Right or wrong, it's a matter of ethics

Sydney
2 March 2003

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Right or wrong, it's a matter of ethics

By Chris Lindsay

"Ethically at 3 am when you've got your wife in the back seat of the car ready to give birth, and it's safe on the roads to do so, then you can jump a red light," says John Quilter, lecturer at the Australian Catholic University's School of Philosophy at its Strathfield campus.

"But does that mean we should change the law to allow jumping red lights in such cases? How pregnant, how imminent is birth, before it is legal to jump the red light - once you get into the details it gets stupid."

It is an argument John uses when discussing the difficult question of euthanasia, and how to approach it from an ethical basis, that is one part of the Ethics of Health Care courses taught within the school and through the Plunkett Centre for Ethics in Health Care.

John says that once the two opposing views are raised - that there are situations of no hope, of terminal disease and serious pain at which point proponents of euthanasia claim it is appropriate to accede to someone's request to end their life, and the other view, that at no time, nor for any reason is it permissible to do so because life is sacred - there is the difficult grey area in between.

The Catholic Church, of course, leans heavily towards the position that life is sacred, at least as one of the philosophical bases from which to look at the issue.

But what does the School of Philosophy say to its students about this?

"The answer differs from lecturer to lecturer. I can only speak from the School of Philosophy (theology is a different matter, it can makecertain assumptions that as philosophers we can't)," John says.

"I think that broadly among all of us there is a recognisable influence of sympathy for the basic outlines of the Catholic position. Some are more conservative and some more liberal.

"But none of us has much time for the extremist liberals, such as Australian philosopher Peter Singer or euthanasia activist Dr Philip Nietzsche."

John agrees that Nietzsche lost a lot of public sympathy on two points: His raising of suicide as an option for depressed teenagers and the death of Nancy Crick, who killed herself and then was found not to have a terminal illness.

"On euthanasia, in my view, there is an awful lot of confusion about ethical questions and the socio-legal positions," he says.

"Many people on both sides of the debate argue that if the ethics of euthanasia or some other ethical question are x, y, z then the law should be a, b, c.

"That's a huge jump. That's an awfully big jump from what the ethics is to what the law should be.

"I like to argue like this: OK, let's give Nietzsche and company their ethical position for the sake of the argument; let's assume it does follow that we should change the law.

"But what happens if we change the law? Let's think that through.

"What would happen if we said that in certain circumstances you can take a life?

"Well, it's very difficult to codify what those circumstances would be - to trust that ordinary people would necessarily get it right all the time, or act wisely all the time.

"There are a lot of pressures in life; grandma could start to cost a lot of money; she might have been an old bugger all her life anyway.

"You might pray for her to die and now you can knock her off. The potential for abuse of legalising such killing is frightening.

"Instead of killing people, we could sit and talk to them and make them feel as if someone cared for them; we could work harder at controlling their pain."

He agrees that the problem of leaving the decision to doctors raises the problem of "which doctors" and "what ethical background do they come from?"

John says: "In Nazi Germany there was a process of doing away with deformed children. But what deformities? A hare lip? Deafness?

"There is a kind of pious myth in a lot of people's minds about just how sure of ourselves we are as citizens in a free democracy.

"Most of us are quite impressionable, and we aren't always certain about what we think is good in the circumstances.

"Most of us can be swayed - even if we are sure we know what is right - under other influences and pressures away from our positions, away from doing what we think we ought to do.

"My guess is that the vast majority of any population is highly impressionable and suggestible. That is one of the reasons why stupid marketing strategies work so well.

"It is why people in a mob can be made to do things they wouldn't normally do - things they wouldn't even think of doing by themselves.

"So if we create an environment by changing the law regarding the taking of lives, after following a couple of what would be relatively easy steps for society we are sowing the seeds for problems in our general attitude to life.

"It is a most dangerous path to tread. And as a social policy it would be barbarous.

"Freedom is a value, but it is not an absolute value. Freedom is important, letting people have space to do what they want is important, but not when it costs other people their lives.

"I reckon the argument for changing the law to uphold such 'freedoms' just doesn't hold up."

While the lecturing staff have their own well-worked out views in these kinds of topics, they don't try to force feed them to the students.

"In a course like ours, because it is ethics, it is essential people's consciences be formed quite maturely," John says.

"We want to get out of the kind of childish, slavish inability to think through issues for themselves, or to engage in debates with people who they can't agree with, or understand others' points of view.

"To think things through, people need to be able to respect sensible points of view and to criticise intelligently less good aspects of opposing debates and positions.

"We want to help people avoid becoming slaves to fashion or pet philosophical theory."

John says the school tries to encourage students to become well informed about the debates; so, in health care, for example, they need to have a grip on the science of the things they are talking about.

"We try to equip people with a good exposure to the range of positions, at least the influential positions that are in play or are making their claim in the public space about these debates," he says.

"We try to inform them fully. A lot of people may think or expect, particularly those unrelated to a Church, that because it is a Catholic university all we teach is Catholic theology.

"What people forget is that this is a philosophy school. The theology faculty will teach the theology.

"As a school of philosophy we take seriously our responsibility to inform people of the state of philosophical contributions to health care and business ethics.

"We look at ultilitarian writers, contractarian writers, the great figures from history of moral philosophy.

"As far as possible we look at all the voices, we engage with these writers in a philosophically rigorous and open way.

"At the same time, what is true is that in the School of Philosophy at this university I think all of us are of the view that one of the most significant and articulate intellectual voices inethical debate over the centuries has been the Christian tradition.

"We take seriously theological writers, philosophers who write philosophically but with religious convictions as contributors to the debate.

"We present them to students to take or leave on their merits as they in their own conscience best accept.

"Many of our students have a Catholic background but not all; roughly half and half, I would think. We can't assume religious commitment in our students, there are certain basic positions we can't take for granted.

"For a number of us, the influence of our own substantive views, the way we weight arguments regarding any serious religious commitment that we have will probably be visible to people - and we don't resile from that."

Readers interested in philosophical discussions of ethical questions in health care can subscribe to the newsletter Bioethics Outlook by writing to the administrative officer, Plunkett Centre for Ethics in Health Care, St Vincent's Hospital, Darlinghurst, NSW 2010 or calling (02) 9361 2869.

The Plunkett Centre will conduct a one-day seminar on Moral Decision Making and Moral Teaching on May 7 for teachers of Studies of Religion at stage six. For information ring 9361 2869.

Next week: The ethics of informed patient consent