hard in such trials to keep the judgment straight and the conduct pure. We are often compelled to set up standards we cannot reach ourselves, and to lay down rules which we could not ourselves satisfy. But a man has no right to declare temptation to be an excuse, though he might himself have yielded to it, nor allow compassion for the criminal to change or weaken in any manner the legal definition of the crime. It is therefore our duty to declare that the prisoners’ act in this case was wilful murder, that the facts as stated in the verdict are no legal justification of the homicide; and to say that in our unanimous opinion the prisoners are upon this special verdict guilty of murder.

Of course, this is not to argue that the Queen’s Bench Division necessarily got this right (albeit one suspects they probably knew what they were talking about when it came to legal culpability). But nevertheless it does illustrate that it isn’t at all obvious one can argue straightforwardly from pressures and temptations to justification.

 Posted by jerry at 12:15 pm  Tagged with:

Philippa Foot memorial

 Philosophy  No Responses »
Jan 252011
 

The trolley problem, which forms the basis of Should You Kill The Fat Man?, was originally introduced by the philosopher Philippa Foot. Foot died, aged 90, in October last year.

It has just been announced that a Symposium on Moral Philosophy in honour of her memory is taking place in March. Full details here.

TPM (The Philosophers’ Magazine) interviewed Philippa Foot back in 2003. You can read the interview here.

 Posted by jerry at 7:44 am  Tagged with:

Don’t kill me, you’re a doctor!

 Ethics, Philosophy, Philosophy Experiments  5 Responses »
Jan 242011
 

To recap, In The Face of Death (which you should complete before reading this) sometimes features a comparison between a shipwreck situation and a transplant situation. In the former, three shipwrecked sailors kill a barely conscious cabin boy, who was almost certainly going to die anyway, in order to increase their chances of survival (it allows them to eat his flesh and drink his blood). In the latter, you’re in hospital with an illness that will almost certainly kill you, when a transplant surgeon asks whether she can end your life immediately, and then use your organs to save the lives of three of her patients. You say no, but she kills you anyway, and transplants your organs.

The activity complains if you state that the shipwrecked sailors were morally justified in killing the cabin boy, but the transplant surgeon was not morally justified in ending your own life.

An objection that has come up a couple of times is that the transplant surgeon behaves badly not so much because she takes your life, but because she takes your life having undertaken, as a doctor, not to “play God” in this sort of situation. So, for example, here’s an extract from a modern version of the Hippocratic oath:

Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

There are a number of things to be said about this objection.

1. Although, all other things being equal, it is (probably) true we don’t behave well if we break our undertakings, it is hard to think this is true in all situations. This is easily demonstrated: if a doctor can save the lives of a million of her patients, by killing one patient, then it is a brave person who’d claim she’d be wrong to do so (the television series House featured an interesting examination of this issue).

2. It follows, then, that whether “playing God” is justified in any particular situation depends on the nature of the situation. But, in terms of the scenario we’re dealing with here, that just seems to put us back where we started: were the shipwrecked sailors justified in killing the cabin boy versus was the transplant surgeon justified in killing you (and thereby playing God)?

3. Given these two situations, it is hard to think that what is morally decisive is the fact the doctor’s behaviour violated her previous undertaking not to play God. In other words, it is hard to think that what turned a “right” action into a “wrong” action was the fact that she had previously made certain undertakings.

4. Part of the thought here has to do with the extremeness of the acts we’re talking about. Taking a life seems to be a big deal, morally speaking. In comparison, breaking an oath seems like a much smaller deal. Therefore, it is counterintuitive to suppose that the latter can be decisive when looking at the morality of the former.

5. Having said this, it is also true there is no knock down argument here. If somebody insists that as far as they’re concerned the fact the transplant surgeon violated the Hippocratic oath is morally decisive, then probably it isn’t possible to do much more than to show why the claim is counterintuitive. It is in the nature of moral arguments that sometimes all one can hope to do is to pump intuitions in a certain direction.

 Posted by jerry at 8:59 am  Tagged with:

An embryo has some value, but not much

 Ethics, Philosophy  5 Responses »
Jan 212011
 

I have been arguing that there is a strange asymmetricality in the attitudes of some people towards abortion and miscarriage (they are against abortion, but are not particularly troubled by the phenomenon of miscarriage).

Christopher Carr has put forward the following argument which aims to show that given a particular sort of view there might actually be nothing odd about this asymmetricality:

if the value is a potential value, then miscarriage may not mean anything, or it may mean a literal fraction of what it would mean were the fetus further along in development or already born. For example, for a particular individual moral framework perhaps a human fetus is worth “one”, a human infant is worth “two”, a human baby is worth “three”, and thereafter all have reached full personhood of “four”. We would still consider miscarriage to be the destruction of valuable human entities, but we may be allowed to think that an eight-year-old child dying of leukemia represents a greater destruction of value. How we assign respective values depending on cause of death and degree of personhood could give us radically different results as to how we evaluate the medical seriousness of miscarriage in relation to other causes of death.

Okay, so the first thing to say is there is no doubt this is true: we can think the value attached to human life is incremental in this way (though I think Christopher inadvertently switched around baby and infant in his schema). However, the question is how does this view match up against people’s attitudes towards abortion.

There are a number of points to make here.

1. It’s worth starting off by saying that although it is a common view that the value of human life increases as the human entity develops from embryo through to full personhood, it is a very uncommon view amongst people who are opposed to all abortion (the overwhelming majority of whom think an embryo has equal intrinsic value to a human adult just by virtue of being biologically human); indeed, if you read the anti-abortion literature, you’ll find that many people deny that things such as sentience and personhood are the measure of value, precisely because this opens up the possibility that an embryo/foetus does not have the  value of a human adult;

2. Setting this point aside, the question remains as to whether it makes sense to see the value of human lives as being incremental, and yet to be resolutely opposed to abortion. This is actually quite a difficult question to answer, since it means weighing up the value attached to the embryo/foetus against the right to self-determination. However, to put Christopher’s argument in its best light, let’s say there isn’t a problem here: that it is possible to think that even the relatively low value attached to the embryo/foetus in the early stages of pregnancy trumps our right to self-determination (this isn’t an incoherent view, by any means, it’s just it runs into difficulties when held up against the way that de facto we tend to treat the right to self-determination);

3. So how should this person view miscarriage? Well, it is true that they should not see any individual miscarriage as being as great a tragedy as the death of a human person (because embryos/foetuses don’t have the value of a fully developed human being). But equally, it is true that they can’t see any individual miscarriage as being morally neutral (even if we’re focussing only on the death of the embryo/foetus): they are required to think that miscarriage is a bad thing, in and of itself, because it means the ending of the life of something of value (albeit relatively low value);

4. More than that, though, given that the right to self-determination is not trivial, and given that they think the value attached to the embryo/foetus trumps our right to self-determination, then it follows that they can’t think the value attached to the embryo/foetus is merely trivial. We can’t quantify this value, obviously, but we know it’s enough to rule out abortion, even though this means denying the right we have to self-determination. (The counter-argument here that the right to self-determination is trivial or unimportant isn’t persuasive because de facto we don’t think it is trivial or unimportant.)

5. At this point, it becomes (partly) a numbers game. The sheer volume of miscarriages has to be factored into the argument. Okay, it’s true that one might think the numbers of people suffering cancer and heart disease means that these diseases/conditions are a more serious issue than miscarriage (given the fact that these conditions affect human persons to whom there is a higher value attached than to embryos/foetuses). But it is much less plausible if we’re talking about conditions such as kidney failure, Parkinson’s, ALS, etc., all of which we do consider to be serious medical issues. (There is a complication here to do with the possibility that one might attach arbitrary levels of value to the foetus, human person, etc., so that it turns out that just one human death is a greater tragedy than the deaths of say a million foetuses even though the value of a foetus is enough to rule out abortion. If this comes up in the comments, I might deal with it in another post.)

So if somebody is opposed to abortion (in all, or nearly all, circumstances), then it remains true that they should consider miscarriage to be a serious medical issue. Christopher’s argument here is relevant in that it does impact on how serious an issue some people should view miscarriage to be. But, of course, as we already noted, the number of people opposed to abortion who have this sort of incremental view of the value of human life is very small (precisely because it does allow the possibility that the value of an embryo/foetus might not be great enough to rule out abortion given that we think the right to self-determination is important).

 Posted by jerry at 8:49 am  Tagged with:

Whose Body Is It Anyway? – Some data

 Ethics, Philosophy Experiments  2 Responses »
Jan 192011
 

If you’re curious about what sort of data the Whose Body Is It Anyway? activity is throwing up, then you can find out here.

Some of the results are entirely predictable. For example, by far the biggest predictor of whether a person is going to be opposed to abortion is religious belief. So, for instance, 83% of people with no religion support the right of a woman to have an abortion, compared to only 37% of Christians

However, there are some surprises. The comparison between Christians and Muslims, for example, is interesting. This shows that a bigger percentage of Muslims than Christians support the right of a woman to have abortion (42% to 37%), though it should be said that this figure is only statistically significant at p < 0.10.

I’ve discussed what is perhaps the most curious piece of data here. It seems that young women of no religion are much more likely to be opposed to abortion than young men of no religion (which I still think is bizarre).

 Posted by jerry at 10:29 am  Tagged with: ,

The ethics of non-viable pregnancy

 Ethics, Philosophy, Philosophy Experiments  19 Responses »
Jan 182011
 

As noted yesterday, there is a strange asymmetricality in some people’s attitudes towards abortion and miscarriage (spontaneous abortion): they are against abortion in all circumstances, yet do not think miscarriage is a particularly significant medical issue.

There is an argument that aims to justify this asymmetricality which has something like this form:

a) Miscarriages tend to occur when an embryo is not viable;

b) Indeed, some miscarriages involve an embryonic entity that is not only not viable, but also not obviously human (in the sense, that it doesn’t have 2 pairs of 23 chromosomes, etc.);

c) Therefore, even if one thinks that elective abortion is always a tragedy (and also morally wrong), one does not need to think that miscarriage is necessarily a tragedy (except in the sense that it might be deeply distressing to the person who has suffered it).

There are a number of difficulties with this argument.

First, there is the obvious point that in those situations where an embryo is neither human, nor sentient, it is hard to see there can be any moral objection to abortion.

Second, if it is your belief that human life begins at conception, and that all human life has intrinsic and equal moral value (simply by virtue of being human), then the non-viability of an embryo doesn’t alter the situation. The death of a human is just the death of a human; the fact we’re talking about the death of a non-viable human life makes it no less of a tragedy – indeed, the tragedy is precisely that it is non-viable. Consider also that there are medical conditions which make their presence felt during adulthood – for example, Huntington’s – where it is not too much of a stretch to argue that death occurs as a result of factors linked to the intrinsic non-viability of the (human) organism, yet we wouldn’t dream of downplaying the moral significance of such deaths.

Third, while it is true that many of the miscarriages that occur in the early stages of pregnancy have to do with the non-viability of the embryo, this is much less true of late-term miscarriages  (so, for example, cervical incompetence is a cause of recurrent, late-term miscarriage). So even if you think there is little reason to be concerned with early-term miscarriage, it doesn’t follow that the same is true of late-term miscarriage.

 Posted by jerry at 12:14 pm  Tagged with:

But miscarriage is a natural occurrence…

 Ethics, Philosophy, Philosophy Experiments  4 Responses »
Jan 172011
 

Near the beginning of Whose Body Is It Anyway? (which you should complete before reading this), you’re asked to rank the following medical issues in order of seriousness (focussing only on numbers of deaths): cancer, multiple sclerosis, miscarriage, stroke, heart disease and housemaid’s knee. Then, if it turns out that you’re against abortion, the activity complains if you haven’t ranked miscarriage as being a serious medical problem (since, for example, in the United States alone there are estimated to be more than a million miscarriages each year).

Occasionally, people object to this point on the grounds that miscarriage is a natural occurrence, whereas abortion isn’t. However, this objection is flawed for the following reason.

The assumption seems to be that the point relies on a direct comparison between miscarriage and abortion, but, in fact, it does not. The structure of the argument is as follows:

1. If you’re opposed to abortion, then likely you think a foetus has intrinsic moral value;

2. If a foetus has intrinsic moral value, then presumably you believe that its life if worth saving (all other things being equal);

3. It is estimated that up to 50% of pregnancies end spontaneously (i.e., as a result of miscarriage);

4. This is a serious problem because (a) we’re talking about the “deaths” of millions of foetuses, each one of which has intrinsic moral value; and (b) we’re talking about the “deaths” of millions of foetuses, each one of which has a life worth saving (all other things being equal);

5. Therefore, given the number of deaths that occur, miscarriage should be ranked as a serious medical issue;

The response that miscarriage isn’t a problem because its natural doesn’t work for two reasons. First, the fact it is natural doesn’t alter either of the points made in stage 4 of the argument above. Second, all sorts of medical conditions are “natural” – cancer, for example, or ALS (motor neuron disease) – but this doesn’t for a moment mean that we don’t consider them to be serious medical issues.

It is strange that people get incredibly worked up about abortion, yet pay so little attention to miscarriage. If you really think that a foetus is a tiny baby, especially if you think this is the case from the moment of conception, then why aren’t you out there campaigning for more attention to be paid to what by your own lights you must see as a medical catastrophe: the fact that we have no idea how to ensure that all pregnancies are carried to term?

 Posted by jerry at 9:14 am  Tagged with:

But I told her not to kill me!

 Ethics, Philosophy, Philosophy Experiments  2 Responses »
Jan 142011
 

The activity In The Face Of Death (which you should complete before reading this) sometimes features a comparison between a shipwreck scenario and a transplant scenario. In the former, three shipwrecked sailors kill a barely conscious cabin boy, who was almost certainly going to die anyway, in order to increase their chances of survival (it allows them to eat his flesh and drink his blood). In the latter, you’re in hospital with an illness that will almost certainly kill you, when a transplant surgeon asks whether she can end your life immediately, and then use your organs to save the lives of three of her patients. You say no, but she kills you anyway, and transplants your organs.

The activity calls foul if you claim that the shipwrecked sailors were morally justified in killing the cabin boy, but the transplant surgeon was not morally justified in ending your life.

The main objection to the comparison as it is set up seems to be that in the latter scenario you explicitly state you don’t want to be killed, whereas in the shipwreck scenario the cabin boy is just killed (he’s simply not asked whether or not he consents to being killed).

It is true that the scenarios differ in this way, but it is highly implausible that it is a morally relevant difference. Two thoughts in particular are pertinent here.

1. When we’re talking about ending somebody’s life, the assumption must surely be that in the absence of their explicit consent, they are not consenting to their life being ended. Certainly, in normal circumstances, we wouldn’t think there was a moral difference between two near identical murders if it so happened that in one case the victim shouted “No, don’t do it” before he was killed, and in the other case, the victim didn’t.

2. If the problem in the transplant scenario is that you explicitly refused consent, it would seem to follow that had the transplant surgeon just killed you without asking first, then she would have been justified in her actions. However, this would make the act of not asking the difference between a killing being justified and not justified, which seems nonsensical.

In sum, then, although it is true that there is this difference of explicit refusal of consent between the two scenarios, it is very difficult to think it makes a moral difference when it comes to weighing up the actions of the people involved.

 Posted by jerry at 8:55 am  Tagged with:

Acts and omissions

 Ethics, Philosophy, Philosophy Experiments  16 Responses »
Jan 132011
 

Near the beginning of Should You Kill The Fat Man? you are asked whether you agree with this statement:

It is always, and everywhere, wrong to cause another person’s death – assuming they wish to stay alive – if this outcome is avoidable.

If you respond “Yes”, and then when it comes to the first Trolley Problem scenario, opt to divert the train in order to save the lives of five people with the effect of causing the death of one person, you are told that your responses are out of line with each other.

People complain about this on the grounds that the Trolley Problem is set up so that either way you are in effect causing the deaths of some number of people: the only choice is whether it is five people or one person.

There is something to this criticism. Should You Kill The Fat Man? plays rather fast and loose with the distinction between acting and omitting to act. This holds that it makes an ethical difference whether somebody actively intervenes to bring about some result, or whether they omit to act in a situation where it is reasonable to suppose that as a consequence the same – or similar – result will occur. So, for example, if you think there’s a moral difference between acting and omitting to act, then likely you’re going to think there’s a moral difference between blowing up somebody’s house while they are inside it, and failing to warn somebody  that someone else is going to blow up their house while they are inside it.

Should You Kill The Fat Man? plays fast and loose with this distinction in two ways.

1. It sneaks in the assumption that the driver of the train is omitting to act rather than acting if he doesn’t divert the train. Put simply, if the choice is between two acts (rather than between one act – i.e., diverting the train – and one omission – i.e., allowing the train to continue), both of which cause the death of some number of people, then there is no contradiction in saying that it is always wrong to cause another person’s death if the outcome is avoidable, and then choosing the action that kills the smallest number of people.

2. It assumes that there is an ethical distinction between acting and omitting to act (since if there isn’t in this particular case, then there can be no moral problem in choosing to kill the smallest number of people).

The assumption that there is an ethical distinction between acting and omitting to act is not such a big problem for the integrity of the activity because of the phrasing of the original moral claim: it is always, and everywhere, wrong to cause another person’s death. Put simply, even if it were true that there is no moral difference between acting and omitting to act, it seems like a stretch to claim that omitting to act is the same as causing some result to occur (even if the effect of omitting to act is to allow the same result to occur). Moreover, it just is the case that many people think there is a moral distinction between acting and omitting to act.

However, the assumption that the driver of the train is omitting to act rather than acting if he doesn’t divert the train is more problematic. It does seem reasonable to think that the driver is not uninvolved in what transpires if he allows his train to continue on with the effect that it causes the death of five people. In other words, it does seem reasonable to think that while he is the train driver he is acting.

If that’s right, then it is probably true that Should You Kill The Fat Man? is just a little too eager to pronounce a contradiction in this particular instance.

 Posted by jerry at 11:07 am  Tagged with:

Torture scenario not realistic

 Ethics, Philosophy, Philosophy Experiments  17 Responses »
Jan 122011
 

A frequent criticism of the torture scenario in Should You Kill The Fat Man? is that it is not realistic.The criticism tends to be that torture isn’t effective in the real world, therefore, (a) the scenario is flawed, since it states there’s a 75% chance that torturing the fat man will be effective; and (b) there is no contradiction in claiming that torture is always wrong, and yet thinking the fat man should be tortured, since there could be no real world equivalent of the fat man torture scenario.

This criticism is misplaced for a number of reasons.

The first thing to say is it just isn’t true that thought experiments, such as the torture scenario here, have to be straightforwardly realistic (if this were true, then many of philosophy’s most important thought experiments – for example, Judith Jarvis Thompson’s “famous violinist” thought experiment – just wouldn’t get off the ground). Although thought experiments are designed to tell us something about the nature of things (including, as in this case, our intuitions about moral choices), it isn’t necessary for them to replicate the details of empirical reality. Put simply, thought experiments have to be logically coherent, but they don’t have to describe events and situations that are actually possible.

This means that even if it were the case that the torture scenario in Should You Kill The Fat Man? is unrealistic, this wouldn’t be a problem in principle: it’s entirely possible for us to learn something about the way we see moral choices by seeing how we would react to a hypothetical situation.

The second thing to say, though, is that it isn’t clear that the torture situation is unrealistic in the sense that we can be confident it could never occur. Yes, it’s true that there is plenty of testimony – if not evidence – that torture is ineffective. But it’s also true that there is no consensus on this issue; and also that while it might be true that torture isn’t generally effective, it’s a much harder case to make that it is never effective, or that there will never be circumstances where one might come to the conclusion that torture would be the most effective technique to elicit particular information. There is enough individual variation in the way that people respond to situations to make this kind of blanket claim highly suspect.

The final point to make here is that even if it were true that torture is never the most effective interrogation technique, it doesn’t follow there is no contradiction in claiming that torture is always wrong, and yet thinking the fat man should be tortured (where the argument is that there is no contradiction because de facto one would never come across a situation in the real world that is equivalent to the fat man torture scenario). The reason it doesn’t follow is because the question about torture at the beginning of Should You Kill The Fat Man? doesn’t just ask whether torture is always morally wrong, it asks whether it is always morally wrong in principle. This makes all the difference: if torture is always morally wrong as a matter of principle, then it means that regardless of the consequences it is never morally justified. To put it simply, principles are not contingent upon outcomes. Therefore, anybody who claims that torture is morally wrong as a matter of principle should not think the fat man should be tortured even in a ticking bomb situation.

 Posted by jerry at 1:43 pm  Tagged with: ,
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