Hanneke van Ravenswaay and Ben Jurna, “Moral Dilemma … Can Ethics Help?” (1998)
This episode of “The Examined Life” investigates a moral dilemma faced by a young couple in Holland: they have just had twin boys, born prematurely at 26 weeks, and one of them is barely surviving and needs artificial respiration. He is barely a few days old and already has suffered two brain haemorrhages, one in each hemisphere of the brain. Hospital doctors believe that the probability that he will be severely handicapped is very high. The choice the couple and the doctors face is whether they should save the child, who most likely will need 24-hour care and will have a limited quality of life, or allow him to die. The young parents are uncertain as to what to do and their distress is obvious.
The program considers three theories of ethics as ways to a solution: Kantian ethics, utilitarianism and Aristotelian virtue ethics. Immanuel Kant’s ethics argues for the child’s interests and asks if we are acting with good intentions towards the child and considering his needs when deciding whether to prolong his life (and perhaps his suffering and pain) or to end it. As the child is in no position to act morally and rationally as to his fate, we must have his welfare in mind and act compassionately. Utilitarian ethics emphasises the consequences to the child’s family, community and society if we save the child’s life or allow him to die: saving the baby would mean enormous sacrifices the parents and other child would have to make to accommodate his needs, and there would be a cost to society as well in the form of allocation of funding and resources away from other groups and individuals who also need long-term medical care. Virtue ethics asks whether the decision we make is likely to be detrimental to the moral character of the parents and doctors who have to make that decision, whether it will strengthen them or debase them as human beings.
No easy answers, no right or wrong answers are to be found: the theories here point out what criteria people should use on which to base decisions and actions that will have long-term or irreversible consequences. There are strengths and weaknesses in all three approaches to the problem. Kantian ethics and virtue ethics can’t tell people what they should do; these philosophies only advise people to examine their consciences and reasoning and defend the decisions the make. Utilitarian ethics appears to provide an answer but the morality behind it seems unsavoury, as though the choice were purely a kind of business transaction.
As an introduction to the use of philosophy and three approaches to ethics, and how these can help people in situations where they have to make important decisions whose execution can’t be reverse and which will have ongoing consequences for an entire life-time, “Moral Dilemma …” is a very useful tool; it is structured and presented clearly and the program is impartial as to which ethics approach to use. It is not sentimental though it is sympathetic to the couple and doctors caught up in deciding whether a baby should live or die.