THE ETHICS OF OBLIGATION

1. THE ETHICS OF OBLIGATION “How Should I Behave In Order To Promote A Cooperative Society Where I, And Every Other Human Can Pursue Their Life’s Plan?”ORHow Do We Implement the Social Contract In Our Day to Day Living?

2. Heinz and the Drug In Europe a woman was near death from a special kind of cancer. There was one drug that doctors thought might save her.  It was a form of radium that a druggist in the same town had recently discovered.  The drug was expensive to make, but the pharmacists was charging ten times what the drug cost to make.  He paid $200 for the radium and charged $2,000 for a therapeutic dosage of the drug.  The sick woman's husband, Heinz, went to everyone he knew to borrow the money, but he could only get about $1,000, which is half of what it cost.  He told the pharmacist that his wife was dying, and asked him to sell him the drug at a cheaper prize, or let him pay the balance later.   But the pharmacist said, "No, I discovered the drug and I am going to make money from it." So Heinz became desperate and began to think about breaking into the man's pharmacy to steal the drug for his wife. • Should Heinz steal the drug? Why or why not?

3. Justifications for Decision • Whether a community’s laws or going to be upheld? • Natural for a loving husband to care so much for his wife he would steal? • Is Heinz willing to steal and risk going to jail with the hope that the drug might help? • Whether Heinz is stealing for himself or for someone else—his wife? • Whether the druggists rights to his invention have to be respected? • Whether the essence of living is more encompassing than the termination of dying? • What values are going to be the basis for governing how people relate to one another? • Whether the druggist is going to be allowed to hide behind a worthless law that only protects the rich? • Whether the law in this case is getting in the way of the most basic claim of any member of society. • Whether the druggist deserves to be robbed for being so greedy and cruel? • Would stealing in this case bring about more total good for the whole society or not?

4. Obligations of the Social Contract • Our duty, to gain the benefits of an ordered society, requires that we set aside our short term self-interested inclinations in favor of general rules that impartially promote the welfare of everyone … including ourselves (ultimately); rules that are in our enlightened self-interest. • We can do this because others in society have agreed to do the same thing, because it is in their enlightened (ultimate) self-interest as well. • The social contract is how we create an ordered society, thus escaping anarchy.

5. MORALITY: A New Justification for the Moral Rules Bernard Gert Stone Professor of Philosophy Dartmouth College 1988

6. “Common Morality” • Gert refers to his moral theory as “common morality.” • He does not believe his views are particularly original, for he has appropriated elements of each of the four traditional moral theories. • From Hobbes he is accepts the necessity of a social contract, as a basis for social cooperation, and to keep us from suffering evil at the hands of another. • He is Kantian, in advocating the existence of universal moral rules, but believes such rules are not absolute but depend are to be followed based on consequences. • He is a Utilitarian in that he focuses on utility, or consequences, in the application of moral rules. • He is Aristotelian, in that he believes virtues (habits of conduct) are necessary to keeping the moral rules. • Thus, Gert’s “common morality” is a synthesis and application of all four of the major theoretical ethical perspectives.

7. “Common Morality” Gert belives: • Most moral matters are so uncontroversial that people do not even make any conscious decision regarding them. • There is widespread agreement on most moral matters. • Some moral questions have unique right answers and some do not, and those that do far outnumber those who do not, (90% to 10%). • Morality is a “public system,” meaning that everyone who is subject to moral judgment generally knows what morality prohibits, requires, encourages, and allows; and that it is not irrational for any of these persons to accept being guided and judged by that system. • Although a public system, it is not a simple system. • Morality is also an “informal system,” as there are no authoritative judges or procedures for determining the correct answer; law, by contrast, is a formal system. • The goal of “common morality” is to lessen the harm suffered by those protected by it. • “Common morality” is based on moral rules.

8. BIOETHCSA Return to Fundamentals by: Bernard Gert Charles Culver K. Danner Clouser Oxford University Press 1997

9. Moral Rules are rules that no rational person would want violated with regard to themselves or anyone for whom they cared … without reason. They are rules that protect the individual from suffering harm or evil at the hands of another.

10. THE MORAL RULES(The First Five) The first five moral rules directly cause five harms, which all rational people would want to avoid. 1. Don’t Kill 2. Don’t Cause Pain 3. Don’t Disable 4. Don’t Deprive of Freedom 5. Don’t Deprive of Pleasure

11. THE MORAL RULES(The Second Five) The second five moral rules usually, but not always, cause harm: • Do not deceive • Do not break your promises • Do not cheat • Do not break the law • Do not neglect your duty

12. The Moral Rules • There should be no real surprises in this list of moral rules. • They are consistent with our thinking about everyday morality; that is, they are simple kinds of actions that everyone counts as immoral. • However, there is not always agreement on what counts as breaking a moral rule. • And, there is almost universal agreement that there are justified exceptions to keeping rules, but disagreement regarding the circumstances that justify violating a moral rule.

13. Moral Rules Summarized:“Don’t Cause Evil or Harm”

14. “The only purpose for which power can be rightly exercised over any member of a civilized community, against his will, is to prevent harm to others…He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because in the opinions of others, to do so would be wise or even right.” John Stuart Mill in On Liberty

15. Ethics as a ‘Blunt Instrument’ • Ethics is a fairly ‘blunt instrument,’ it is not a ‘scalpel’ that cuts sharply. • Although precise and rigorous, ethics does not enable one to determine that one and only one action is moral. • Certain alternatives may be ruled out, but not infrequently range of possible actions often remain that are morally acceptable.

16. Ethics As A ‘Blunt Instrument’(continued) • Sometimes all possible actions infringe on one moral rule or another. • It sometimes becomes a matter of determining which is the lesser of two evils, or • Which moral rule deserves receiving the most weight in a particular circumstance.

17. Moral Rules AreUniversal, Not Absolute Universality in applying the moral rules means that all rational human beings with voluntary abilities are to abide by the moral rules. Moral absolutism is the claim that we ought never break any moral rule for any reason.

18. Kant’s Perspective on Moral Rules • What is A “hypothetical imperative?” • What is a “categorical imperative?” (Page 120-21 of text)

19. Kant’s Categorical Imperative “Act according to that maxim by which you can at the same time will that it should become a universal law.” Immanuel Kant Groundwork of the Metaphysics of Morals (1785)

20. Kant’s Moral Theory • Kant’s theory that moral rules are absolute is referred to as “deontology.” • Deontologyis a term used to identify an approach specifying that actions are made obligatory for reasons other than their consequences. Sometimes called “duty-based ethics.”

21. “The Case of the Inquiring Murderer” Imagine that someone is fleeing from a murderer and tells you he is going home to hide. Then the murderer comes along and asks where the first man went. You believe that if you tell the truth, the murderer will find his victim and kill him. Furthermore, suppose the murderer is already headed in the right direction, and you believe that if you simply remain silent, he will find his victim and kill him. What should you do?

22. Kant’s Arguments • What is Kant’s argument indicating that lying is always wrong? (Page 123 of text) • What is Anscombe’s argument refuting Kant? (Page 123-24 of text) • What is a second argument refuting Kant? (Page 124 of the text) • What is Kant’s argument against lying, even when we are think lying will result in the avoidance of a significant harm to another?(Page 124-5 of text) • What is an argument refuting Kant on his insistence that we can never know the consequences of an action that violates a moral rule, such as lying? (Page 125 of text)

23. Conflict Between Rules • Story of Dutch fishing vessel and Jewish refugees (Page 126 of text) • It is wrong to lie, and • It is wrong to permit the murder of innocent people. • Kant’s theory would make both absolutes, making such a theory untenable. • Gert accepts Kant’s notion of universal moral rules, but argues that they are not absolute, rather that departures from them are necessary but must be justified.

24. Moral Justification Everyone is always to obey the rules except when impartial, rational people can advocate that violating it be allowed. On reflection, the consequences of following a moral rule in a situation could result in more harm than good. And, as has been indicated, not infrequently all of the options available in a situation would result in violating a moral rule. Thus reflection forces consideration (and justification) of which course of action will result in the greater good or the lesser harm. (a utilitarian / consequentialist dimension) Example: Nazi storm troopers at the door of the Dutch home where Anne Frank and her family are hiding--does one lie to the storm troopers, and violate the moral rule, "do not deceive," or tell the truth, revealing the hiding place of the Frank family, and violate the moral rule, "do not deprive of freedom or opportunity?" The moral life is ambiguous, and frequently requires reflection and justification.

25. Moral Justification There is general agreement that: • First, violations of the moral rules require justification; and, if a violation is permitted for one person in a given circumstance, the violation must be permitted for another in another circumstance when the morally relevant features are the same. • While Kant did not permit exceptions in his theory, one of the strengths of his thinking was that there must be consistency in application of the moral rules; rational people would not show partiality to one person over another. Kant’s emphasis on impartially is a critical important contribution to moral theory.

26. Moral Justification • Secondly, It has to be rational to favor everyone being allowed to violate the rule in similar circumstances. • Lastly, there is also general agreement that there is some kind of publicity requirement, that is, that everyone know that this kind of violation is allowed. • Such a publicity requirement guarantees the kind of genuine impartially required by morality. • Gert believes that justification for violating a moral rule must meet each of these three conditions.

27. Moral Attitude “Everyone is always to obey the rule unless an impartial, rational person can advocate that violating it be publicly allowed. Anyone who violates the rule when no impartial rational person can advocate that such a violation be publicly allowed may be punished.”

28. Moral Justification • If all informed, impartial, rational persons would estimate that less harm would be suffered if this kind of violation were publicly allowed, then all impartial rational persons would advocate that this kind of violation be publicly allowed and the violation is strongly justified. • If all informed, impartial, rational persons would estimate that more harm would be suffered if a particular moral rule were broken, then no impartial, rational person would advocate that this kind of violation be publicly allowed and the violation is unjustified. • However, impartial, rational persons, even if equally informed, may disagree in their estimate of whether more or less harm will result from this kind of violation being publicly allowed. When there is such disagreement, even if all parties are rational and impartial, they will disagree on whether to advocate that this kind of violation be publicly allowed, and the violation counts as weakly justified.

29. Examples • Circumstances (bioethical or otherwise) of strongly justified violations of the moral rules? • Circumstances (bioethical or otherwise) of weakly justified violations of the moral rules?

30. Morally Relevant Features Reference pages 38-39

31. Rationality Rationality is concerned with actions/behavior. Rational actions are actions that comport with one’s “enlightened self-interest,” or the interest of one for whom one cares. Rationality is intimately related to harms and benefits. Everyone agrees that unless one has an adequate reason for doing so, it would be irrational to avoid any benefits, or not to avoid any harm for oneself or for those for whom one cares. Irrational actions are actions everyone would agree they would not advocate for one for whom they were concerned or cared. Rather they would avoid these actions. They are actions prohibited by reason … against reason.

32. Irrationality • Actions against reason; prohibited by reason. • To act contrary to one’s self-interest, or the self-interest of one for whom one cared, for no reason. • Actions characterized as crazy, stupid, idiotic, and insane. • “To act irrationally is to act in a way that one knows, or should know, will significantly increase the probability that oneself, or those one cares for, will suffer death, pain, disability, loss of freedom or loss of pleasure’ and one does not have an adequate reason for so acting.”

33. Adequacy of Reasons • A reason is adequate if any significant group of otherwise rational people regard the harm avoided or benefit gained as at least as important as the harm suffered. • Jehovah’s Witnesses and blood transfusions. (Gert, page 28)

34. Irrational Versus Mistaken • We may believe it is a mistaken view of the Jehovah’s Witnesses (if you are not a Jehovah’s Witness), but we cannot say it is irrational. There are a significant number of otherwise rational people who believe such. • It is irrational for otherwise mature, rational adults to believe in Santa Claus, the Easter Bunny, the Tooth Fairy, or that the world is flat. • It is not irrational, though likely mistaken, for people to believe that Oswald did not kill President Kennedy, that the Holocaust did not exist, or that the Enron executives are being falsely accused of impropriety.

35. Impartiality Morality is a public system, and with regard to the moral rules it requires impartiality. It is morally unacceptable to violate a moral rule if one could not publicly allow that violation by another, that is, if one could not will that everyone know that they are allowed to violate that same moral rule when all of the morally relevant features are the same. A person is impartial when their evaluation of actions is not influenced by who is benefited or harmed by those actions. Impartiality is required in a moral system only when one is violating a moral rule. One does not have to be impartial in distributing favors, e.g., family and friends.

36. Kant’s “Categorical Imperative” • Kant helps further characterize moral justification with his famous dictum, “act only on that maxim that you would will it as a universal law.” • If your action in a given circumstance could be willed to be universalized, that is, you would advocate that all people do what you are proposing to do in like circumstances, then you could make the claim that the action is impartial...and appropriate .

37. Applying Moral Justification “Moral Justification” suggests that when impartial, rational people agree on the the resolution of a particular moral issue when applying the moral rules, then such is morally permissible. When they cannot agree, the limits of acceptable behavior are determined by what impartial, rational people can accept.

38. Moral Rules(Duties to Others)Correspond to Individual Rights

39. Reciprocity

40. “Rights are correlates of duties--the performance of which we are not willing to leave to individual discretion.” James Rachels in Created From Animals

41. But…What Is the Role of “Doing Good” in the Moral Life? The Moral Ideals “Prevent Evil or Harm”

42. The Moral Ideals 1. Prevent Killing 2. Prevent the Causing of Pain 3. Prevent Disabling 4. Prevent Deprivation of Freedom 5. Prevent Deprivation of Pleasure 6. Prevent Deception 7. Prevent the Breaking of Promises 8. Prevent Cheating 9. Prevent Disobeying the Law 10. Prevent Others From Failing to do Their Duty

43. Gert’s Summary... “Obey the moral rules… follow the moral ideals.”

44. The Moral Ideals • Encouraged but not required. • Sanction someone for violating a moral rule… causing harm, unless able to be justified. • Do not sanction someone for failing to follow the moral ideals…doing good. • Can we require the doing of good? Why? Why not?

45. The Nashes at the Beach

46. Moral Heroism • Heroes are individuals who, in the view of society, take actions that are dangerous to self, in general, put their lives at risk, in an attempt to come to the aid of another. • Heroes are people who do not only “not kill” (moral rule) but go beyond that, risking harm to self (even death) to prevent killing (moral ideal.) • In moral language, their behavior issupererogatory, praiseworthy, but not required. • This introduces the subject of “altruism.”

47. Altruism • Altruism refers to actions taken by one person, which at some cost to the self, improves the welfare of another. • “behaves in such a way as to increase another entity’s welfare at the expense of his own.” Richard Dawkins • Definition of altruism is based solely on outcome, not motivation.

48. Motivations To Altruism • desire to provide aid to another that has no self-interested dimension: strong altruism. Many do not think such exists. • to escape the personal distress from seeing another in distress. • to avoid the guilt and shame which would result from not helping. • to gain social rewards that come from acting in socially approved ways. • to avoid social (not legal) sanctions that could be incurred from not helping. • to develop in the other a sense of responsibility to help one in return at a later date...reciprocal altruism--I’ll help you now so that I can depend on you to help be later. Reciprocal altruism is the technical name forwhat is understood as cooperation; or • to share in the joy the distressed may be expected to receive.

49. Altruism • The dominant view is that all helping acts are fundamentally egoistic. That is, despite any surface indications that a helping act is intended simply to aid the victim, all helping ultimately results from a desire to ultimately increase the welfare of the helper, rather than the victim--weak altruism. • Altruism, in the strong sense of the word, that is, motivated solely by increasing the welfare of the other, does not exist except potentially in relationship to individuals who are closely related genetically, such as children, siblings, or other closely genetically related individuals.

50. Altruism • Are public health professionals, or any “professionals” altruistic? • If so, in what sense? • Does the concept of professionalism require that professionals be altruistic if they are to be ethical?