Is philosophy (and specifically moral philosophy) any real use in practice? This question is sometimes asked, not only by hard-headed practical people, but even by moral philosophers themselves। In both cases, there is an assumption that moral philosophy is a purely theoretical and abstract activity, and as such is divorced from the messy and complex decisions we have to take in the real world. My own experience of serving as a moral philosopher on a number of Ethics Committees, and of having to make my own professional contribution to their deliberations on a number of very thorny practical decisions, leads me to think this assumption is wrong. It involves a misunderstanding, both of the nature of moral decision-making and of the nature of moral philosophy. In this paper, I want to try to defend that claim, using as illustrative examples the ethical problems created by developments in medical technology.
Those who believe in the practical relevance of moral philosophy often invoke a comparison with the way in which a theoretical science like physics can be applied in engineering (although, strictly speaking, their analogy is rather with the way in which they think that physics is applied to engineering problems than with the use which engineers actually make of physical theory)। This 'engineering model', as we may call it, is implicit in the very term 'applied ethics', which has come to designate a whole area of philosophical activity in recent years. I want utterly to reject the engineering model, and with it the description of the role of the philosopher in practical moral decision-making as 'applied ethics'.
What, in greater detail, is 'the engineering model'? It is supposed that what happens in engineering is that answers to practical problems (such as the construction of load-bearing structures or of an efficient machine for achieving a particular task) are obtained by deducing them from relevant scientific theories। The general laws of physics are 'applied' to the particular case which constitutes a problem: that is, the particular case is seen as an instance of a certain general law or laws, and in this way a solution for the problem is found based on rational scientific principles, rather than mere hunch। In the same way, according to the engineering model, moral philosophy provides a set of general rational principles, from which the answers to concrete moral problems can be deduced when the particular case is seen as falling under a general moral rule or rules. These philosophy-based solutions will be better than those which may be offered by people without philosophical training in that they will be more rational, more (as it were) 'scientific'. Like the engineer, the moral philosopher will be, in virtue of his or her specialised training, an expert in the relevant field.
This view is, I want to argue, flawed in a number of related ways। First, the conception of the moral philosopher as an expert in moral decision-making is objectionable. The objection is not so much to the idea of a moral expert as to the idea of the philosopher as such an expert. Some people do seem to be better at making good moral decisions than others, and so might be described (perhaps not very felicitously) as 'moral experts': but their expertise arises, not from possession of some specialised knowledge, but from the acuteness of their moral sensitivity and the extent of their commitment to leading a moral life. In a word, moral experts are saints. But most moral philosophers are patently not saints, and saints are not moral philosophers, except accidentally.
Secondly, there is no science of morality which stands in the same relation to practical decision-making as, say, the science of physics stands to engineering decisions (which is why moral 'expertise' does not consist in possession of such scientific knowledge)। The rules of morality are not like the laws of science: they are not established by careful empirical investigation involving the use of specialised technical procedures and concepts, and so knowledge of them is not confined to specialists. Rather, we are all capable of acquiring an awareness of right and wrong in the course of our ordinary upbringing. Every sane, decent, properly brought up person knows that murder, torture, rape and exploitation are wrong, and that kindness, generosity, and cooperation are good things. All decent human beings thus have the knowledge required to make moral decisions: if some are better than others at making such decisions, as said above, it is because they have a more acute sense of how these general values apply in actual situations, combined with a greater willingness to apply them.
Thirdly, moral philosophy, as it has been practised in our culture from Plato onwards, is not to be identified with this universally shared knowledge of the rules of morality। It could not be, since it presupposes that knowledge. Different moral philosophers - Aristotelians, Kantians, utilitarians, intuitionists, and so on - do not disagree about the wrongness of murder or the goodness of generosity, but about how we should account for that wrongness or goodness. Moral philosophers are concerned with understanding the nature of morality in general and the connection of moral concepts with other concepts, such as those of a 'fact', of 'human nature', of an 'imperative', of 'reason' and so on. Training in moral philosophy is not the acquisition of scientific knowledge of what is right and what is wrong, but the development of the ability to reflect on the nature of our judgements of right and wrong.
It is significant that the one school of moral philosophy which does present itself as a quasi-scientific discipline, capable for instance of criticising received views of what is right and wrong, is utilitarianism in its various forms। The principle of maximising utility is supposed to be directly applicable to concrete moral decisions, when taken in conjunction with relevant facts. I say that this is significant because there is a marked (though not universal) correlation between practitioners of 'applied ethics' and utilitarians [1]: those 'applied ethicists' who follow the engineering model, in particular, are almost always utilitarians. They see themselves as moral experts in much the same way that the scientifically-knowledgeable engineer is in that field [2]. This is perfectly intelligible, given the nature both of utilitarianism and of the engineering model. But it gives those who object to the utilitarian conception of morality as concerned with the maximisation of pleasure and pain rather than with the well-being of persons an additional reason for thinking of the engineering model as flawed.
If we accept such arguments, does it follow that moral philosophy can have no possible practical relevance in moral decision-making? Only if the one way in which it could have relevance was that described in the engineering model। I want to argue, on the basis of my own experience, that there is another way. When it comes to making the standard sorts of moral decisions which we all have to make in everyday life, the moral philosopher is in no better position than any other person of equal decency and sensitivity. Should I steal this expensive watch from the jeweller's? Should I betray the confidences of my best friend to a malicious gossip? Should I lie to escape blame for something I have done? We all know the right answers to these questions, whether or not we have had a training in moral philosophy.
Where moral philosophy may come into its own, however, is in those cases in which the guidelines supplied by a good upbringing are harder to apply - cases in which the moral issues are more complex than usual, or in which we are confronted with qualitatively new sorts of moral issue। It is the latter kind of case which I want to concentrate on here, since it is well instantiated by the problems thrown up by developments in medical technology. For what we principally have in mind when we speak of 'medical technology' is the application of scientific knowledge to enable human beings to achieve medical goals which they could not achieve otherwise. Thus, to mention only a few examples, organ transplantation, kidney dialysis, the use of 'iron lungs', ventilators, endogastric feeding tubes and the like, all enable us to prolong human life in circumstances in which in the past that would have been impossible. New reproductive technologies make it possible for human beings who would otherwise be infertile to have babies of their own. And the technologies of gene manipulation may make it possible in future for children who would otherwise have inevitably suffered from some genetic condition causing problems of a more or less serious kind to be born without that condition or those problems.
Being able to do radically new sorts of things in this way also means being confronted with new sorts of moral problems for which our upbringing as normally decent and well-meaning human beings has not prepared us। Faced with a young person seriously injured in an accident, we would all say that we must obviously do all that we can to save that person's life: but does it follow that we need to prolong the (entirely unconscious) life of someone in a permanent vegetative state (as it is now called) by intravenous or intragastric feeding? Is prolonging breathing and heartbeat with no other benefit to the patient what is meant by 'saving life' in the moral principle that we should do all we can to save human life? Or again, we may agree with the claim in the European Convention on Human Rights that there is a universal right to have children. But does it follow that those who are naturally infertile have a right to IVF, and that therefore the state has an obligation to provide IVF treatment regardless of patients' ability to pay? Or finally, we would probably agree that cystic fibrosis is a terrible disease, and that we should do all we can to find a cure for it, or at least some way of alleviating its worst consequences. But does it follow that we should, if we can, use germline gene therapy to eliminate the cystic fibrosis gene altogether from the human population, so that no one will ever have to suffer from this condition again?
In all these cases, our ability to do new sorts of things creates moral problems of a new kind। It is in cases like this that a training in moral philosophy can be a help. The ordinary moral training which we receive in the course of a decent upbringing consists in learning to apply standard moral rules (don't steal, don't tell lies, keep your promises, be considerate to others' feelings, etc.) to cases in which their application is clear. But in the cases just cited, what is in doubt is precisely which rules should be applied and how they fit these new circumstances. We need to have developed a certain kind of moral imagination, consisting in a capacity to pick out the morally relevant features of these new sorts of case and so to determine which of our fundamental moral principles may apply to them and how.
What is it about human life, for instance, which makes it worth preserving, and is that feature to be found, say, in the PVS patient whose life can be preserved only by tube-feeding? What does the right to have children consist in, and do naturally infertile people who can have children only by IVF qualify for that right? How far does our obligation to prevent human suffering extend? Does it include suffering which is preventable only by intervention in the whole future development of the human species?
Answering questions such as these requires reflection on the whole nature of our moral concepts - standing back from the demands of practical decision-making in order to think in a more theoretical and general way about the principles involved। But such theoretical reflection is precisely what we mean by moral philosophy. A training in moral philosophy may not be the only way, but it is the best and most obvious way, to develop one's powers of reflection on moral concepts and moral principles. Furthermore, one cannot study moral philosophy seriously without being aware that such reflections may and do lead to differing conclusions, not only about what the moral concepts mean, but about which concepts are important in moral thought. Singer's talk (see endnote 2) about the meaning of the moral concepts results from an excessively narrow understanding of moral philosophy, no doubt inseparable from his utilitarian view of moral philosophy as a quasi-scientific discipline.
In his essay 'Philosophy and Government Repression' [3], Isaiah Berlin argues that philosophy is not like a science: it solves its problems, not by the accumulation and ordering of facts, but 'by altering the point of view from which the problem seemed a problem; by shifting emphasis, by transposing, by shifting the vision of those who are perplexed, in such a way that they perceived distinctions which had hitherto not been visible, or came to see that the distinction upon which they had laid so much stress did not in fact exist, or rested upon muddles or lack of insight' (p।60). It is my contention that a training in this way of problem-solving is peculiarly useful in approaching the new and particularly difficult kinds of moral problems thrown up, for example, by developments in medical technology.
This still does not make the moral philosopher an 'expert', informing his or her colleagues in medicine, law or whatever what is the 'correct', rational, scientific answer to their problems। Not only would this be offensive, it is also not the moral philosopher's job. The usefulness of the moral philosopher, according to the picture presented in this paper, does not consist in making the decisions for the professional people: that is their responsibility and theirs alone. Nevertheless, the philosopher can perform a useful, indeed a vitally important role, by bringing his or her training to bear on the task of elucidating the morally relevant features of the problem-situation and so making clear what factors need to be taken into account in arriving at a decision. It is my experience that performing that task is making a genuinely useful contribution, and is appreciated as such by most of those who have in the end to make the decisions.
Notes For further discussion see Anne Maclean, The Elimination of Morality, London, Routledge, 1993। A leading protagonist of this view (and a utilitarian) is Peter Singer: in a book which he wrote with Deane Wells in 1984 called The Reproduction Revolution (Oxford University Press), he argues that we could make more progress with difficult moral issues if we were 'a little more ready to gather together those best qualified to consider the issues in an open and informed manner' (p।199): among their qualifications would be 'an understanding of the nature of ethics and the meanings of the moral concepts' and 'a reasonable knowledge of the major ethical theories' (P.200). Reprinted in Isaiah Berlin, The Sense of Reality, London, Chatto and Windus, 1996. Eric Matthews is Professor of Philosophy at the University of Aberdeen
Cited from:http://www।abdn।ac.uk/philosophy/endsandmeans/vol2no1/matthews.shtml
February 29, 2008 12:34 AM
