Bioethics and Values Clark Wolf Iowa State University

1. Bioethics and ValuesClark WolfIowa State University

2. BIOETHICS AS A BRANCH OF PHILOSOPHY: “The problems of philosophy involve questions in which we are all (or should all be) deeply interested at the most basic level. They are important to us as we make decisions about what to believe, and how to be critical of our own naively held beliefs. Philosophical investigation may help us to determine what kinds of choices we should make, and what kind of person to be. It may help us to understand and justify our belief (or disbelief) in God. It may help us to form a rational life plan, and to better understand our own motives and fears. Philosophical questions are important to us as we try to understand what we are and to determine our place in the scheme of things. And they are important to us as we try to choose right actions in a complicated and difficult world, and to find meaning in our lives. These are not trivial projects.”

3. Identifying Ethics: Principles of ethics should provide us guidance as we make choices in a complicated world. Ideally, an account of ethics should help us to identify moral principles and morally relevant features of the choices we face.

4. There is no simple “recipe” for ethical decision making. Philosophical and religious theories about ethics do not remove our need (obligation?) to exercise deliberative judgment and to evaluate alternative values that are at play in concrete cases.

5. Ethical codes of conduct instruct us on what we ought or ought not to do. • Typical ethical theories or ethical codes include basic principles that are intended to be used to guide conduct.

6. Ethics and Reasons: Our ethical values are supported by reasons and principles. For any moral or ethical claim, we can evaluate it by considering the reasons that support it. • Upshot: We can be self-reflective and critical about our moral values. The goal of philosophical ethics is to help us to be self-reflective in this way.

7. Ethical Theories: • Principles, concepts, and ideals that can be used to justify moral judgments and choices, or to rank outcomes as good, better, worse, or bad. • An ethical theory should be capable of serving as a guide for conduct and judgment.

8. Case for Consideration: The Trolley • You’re riding a run-away trolley car, and the only control you have is to direct the car on to one track or another. On one track ahead there are five people, on the other there is only one. If you do nothing, the trolley will kill five, but if you intervene it will kill only one. Should you “kill one person” to save five? What should you do?

9. What justifies your judgment about what should be done? • “Save as many as you can.” • “Day After Tomorrow” Scientist • “The good of the many outweighs the good of the few.” -Spock • “Act so that you provide the maximum benefit to the maximum number of people.” • Are there other principles that could be used to justify the judgment that one should direct the trolley to kill as few as possible?

10. Utilitarianism: • “Act always such that your action produces the greatest benefit for the greatest number of people.” • J.S. Mill, • Jeremy Bentham

11. Is Utilitarianism an Acceptable Ethical Theory? • Focuses our attention on well-being. • Leaves room for moral concern for animals as well as for people. “The question is not ‘can they reason’ nor ’can they speak,’ but ‘can they suffer.’”-Jeremy Bentham • Includes an implicit appeal to equality: Everyone’s interests count the same.

12. Testing an Ethical Theory: Apply the theory to a different problem. Case: The Surgeon’s Dilemma You are a surgeon with six patients. Five of them need major organ transplants, which you could easily do if you had access to transplant organs. The sixth, an ideal donor for all the relevant organs, has a cold. Should you kill one person to save six? • Question: What does utilitarianism imply in this case? Should this cause us to call the theory into question? Do we need to appeal to non-utilitarian values to explain what is wrong with killing one patient to save six?

13. Revising Utilitarianism? • Rights: “The reason it is wrong to kill one to save six is that it would violate the rights of the person killed.” This response requires that we give an account of rights, explain what they are, why they have moral significance, and how they may interact with utilitarian considerations.

14. Universal Rules: • Perhaps we can’t ‘universalize’ a principle to kill one to save six: “Act only such that you could will the maxim on which you act as a universal law.” -Immanuel Kant • Interpretation: • Ask “What if everyone did that?” • Kant says that this is a more general statement of the principle that lies behind the Golden Rule: “Always treat others as you would have them treat you.”

15. Revising Utilitarianism? • Using People as Means: “Always act such that you treat humanity, whether in your own person or that of another, always as an end in itself and never as a means only.” –Immanuel Kant Analysis: Perhaps what’s wrong with killing one patient to save six is that it would be using the one as a mere means for the benefit of others. -We use others as means all the time: Does this principle imply that it is morally problematical to do so? -Once again, we need to consider what it means to “treat a person as a mere means,” and make it quite clear.

16. Using Ethical Theories to Make Judgments and Decisions: • Ethical theories can give us insight into the morally salient features of the choices we face. • By reflecting on the principles that lie behind our moral choices, we may come to make better choices, and to gain a deeper understanding of ourselves. • Ethical theories cannot provide a simple “recipe” for correct moral decision-making. It is always necessary to use reflective judgment, to ask whether there are other morally significant factors to consider.

17. W.D. Ross: List of Prima Facie Duties: 1) Duties that rest on previous acts of my own. a) Promises. b) Previous wrongs in need of reparation. 2) Duties that rest on previous acts of others (Example: gratitude) 3) Duties of justice (A duty to endeavor to bring the distribution of pleasure or happiness in line with merit.) 4) Beneficence- Duty to benefit others. 5) Duty to improve one's own virtue or intelligence. 6) Duty not to harm or injure others.

18. Joel Feinberg: List of Prima Facie Obligations: 1) Fidelity- Obligation to keep promises. 2) Veracity- Obligation to tell the truth, or (or better-- not to tell lies). 3) Fair Play- Obligation not to exploit, cheat, or "free load" on others 4) Gratitude- Obligation to return favors 5) Nonmaleficence- Obligation not to cause harm, pain or suffering to others, 6) Beneficence- Obligation to help others in distress, at least when this involves no great danger to oneself or to third parties. 7) Reparation- Obligation to repair harms to others that are one's fault. 8) Obligation not to kill others (except in self-defense). 9) Obligation not to deprive others of their property. 10) Obligation to oppose injustices, at least when this involves no great cost to oneself. 11) Obligation to promote just institutions and to work toward their establishment, maintenance, and improvement.

19. Is Ethical Decision Making Easy? • Some ethical theories present themselves as a simple recipe for decision making, but it can’t be that easy. • Other theories present themselves as a more or less un-ordered list of obligations to be evaluated against one another using judgment.

20. What good is philosophical ethics? • Philosophical theories can’t remove the burden of moral decision-making. • What philosophical theories can do is to direct our attention to features of our choices that are, or may be morally salient.

21. What good is philosophical ethics? • Most importantly, reflection on the motives and principles that lie behind our choices shows that our moral judgments are based on reasons. By articulating these reasons, we gain the ability to evaluate them and to consider alternatives.

22. Ethical Arguments • Argument: A set of statements, some of which serve as premises, one of which serves as a conclusion, where the premises are intended to provide evidence for the conclusion.

23. Ethical Arguments: • When presented with an argument, one may either 1) Accept the premises and the conclusion 2) Reject the premises 3) Argue (or show) that the conclusion does not follow from the premises.

24. Questions Requiring Ethical Judgment: 1) Should developed countries control availability of GMOs in developing (poor) countries? 2) Who should make decisions regarding the use of land for agricultural, commercial and residential use? 3) Do animal housing systems (crates, cages etc) need to be altered to improve animal welfare? 4) Is it ethical to dehorn, brand, beak trim, or castrate farm animals? 5) Should cloning be allowed in farm animals? in humans? 6) Should wolves be reintroduced into areas where human activity has been responsible for their absence? 7) Should stem cell research derived from human embryos be allowed? 8) Is it ethical to eat meat? 9) Hunting and fishing…should it be allowed, how much, who can do it? 10) Are livestock shows ethical?

25. Questions Requiring Ethical Judgment: 11) Is it ethical to encourage livestock use in poor and developing countries? 12) Should livestock producers be responsible for air and water quality? 13) Is it acceptable to use animals to test products for human use/consumption? 14) Should the use of subtherapeutic antibiotics be banned in livestock? 15) Should diverse breeds of livestock be maintained and who should pay? 16) Should rodeos and circuses be allowed to exploit animals? 17) Should the use of growth enhancing agents be allowed in the production of farm animals? 19) Is it ethical to trim ears, dock tails, and train companion animals? 20) Should the family farm be maintained at the expense of corporate farming? 21) Should life be patented?

26. Thinking Clearly about Ethical Judgments: • 1) Clearly articulate alternative positions. Example: “We (should/should not) maintain institutions that grant patents on living organisms.” 2) Develop a list of arguments for each position, for and against. (This requires balance and fair-mindedness!) 3) Think about how the different reasons you have listed interact with one another. 4) Try to come to a balanced and fair conclusion, giving appropriate weight to all relevant reasons.

27. Some Moral Concepts • Individual Moral Choice: • Utility • Right and Rights • Universality • Virtue • Exploitation • Institutional Norms: • Legality • Liberty • Justice • Social Utility • Democracy • Community

28. Norms for Individual Moral Choice: • Utility: Happiness and well-being are typically taken to be ‘good’ things, significant from the moral point of view. To argue that a policy or procedure would compromise happiness or create misery is to give reasons why it’s a bad thing. (Maybe not decisive reasons, since there may be other relevant considerations.)

29. Norms for Individual Moral Choice: • Right and Rights: Rights are claims that people have against others. If a person has a right, then it is not permissible to do what would violate that right, even if doing so would maximize utility or have good consequences. Rights (if there are any) are side constraints on the maximization of utility.

30. Norms for Individual Moral Choice: • Universality: What if everyone did that? • Kantian principles involve an appeal to universal judgment. • Example: In considering whether it is legitimate to engineer people to be better basketball players, one might ask whether the general policy would be self-defeating: “If everyone did that, no one would be specially advantaged.”

31. Norms for Individual Moral Choice: • Virtue: What would a “Good Person” do in a situation like this one? • According to Aristotle, we need to ask what principles of character we should inculcate into ourselves, and any action we undertake should be evaluated in terms of the effect on our character and judgment. • Aristotle did not intend for his concept of virtue to be used for practical ethical dilemmas like those we will (mostly) be considering in this class.

32. Norms for Individual Moral Choice: • Exploitation: • “We should treat people always as ends in themselves and never as means only.” • Immanuel Kant • “We should avoid actions that improve our situation at cost to those who are worse off than we are.” –John Rawls (paraphrase)

33. Institutional Norms: • Legality: We can always ask what the law requires, and sometimes it’s relevant from the moral point of view. But we still need to consider whether the law is a good law, whether it is a bad law, and whether we have an obligation to obey (or disobey) it.

34. Institutional Norms: • Liberty: • “The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. 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 opinion of others, to do so would be wise, or even right. These are good reasons for remonstrating with him, or reasoning with him, or persuading him, or entreating him, but not for compelling him of visiting him with any evil in case he do otherwise. (…) Over himself, over his own body and mind, the individual is sovereign.” -J.S. Mill, On Liberty

35. Institutional Norms: • Justice: Involves the fair distribution of burdens and benefits of social cooperation. • Equality: Equal distribution is one theory of justice. But sometimes it can be argued that unequal distributions are required by justice.

36. Institutional Norms: • Social Utility: We can evaluate policies based on their likely consequences, and on whether the benefits they provide are likely to outweigh the burdens they impose.

37. Institutional Norms: • Democracy: If policies undermine democracy or democratic equality, this is a powerful argument against them. • Example: “The genetic inheritance of the earth belongs equally to all people. Allowing patent rights in organisms and species would be undemocratic, since it would take this right away.”

38. Institutional Norms: • Community: If a policy would undermine the bonds of community that link us together, this is a powerful argument against it. • Example: “Allowing genetic manipulation and ‘improvement’ of human beings would undermine social solidarity, creating a genetically normal and thus disadvantaged underclass.” • Michael Sandel (paraphrase).

39. Using Norms to Evaluate Cases: • Consider different normative concepts and how they apply to a given policy or case. • What rights are involved? • What will the consequences be? • What if everyone did that? • Is it legal? • Does it undermine liberty? • What does justice require? • Is the proposal democratic? • Would this undermine community?

40. Patenting Life: Reasons Against • “Patents on life reflect a disrespect for life.” • “People who gain patents on life aren’t really the creators of what they patent.” • “Patents on life permit or facilitate the oppression of people in the developing world.” • “Patents undermine people’s free right to use the earth’s genetic heritage, which should be a common available to everyone.” • Other reasons?

41. Patenting Life: Reasons For: • “Plant and animal breeders deserve protection for their efforts, and patents are an appropriate means for protection.” • “Plant and animal patents promote research in livestock and plant varieties, improving agriculture for everyone. • “Appropriate patent institutions can protect the welfare of people in the developing world while protecting the rights of researchers and innovators.”

42. Beyond “For and Against…” • Once you have identified the reasons and arguments that lie behind alternative positions, you may be in a position to reformulate the question. • For example: “Are there intellectual property institutions that can protect the legitimate claims of researchers without causing disadvantage to others, and without violating other important moral convictions?”

43. Patenting Life: • What do you think? “One who knows only his own side of a case knows little of that.” -Cicero. • Only if you are able to articulate the arguments of those who disagree with you are you really in a position to defend and understand your own judgments.

44. What good is Ethics? Ethics and ethical decision making are not simply the province of philosophers or ethicists. Our choices reveal our values to the world. These values are either unreflective and shallow, or reflective and deep. Philosophical deliberation should help us to make our values and choices deep and thoughtful. Maybe this makes it more likely that our choices will be the right ones.

45. Clark Wolf • Director of the ISU Bioethics Program. • Questions? Email me at: jwcwolf@iastate.edu