Saturday, March 15, 2008

Ethics

Consciously and unconsciously, most of us are concerned with ethics every day. It could be a personal question ("What should I do with the $20 I found on the ground?") or it could be an opinion about current events ("Should assisted suicide be legal, and in what cases?") The more complicated the world, our technology, and our relationships, the more complicated ethics becomes.

I spoke briefly once with a man whose academic background is in ethics. If I remember correctly, we discussed a case of conjoined twins, one of whom would live if they were separated and both of whom would die if they were not. The issue, at least as presented by the media, was that the parents would not consent to the separation for reasons of religion.

Again, if I recall correctly, my acquaintance said ethics often boils down to what results in the least harm. In a complex world, every choice may lead to harm, which is why even the most ethical leader must make decisions that will cause harm to someone. In the case of the conjoined twins, my acquaintance seemed to think it was less harmful to save the one child's life than to respect the parents' beliefs and condemn both children. With all of our medical technology and knowledge, this seems to have become an increasing dilemma: the immediate issue of a human life versus the broader philosophical issue of individual rights and the potential implications of the decision made, were it to be taken further. "The least harm" is relative, subjective, and open to interpretation, that is, assuming I understood my acquaintance correctly. Persuasive arguments can be made for both sides.

Almost instinctively, we want to provide care, including surgery, because we can. We also do not want government to interfere with the raising of our children or our family decisions. In either case, something is important is lost. Ethics is, I think, in part determination of which compromise we as a heterogeneous society find most acceptable. The child's life is tangible; the parents' religious beliefs are not.

This case, and others like it, is more complicated of course; the surgery could be interpreted as the intentional killing of one child, while no attempt at a reasonable treatment could be considered intentional neglect resulting in two deaths.

Natural law, human law, religious beliefs, medical ethics, precedent, and other agencies are to be taken into account. In cases like this, the public does not know the complete story because the media distorts, misrepresents, or simplifies it. It's also easier for a reporter to pit rational science against irrational religion. According to the parents, they were not against medical intervention per se, but against the intentional killing of their child.

The parents also knew that making the other decision would condemn both children to death, which points out the problem that occurs when humans take on the responsibility of determining "God's will."

I have never faced such a large, personally difficult decision, but my conscience is always on the alert, consciously or not. I realized this one day last summer when I was outdoors at Bonjour Bakery Café and heard and saw fire trucks headed east on 55th Street. I thought without thinking, "I hope they're not going to The Flamingo," a worry I've had since the fire next door at Promontory Apartments, and continued to sip coffee comfortably.

At some point later, it occurred to me that when I hoped that it wasn't my building or apartment on fire, I was tacitly hoping that it was someone else's. I found this very disturbing. Months later, the thought still bothers me because I would not wish a fire or similar catastrophe on anyone—yet I am doing it every time that I hope the fire department isn't headed my way.

I know this isn't an ethics question because I am only hoping, not deciding. The emergency is where it is, and I have no influence over it. The question does hint at why ethics is especially difficult for me. While I am not convinced of the science behind Myers-Briggs, I do fit much of the INFP (healer-idealist) profile, even if I don't want to. My idealism makes it difficult and emotionally painful to make necessary choices that will result in harm. Even the abstract hope that the firefighters are going somewhere else upsets me because of what it implies.

Perhaps this makes me unfit for leadership, because I would have to fight my natural impulse to regret my choices given that many if not most would have a negative impact on someone. The idealist in me wants to find perhaps nonexistent solutions that allow both children to survive and that prevent any place from catching fire.

Leaders are necessary; someone must be pragmatic and choose between the proverbial rock and a hard place. Any of us can do it, if we must, but most prefer to leave decisions to their leaders. I would be overwhelmed by the conflicting complexities and guilt-ridden over any negative results. I would always believe that there must be a better solution, if only we had the wisdom to see or to invent it. I dislike that I don't have that wisdom, and I mistrust that our leaders see the need for it. Pragmatism should be guided by idealism; neither is good or effective without the other. The two should work together to find the least harm that is the most good for all.

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