Wednesday, December 26, 2007

Perplexed

Somebody help me out here: How does a Kantian, deontological-type ethicist justify inflicting pain for medical purposes? Giving an injection, for example? And how is this different from the scenarios where he has to choose whether to trade 1 life for 100 lives?

9 comments:

scoots said...

If you distinguish pain from death, that's a start.

A small amount of pain, like a shot, doesn't prevent a person from pursuing their own life afterwards. Killing someone does take that away, so it's not fair. An in-between example, like requiring someone to go fight in a war, is harder to judge, because some people move on pretty well afterwards, some die, and others are more or less destroyed emotionally so they have difficulty continuing with life.

Maybe the key is to compare X with what the person is likely to encounter in life anyway. A needle prick is less painful than stubbing your toe, which is bound to happen, so there's no reason to call it unjust. Taking away a couple of years of someone's life to make them fight in the military (like many countries do to young men) is relative, because each of those men may well have 60-80 years of life remaining afterwards. The risk of death is relative, because everyone risks death in normal life (heart attack, stroke, getting hit by a bus), and few wars involve any kind of overwhelming likelihood that any give soldier will die. So sending someone to war might be unjust, but it has to be argued for, not just assumed.

What clearly isn't fair is immediate certain death, because no one faces that in any kind of normal life. No matter how bad a person’s situation is, they always might live on and find some degree of happiness.

Matthew said...

The thing is, I don't know that a deontological ethics allows a person to distinguish pain from death: only duties from non-duties.

I'm under the impression that - according to Kant - if a person has a duty not to inflict pain on another person, then that duty cannot be superseded by another duty, even if there is some eventual good that might result. The extreme example is torturing a single person to extract information that might save a city. Deontological ethicists seem to say you ought not torture the one person (I agree), but the rationale is that you have a duty not to inflict pain, but no duty to save life.

Note that I'm not looking for a general ethical solution, I'm just wondering what deontological folks say about the practice of medicine.

Aric Clark said...

Matthew,

You're basically right that a kantian deontologist would break down in situations like this. Frankly, I don't think it's a very good ethical system.

What a Kantian might say, is that there is no categorical imperative to avoid causing pain. Perhaps there is a categorical imperative to avoid causing unnecessary pain, but, for example it is okay to impregnate a woman knowing that the Child birth will be painful.

Aric Clark said...
This comment has been removed by the author.
Matthew said...

@Aric:
"What a Kantian might say, is that there is no categorical imperative to avoid causing pain.

So then what happens in the extreme example: torturing a single person to extract information that might save a city?

Also, I was under the impression that deontological ethics rejected the idea that a person can calculate eventual goods (or eventual evils) and so should only rely on their ability to apply moral rules to the situation at hand.

Aric Clark said...

True a Kantian shouldn't be calculating goods and evils. However, it seems almost inevitable in the process of considering whether it is possible to create a universal maxim to govern behavior in each situation.

For example in the torture scenario, it depends on the question you ask. Do I think it is a universal maxim that no one may ever torture another person? Sure. Okay so the answer is that I can't torture 1 person to save 100. If the question is framed differently, though - should there be a universal maxim prohibiting causing another person pain? Clearly this is trickier because there are plenty of scenarios we can think of (doctors for example) where causing pain is good, thus I wouldn't make this a universal maxim.

It seems to me that some calculation of goods usually gets in there if only in a backhanded way.

If you take Kant's premise, which is even more difficult, that you should never act at all unless you can construct a positive universal maxim to support you action, then you have to look not only at whether the action is prohibited. Could we say that it is a universal maxim that you should always torture 1 person to save 100? Or Could we say that it you should always cause other people pain? etc.. etc.. framed this way it's almost impossible to come up with a justification for any action. What should everyone always do? Anything?

paul martin said...

It seems to me that morality that isn't pragmatic leads to immoral conclusions because one places greater value on conceptual consistency than flesh and blood realities.

And that the scenarios used to represent moral quandries usually amount to stuff that rarely if ever actually happens.

I speak in generalities because I didn't even know Kant was an orthodontist and feel I can't comment on the dentological specifics of this discussion.

I think Aric's last paragraph tends to support me, though I Kant be certain.

Matthew said...

@Aric and Paul:

I have a feeling that this comment thread is about dead, but ...

One of my philosophy professors described these dramatic ethical dilemmas as "inherently tragic". What I think he meant by this was, there is no perfect way to behave in these situations, no resolution that allows one to remain morally blameless.

Given that you're going to find these ethical dilemmas no matter which system you choose, it seems to me that one of the tests of a good ethical system is how well it handles everyday quandaries. So an ethical system that only failed under the "do you steal the medicine for your dying wife" scenario wouldn't really have failed at all, but one that couldn't handle the day-to-day practice of medicine would be, as Aric put it, "not a very good ethical system".

I'm basically trying to tease out some hard-core duty ethicist and get him to explain to me why his ethical system really is robust.

Paul martin said...

"One of my philosophy professors described these dramatic ethical dilemmas as inherently tragic".

That sounds true to me, even if they're rare. Like the decision made to let it be "ladies first" when the Titanic was going down.