Bioethics Discussion Blog: Are Ethicists Always Ethical?

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Friday, October 05, 2007

Are Ethicists Always Ethical?

"Are ethicists always ethical?" To be able to try to answer that question, one must first know who is an ethicist, how did they become an ethicist, what are their responsibilities and to whom, what are their common guidelines for behavior and for practice as an ethicist and finally are they as persons containing some personal quality which is different than the rest of us? My questions were more specifically spelled out recently by an ethicist on a bioethics listserv on this issue.


We do not know who counts as an ethicist, bioethicist, clinical ethicist in the absence of any indices of professionalization (professional training, certification, accreditation).

We do not know what do not know what counts as good moral advice in the absence of best practices guidelines, consensus statements, etc.

We do not know what counts as unethical practice for an ethicist, bioethicist, clinical ethicist in the absence of best practices guides or, better yet, a code of conduct for bioethicists.


One must also distinguish in the question "are ethicists always ethical" between their behavior at work and their behavior in their private lives. At work, I can see of possibilities where an ethicist employed by a company may because of conflict of interest direct their decisions in favor of the company rather than assume an unbiased position in their conclusions. The private lives of ethicists hold much room for cheating a bit on what is accepted as ethical behavior because of their assumpion that this is necessary either to preserve or enhance their personal or family life.

On the whole, I think that some ethicists don't follow their own "professional" prescriptions in the same way some physicians fail to follow their prescriptions which they give regularly to their patients. I would be interested to read from my visitors any experiences they have had with ethicists or ethics committees. Also what is your view on the question in the title of this thread. ..Maurice.

ADDENDUM 10-10-2007: A professional ethicist recently wrote me this commentary on the subject and I thought it would be appropriate to add it to the front page of this thread. ..Maurice.


RESPONSE TO ‘ARE ETHICISTS ALWAYS ETHICAL?


Anonymous - Professional Ethicist

The whole enterprise of ethics is about discerning right and wrong, good and bad. However, there is not a consensus on what Right and Wrong/Good and Bad are. There are different theories of the Good. Plato for example said that The Good is an Idea, and good things are good because they reflect this Idea. Philosophers can see The Good and explain it to all others; Aristotle said that this theory produced more problems than it resolved. Later, Mill and other Utilitarians argued that actions are right when they produce the greatest happiness for the greatest number (whether this generality has to include only people, or other animals, or future generations, is open to debate). This theory dissatisfies others, who insist on the character of the agent, rather than on the consequences of individual actions it sounds paradoxical to say that an action is good, even if it is performed for evil or purely selfish reasons, just because it produces happiness to a great number of people. Likewise, it seems paradoxical to say that an action is morally bad if it causes unhappiness, but it was not in the agent's intention to harm others. Intentions, therefore, some claim, are what matters. But others respond: intentions are not measurable and verifiable – even the agent himself, often has not a clear view of his real intentions…

This illustrates that there is not a clear and accepted paradigm of what should count as good, right or ethical.

In absence of a clear paradigm of goodness, not having a code of conduct on the basis of which the life of an ethicist should be regulated has its advantages. This code, in fact, could contain values that are not shared by all, and could limit the legitimate expression of individual autonomy. One of the greatest achievements of contemporary ethics has been to assign high value to autonomy. People's right to shape their lives according to their own values is now secured by all conventions and declarations of human rights and fundamental freedoms. It would be self-contradictory to judge the adequacy of an ethicist according to set-up guidelines.

However, the blog raises an important issue about the relationship between private and public life in our profession. I will argue that in ethics the demarcation line between private and public dimension is not as thick as it can be in other professions (like arts), and that our private behaviour should be consistent with our public role. This does not mean that we should give up our personal freedom and privacy, and accept to be judged on the basis of a code of conduct. It means that extreme behaviours that cross the line of legality and that clearly contradict the message we want to convey in our public capacities should be avoided.

Before I explain my point of view, I should clarify who we, ethicists, are and what we do. Ethics is a philosophical discipline, so, stricto sensu, an ethicist is by background a philosopher. However, given that science and medicine are multidisciplinary areas, that involve psychology, medical sciences, sociology, law and economics, some ethicists might have a different background. This is not inconsistent with our job.

Ethicists are professionals in charge of clarifying what courses of actions are preferable. We work in a variety of contexts. For example, we might be involved in illustrating the ethical issues raised by scientific advances; some of us take part in ethics committees within hospitals. We help clarifying whether for example financial resources should be allocated to one service or another; the modalities in which consent should be gathered; the modalities in which people should be respected, even when they wish to die. We, generally within a team, often take a role of guidance in difficult clinical decisions. We also contribute to shape public policy we are called to assist in the development of guidelines on a variety of issues (genetic engineering; doping in sports; treatment of mental disorders etc.). Our work thus has significant impact on public policy and law. We are also often employed by universities; we are involved in education, another great responsibility towards the public.

In other professions that have marked public resonance, the private life of professionals is open to social/public scrutiny. Politics is a clear example of this. Let me illustrate this point with a coupld of example: In 2004, the UK Home Secretary David Blunkett resigned because he was found to facilitate the VISA of an immigrant who worked for him. He lost his credibility not just because he abused of his powers, but also because somebody who is supposed to protect public justice should not commit an injustice, however well motivated this might be.

A more grotesque story happened in Italy early in 2007. A Member of Parliament, Mr Selva, called an ambulance to deceive the traffic in Rome. He had been invited to a TV Studio for a political debate. On his way to the Studio, his car was stuck in the city centre, where the traffic had been blocked due to the arrival of the US President G.W. Bush. As the police refused to let him go through the barriers, he decided to call an ambulance and fake sickness, to be taken to the Studio. It was Mr Selva himself to tell this story publicly, during the TV programme, smiling that his was a smart move. After this episode, investigated by the Italian Magistrates, Selva resigned.

In both cases the story has not only the private dimension of a wrongdoing (the person has violated the law and is personally accountable for this); the wrongdoing also says something about the agent's adequacy to carry out properly his public role. His private actions erode his credibility as representative of public interests.

Ethics and politics have traditionally been considered twin philosophical disciplines, and the profession of an ethicist is in many relevant respects similar to the profession of a politician. They both act in the public sphere, what they say often has public impact, and they should both protect or promote certain conceptions of the good. There is however a discrepancy between treatment of politicians and of ethicists, in spite of the similar public role we cover. Before this incongruence, we need to reflect more.

Let me narrate a personal story, which raises important ethical issues about the relationship between bios, lives, and ethics. A few years ago, I got engaged with an eminent professor of ethics and director of a centre of bioethics. Before we got married, we decided to have a child. When I was about 20 week pregnant, he broke our engagement and told me over the phone he was going to live with his ex. He said that if I was going to carry the child to term, I should do so in the awareness that the child would be fatherless. He left me and my child with no house, in a foreign country and without assistance.

In addition to this, my ex partner was sending me hundreds of messages: most were love and sexual, some openly obscene, some abusive and threatening. I visited the Domestic Violence Police Department. They asked to have access to all my emails and phone messages, and told me that the man could have been arrested on the basis of what they were seeing. As an arrest would not promote my child’s welfare, I agreed that the PC issued him a Restriction Warning under the Harassment Act. He was told that if he ever contacted me again, he would have been arrested immediately. He signed a paper, in which he declared that he would only contact me through his lawyers. Three months later, he violated the warning.

My ex fiancé did not come at our son's birth, and did not put his name on our son’s birth certificate; he refused to assist the child when he was in intensive care and any time thereafter, when he was informed of medical emergencies. I took the matter to the Courts, asking for recognition of paternity and regulation of maintenance and contacts. I was unable to request a psychiatric assessment for him, as only married partners of relatives can do so. I insisted that if he requested contacts with my son, these should take place possibly through a social worker, and should be regular.

The Judge said that the father has a right to access, but there is no mechanism that can guarantee that an absent parent has regular contacts with his children. The absent parent can make appointments and fail to attend, and this does not jeopardises his right to access. This is exactly what happened for years- my son’s father requested appointments that were regularly cancelled.

This story is important because it helps to highlight a number of ethico-legal issues that are significant to many people, and that yet are not on the bio-ethics agenda. For example, one issue is about how our Family Laws protect our children’s welfare. The Law offers no protection to the child against the harm that absent parents can cause when they abuse of their right to access. A father, or the absent parent, has a right to access to his child (an indisputable right), but he (or she) can do whatever s/he wants with this right. It is clearly of great distress to the child to be regularly disappointed. Whereas many other forms of psychological abuse (mobbing, harassment, discrimination, for example) are recognised by law and people are protected against them, this form of psychological abuse to the child, who is also very vulnerable to his/her parents’ behaviours, is something on which law and society do not express themselves. I have met several mothers and fathers who, just like me, have to minimize on a daily basis the harm that the absent parent's inconstant behaviour and unreliability causes to the children. But my story also raises the issue of the social response that we should give to the private behaviour of people who hold special professional roles. Should these sorts of affairs be regarded as just private, if the agent is also a member of the political or ethical profession? Whether or not ‘Mr White’ declares to be racist might be purely Mr White's business. However, if Mr White was Ministry for Equal Opportunity, his statements would take a public vest in virtue of Mr White's role. It is the credibility that is at stake here. If Dr Shipman took a lectureship and gave a public lecture about the sanctity of life and the duty to preserve lives, would he be credible?

Private choices do sometimes impact on professional roles, and that the say that the quality of a piece of work is independent of the life-style of the author is not true for all works and all professions. People who hold particular professional roles, for example those who are responsible for the protection of public interests, should avoid life choices that openly contradict what they practice. What is at stake, here, is not only the quality of the job that they offer (Dr Shipman could be smart enough to write beautiful and touching lectures on sanctity of life), but also their credibility.

It is indisputable that, as ethicists, we have great responsibilities towards the public. We must be credible, if we wish to hold such a role, and it seems to me that some private affairs, like those that I happened to experience, do impinge on the credibility of an ethicist. They might also have a negative impact on the respectability of ethics itself. Contemporary ethics is populated by rich debates on what sort of life there should be. We should not limit our discussion to what sort of lives there should be: we should reflect on what sort of life we should have, if we want to remain trustworthy representatives of ethics, and if we want to protect the reputation of ethics as a discipline that is indispensable to society. I am interested to hear people's viewpoints on this topic.

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