II. Decision Procedures for Ethics: ADAPT
an Approach to Moral Decisionmaking
People naturally want to do good and avoid evil. For the most part,
we limit our attention to morality to the observance of certain interpersonal rules--of
courtesy, helpfulness, and respect for privacy, for instance--that serve
to make daily life more livable. But sometimes a condition comes to light
that interrupts, imposes itself upon, daily life. Consider the following
case:
Stranded in Ethiopia during a protracted civil war, a French camera
crew began filming the events and conditions in a nearby refugee
camp. Its inhabitants had fled from the fighting between the Ethiopian
central government and the province of Eritrea, where the war had
disrupted all agriculture and commerce, and cut off the food supply.
There was no food for them in the camps. They were dying, starving
to death. The crew filmed babies with the thinned reddish hair, dull
eyes, and distended bellies of starvation; filmed parents, helpless,
trying to comfort their dying children; filmed the burial parties
consigning their bodies to the earth. Then they sent the film back
to Europe, and excerpts started to show up on late night television.
World reaction was immediate. Whatever we thought of Ethiopia,
Africa, or foreign affairs in general, we knew that those children
had to be fed, immediately.
How did we know? We knew that human life is precious, that human
pain is bad, and that starvation hurts. We recognize therefore imperatives
to save lives that are threatened and relieve human pain wherever
it occurs. These imperatives are qualified where the sufferers seem
to have brought the suffering on themselves, for then they are seen
somehow to deserve to suffer; where a person is faced with death
following conviction for a capital crime, we may suspend completely
our intuitive imperative to "save life." But children cannot have
committed crimes, or be in any way responsible for that war and the
conditions that follow from it. They are innocent sufferers and therefore
deserve all the help we can give them.
Accordingly, we looked for ways to feed the children, In addition
to the usual routes of charitable aid, churches etc., many of the
world's popular music stars were brought together by an enterprising
producer to hold a huge fundraiser, called "Live Aid," for the benefit
of the starving children. An enormous amount of money was raised
and directed toward famine-ridden Africa. The strength of the world's
reaction to that famine, incidentally, was a major factor in the
later United Nations decision to send troops into neighboring Somalia
to protect food distribution channels, and the United States' decision
to join that effort.
Was it a good idea? Not long after the big concert, questions were
raised about the effectiveness of that and all such efforts. Was
the money well spent? When food and supplies were bought, were they
transported to the famine-stricken area as efficiently as possible?
Were they distributed successfully to hungry people? In war-torn,
gang-ridden countries, where no central government could maintain
order, was all that food actually getting to the people who needed
it? Especially after the warlord battles in Somalia started going
sour, there was a strong reaction against such humanitarian efforts
in the absence of strong local support.
The case of the starving children, as we may call the above, and all
similar cases, is typical of the kind of moral adaptation that
punctuates the normal routine of moral life. The sequence is characteristic:
First: some condition is brought to light, some situation, or array
of facts. This condition captures our attention, alerts us
to something that stands out from the background noise of our lives
as requiring our concern.
Second: that condition is discussed, the information is disseminated through
the community, a community dialogue is conducted where public
opinion is actually formed. That "community," incidentally, may be
as small as a family or as large, as in this case, as the whole world.
Third, the discussion incorporates the moral assumptions that
guide our lives, ordinarily without conscious thinking about. We
do not have to reason out what we ought to do in most situations;
most of the moral work is already done.
Fourth, proposals for action are put forward and policies adopted.
Decisions are made, implementing the imperatives in a way appropriate
to the situation that caught our attention.
And Fifth, the results of the action are tested against
the results expected. The test results are fed back in to the data
from the initial situation: Was the action taken in fact appropriate?
Were the imperatives successfully implemented? Or should we go back
to the drawing board, and introduce new proposals for action or policy?
Note: the decision process, on review, does not return to the starting
point, but only asks after the effectiveness of the policy for
action--we have agreed about the ends of the proposed action,
and now we seek the most effective means.
From the above, we can put together a normal moral reasoning procedure,
easily remembered in the acronym ADAPT:
- Attention
- Dialogue
- Assumptions
- Proposals
- Test
(Note: allow me to apologize right now, for this and subsequent acronymic
tricks of this sort. They give the appearance of slickness, I know, but
they really do help us to remember.) These normal procedures are used
whenever changes in our world require new policies in order to continue
normal life in accordance with our ordinary commitments.
Now consider the following cases:
- You are a physician called in to confer with the family of a terminally
ill man in a nursing home. He is conscious, in some discomfort, confused
much of the time. He will not get much better, but his heart is strong,
and he is not expected to die soon. His children (his wife is dead)
are distressed at the length of time it will take him to die. They
would like you to inject a fatal dose of morphine to hasten death,
on grounds that his estate is being eaten up by the medical and nursing
home costs.
- You are the production manager of a pharmaceutical company under
a lot of competitive pressure. Your boss suggests that you could
double productivity if you filled half the penicillin ampules with
saline solution instead of penicillin. To be sure, the patients wouldn't
get the penicillin prescribed, but most penicillin prescriptions
are unnecessary anyway, so probably it wouldn't do anyone any harm.
In practice, cases A and B would probably not call forth any high-level
moral reasoning. They are for you, we may suppose, new cases; but the
Assumptions that have always worked for you will work here. Physicians
do not kill their patients; children do not kill their parents to accelerate
the inheritance; you do not deliberately adulterate product runs or market
trash under a product's label. The answer is No; if asked for reasons,
the normal ADAPT-level reasons will do: most basically, "That simply is
not done, or not acceptable"; more personally, "I couldn't sleep nights," or, "I
couldn't look at myself in the mirror when I shave tomorrow, if I did
anything like that"; more spiritually, "My religion forbids me even to
consider anything like that"; or more ominously, "I don't look good in
stripes. And neither do you." The moral rules that back these up are clear
to all: practice medicine only for the benefit of the patient; never tell
lies, especially to customers.
Principles and reasoning based on consensus morality are not always
in such good shape. Recall the Third Reich, and the fact that in Germany
in Hitler's time, it was accepted practice, and in accord with the religious
intuitions of the leaders of the country, and definitely in accordance
with law, to kill Jews wherever you found them (in an orderly manner,
of course). That is why we have to know ethics; to know when the principles
and reasoning that we ordinarily use need to be re-examined, criticized,
and maybe changed-- to know, in short, when ADAPT is not sufficient.
Materials prepared by Lisa H. Newton, Ph.D. 1998
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