Monday 10 April 2017

The basics of - Morality & Ethics part 3

Recently I've been pondering a thought.

Is "vested interest" and what is deemed "appropriate" replacing the human progression towards "universal good"?

Universal good in this context being, opportunity, parity, education, prospects, happiness, and the access to sufficient means to provide for ones self and ones family.

It kinda ties into the 3rd part of my philosophical mini series:

Applied Ethics.

Consider the theatre of politics. Very often lobby groups will push their agenda and may, via quiet meetings with various people, agree to support certain other agenda's or goals - IF their own needs are met. This in essence is the very spirit of collaborative working and compromise, but the driver, or "maxim" to use Kant's expression, is merely a vested interest in a certain type of outcome.

Arguably an immoral use of a system.

BUT if that lobby group happens to be trans rights, or funding for pre natal hospital care, or women's access to health care, or ACLU, the Gun lobby, Oil industry, even evangelical groups etc, then people will make various decisions regarding the morality of the lobbying process based on the cause that is being lobbied for.

Me for instance, I'd suggest trans rights would be a "good cause" but judging by the comments section in the lower third of the internet, I'm sure many would disagree. The reasoning behind a decision as to the morality of a given goal or methodology could be the application of the consequential, or maybe duty bound theories.

For example I believe it (trans rights) an ethical cause because the outcome of success would see an improvement in peoples lives, and improvement in their access to the universal goods listed above. An opponent might disagree on religious or scientific grounds, since they subscribe to a view that the concept of "trans" isn't a legitimate way of being and thus to promote it is ethically wrong, since its harmful in wider sense, regardless of the consequences of such a view point to a given indivudal.

Of course I am trans. ( Or, if your an opponent of that concept, you would have to accept that I at least believe myself thus, even were you to disagree) So does that place me in the the vested interest category? You betcha it does. Does that undermine my arguments? No, only my perceived (and actual) impartiality.

That issue of impartiality is the central reason for my preference to look at the trans issue through the lens of anthropological and philosophical thought, rather than the reverse, which is to perceive everything in life through the lens of my vested interest in the trans question. If (some of) the arguments made by the trans community on its own behalf cannot stand up to structured critical scrutiny, they are thus proven as bad arguments. That fact doesn't change, regardless of how I feel about the underlying wider context.

It's small though signiifcant effort on my part to "balance the books" as it were.

Back in my nursing days I often considered the use of the word "appropriate" in the medical context. Seldom would you hear  "right", "wrong" or "good" "bad" used in the context of an action pertaining to a patients care.

The "most appropriate treatment" was the universal phrase.

Yet this, like many things is open to interpretation. Appropriate for whom? The establishment? The patient? The family? The wider society?

This "appropriate argument" is raging in America at the present with regard to not just trans issues, but a whole swathe of the population for whom it is deemed "inappropriate" by some to provide the basics of what we in the UK have come to expect of a healthcare system.

The ACA was America's first foray for many years into addressing its healthcare access disparity. Yet still some people wanted to pull it down, presumably for their own vested interests rather than the common of access to a universal good. (health)

After all, History will record that it was postulated and set up by a black guy. Certain sections of  todays America simply won't stand for that. Nor the idea that "an underserving poor" can access health care that "they pay for". Both premises are of course open to fairly stringent rebuttal, yet  a significant number of people still cling to these types of "moral" viewpoints.

I read recently of the case of a poorly baby girl. Again this is in America. She was denied treatment for a minor, yet potentially serious condition. One easily sorted within todays modern medical world.

The reason for the denial of health care to this infant? Her parents were Lesbian and the Dr objected to treatment on the basis of religious moral objection to the parental lifestyle.

Consider the hypocratic oath: written by Hippocrates, in ancient greek times, circa 300BC (damn those clever greeks again!) A modern version of which is shown below:

I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
Consider those lines of the text in bold. The doctor in question cited "religious objections". Not to the treatment, but to the actions of a family member of the patient. 

Religious/ethical exceptions do apply in the UK and US. To cases of abortion for example. However the essential difference here is that in the case of abortion, medical personnel object to the action and/or proceedure they are being asked to perform, and not an extraneous factor that is irrelevant to the treatment of the patient. 

Duty based theories of right and wrong, such as those derived via a literal interpretation of some of the Christian teachings, would suggest this Dr "may" have a case. However, those same arguments would preclude her from treating people who are Bisexual, polyamorous, or eat shell fish and wear mixed fibre cloth. (Leviticus) Thus it would seem theres an inherent objection present and the  religious argument is brought out when convenient. Where have heard that before? 

Furthermore in taking the hippocratic oath, or subscribing to the broader tenant of it meaning, by virtue of being a Doctor, there is an expectation to put aside personal and moral view points and act "in the interest of the patient" at all times. Clearly the Doctor is in breach of that specific and central premise of being a healer of others. 

Is she therefore demonstrating a fitness of judgment sufficient to the work of a Doctor? You decide. 

It raises an interesting point however. The separation between church and state. Or moreover Church and legislature. Something the USA is again currently wrestling with. Religion is a duty based theory or morality and ethical out come. It presupposes right and wrong actions as prescribed via it's teachings and disregards the outcome of those actions. Law is utilitarian, derived from a branch of consequential theory. Creating either the greatest "happiness" or the least "sadness" for people via prior examination of the potential outcomes of any decision.

It doesn't take much to deduce that the two are in many ways mutually exclusive.

So Applied Ethics is a minefield. Since the answer one gets or seeks, in response to ethical questions depends almost entirely on which ethical model one uses to frame those questions. The unscrupulous will use one or other ethical model to justify their actions in rebuttal of condemnation from those who see things differently.

Philosophers are generally agreed that the existence of human nature is a contentious concept, since it would contravene the free will argument and thus responsibility for our own actions.  But, given all the above, and the contradictory outcomes inherent to differing views of what it means to be/do good or bad, it it puts me in mind of Moral Relativism.

The first law of Einstein's theory of relatively suggested that "everything will be measured in relation to Something else"

And so it is with Ethics. judgments cannot exist in a vacuum. They must be compared to something, be it history, or examples of another viewpoint.  To say Morality is relative, in as much as it shifts with time and perception, is true enough. After all what was once viewed as immoral is now not, and what was once viewed as moral is not now so. The two major examples in recent times being homosexuality and Slavery. Of course there are some who still condemn homosexuality on the basis of they preferred moral framework, yet that stance carries all the legitimacy of an opinion, if not backed up by reason.

So, to conclude my mini series on ethics and the morality of actions, thoughts and intent. I will once again revisit a paraphrasing of the words of Dr John Corivino, for I cannot put it any better. (I hope he will forgive me the small change)

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I'm not suggesting to you "don't make moral judgements",
I'm asking to make sure you have reasons for the moral judgements that you make. 
To put yourself in someone else shoes, before you judge them. 
Not to Judge someone on how they live and love, but on whether they Live and love.

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Sarah.

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