Ethical Dilemmas Research Paper

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1. Ethical Dilemmas In Moral Theory

1.1 Causes And Kinds Of Dilemmas

Dilemmas appear in situations where (a) moral principles seem difficult to apply to the case at hand, or (b) where various moral principles clash and/or do not guide action.

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As to the first case, ethical dilemmas arise due to an epistemic uncertainty like risk assessment or evaluation of the ethical implications of scientific and technological change and/or due to conflicting obligations in light of the new technological advances that support different courses of action. Two kinds of ethical dilemmas can be distinguished: an agent faces conflicting obligations which he cannot both fulfill, and neither obligation is overridden: he ought to do A and he ought to do B, but cannot do both A and B. For example, a father is unable to rescue both of his children from a burning house. He has an obligation to rescue his first child, and he has an obligation to rescue his second child, but neither obligation outweighs the other. Or, moral reasons speak equally for and against an option with respect to different features of that option: and agent ought to do C and ought not to do C. A doctor, for instance, who has an obligation to provide medical assistance, faces such a dilemma if his help implies a questionable prolongation of a patient’s life that might be difficult to assess. No matter how the person in moral dilemmas acts there will be moral losses.

In the second case, an ethical dilemma is due to disagreement about which moral convictions and principles like ‘maximize the expected utility’ or ‘treat a human being as an end in itself’ apply to the case. Thus, there is a deeper difficulty about the application of moral principles to practice, if there is disagreement about the principles or if there are several principles that are applicable to the respective case and yield different solutions. There is no standard way of weighing the contending principles in order to decide which predominate in specific cases. Such dilemmas constantly arise in medical practice where it is difficult to assess whether life-saving treatment regards the patient as an end in itself, and should therefore be provided, or whether it disregards patient interests and values.




1.2 Epistemic Dilemmas

Ethical theorists have concentrated on the question about which there is widespread disagreement whether ethical dilemmas can be solved. Some have tried to tackle the problem of moral principles that, if jointly applied, lead to inconsistencies. Two principles are inconsistent, if they cannot be both fulfilled.

Two moral principles in particular are alleged as being unable to guide action in light of seemingly conflicting obligations. (a) The so-called ‘agglomeration principle’ entails that an agent S is obligated to do A, and is obligated to do B, and therefore is obligated to do both A and B: [(OA & OB) →O (A & B)]. (b) The principle of deontic logic ‘ought implies can’ infers from the premise that an agent S is obligated to do both A and B that the agent can do both A and B: [(O (A & B)→c (A & B)].

These two principles contradict the standard definition of ethical dilemmas according to which an agent is obligated to do A, and is obligated to do B, but cannot do both A and B. Some theorists have tried to differentiate between prima facie obligations and all things considered obligations in order to show that not every obligation requires to be acted upon. A so-called deliberative ought (B. Williams in Gowans 1987) is supposed to help us decide which obligation overrides a seemingly conflicting obligation by referring to stronger reasons (P. Foot in Mason 1996). Dilemmas are thus described to be merely ‘epistemic.’ Moral principles are shown to be consistent by distinguishing between preliminary and final (R. M. Hare in Gowans 1987) or general and specific (A. Donagan in Gowans 1987) principles. According to R. M. Hare (in Gowans 1987), for example, conflicting prima facie duties are selected on a ‘critical level’ with the help of actutilitarian considerations. A generally accepted rule might thus be overridden in light of the case at hand. A. Donagan (in Gowans 1987) proposed to specify principles with additional premises in order to provide exceptions to such principles if they seem to be justified. A promise, for example, can be broken if a more urgent and morally defensible action calls for it.

1.3 Are Dilemmas Genuine?

Even though many ethical dilemmas might be solved in such a way, there still remain cases in which no ‘deliberative ought’ can show which prima facie obligation outweighs the other. Furthermore, it can be maintained that even obligations that are supported by less weighty reasons might still remain in force and do not cease to obligate. There are three arguments that try to support the hypothesis that ethical dilemmas can be insoluble. (a) So-called residual emotions like regret that agents express after a choice between conflicting obligations are purported to show that the obligation not acted upon remains in force like an unfulfilled desire (B. Williams in Gowans 1987). (b) Conflicting oughts are considered to stem from plural sources of value, e.g., obligations, rights, utility, perfectionist ends, and commitments. Hence, if values (and also moral principles) are plural, dilemmas seem to be unavoidable (T. Nagel in Gowans 1987). (c) Feelings of guilt that agents display after a difficult choice are taken to motivate the avoidance of conflicts in the future. They show that dilemmas are real (R. B. Marcus in Gowans 1987; in Mason 1996). As to the solution of dilemmas the considerations of ethical theorists are also constantly challenged in light of the practical problems that technological research, for example, poses.

2. Ethical Dilemmas In Scientific Research

2.1 Risk And Technology Assessment, Professional Responsibility, And Moral Status

Ethical dilemmas arise in many areas of research, particularly where the development and use of new technologies challenges the application of moral concepts, or leads to conflict between moral principles and demand for their extension or further specification. Thus, for two conflicting courses of action different moral arguments, rules or principles can be equally compelling, or their moral costs are difficult to assess. This pertains to problems of risk and technology assessment, the scope of professional responsibility, and to questions of autonomy and the moral status of those affected by these technologies. Ethical dilemmas typically arise in the controversies surrounding life-saving technologies at the beginning and end of life, life-enhancing technologies to improve the quality of life, the technologies of reproduction, and genetic engineering.

Technological and risk assessment can be dilemmatic in the following way: in the early stage of a technological development, when it is still relatively easy to control its direction, there is an inevitable lack of knowledge to exercise reasonable control; by the time more experience and better understanding of the risks involved is gained, the technology has often developed so much social momentum that it is almost impossible to control it (Collingridge 1980).

The responsibility of scientists can be said to consist of the pursuit of truth in their own area of competence, for wielding social power appropriately, and for making their results generally accessible. Professional responsibilities can lead to moral conflict if, for example, research results and/or the effects of technologies have a potential to endanger others. For example, scientists can have a duty to pursue truth, and they can equally have a duty to avoid harm, and they might not be able to fulfill both. The justification of scientific investigation can only be provided from within scientific research, since expertise is needed to evaluate it. This can undermine social control of research (Erwin et al. 1994).

The application of moral principles to practice also sheds light on the question who or what has autonomous moral status with regard to fetuses, those in permanently vegetative states, members of future generations, animals, and inanimate nature. For example, is research on human embryos permitted in order to foster medical therapy and relieve suffering or do we also have obligations to embryos? Particular moral uncertainty is thus engendered by contexts that demand divided allegiances.

2.2 Ethical Dilemmas In Biotechnology

The far-reaching potential advances in gene therapy and genetic engineering for humans (The Human Genome Project), and the implications for humans of cloning, have given rise to ethical dilemmas scientists have to face. The following examples can illustrate how progress in genetic engineering generates dilemmas between conflicting obligations and/or conflicts due to risk assessment (Chadwick 1992).

The identification of human genes, for example, can lead to the following conflict: on the one hand genetic knowledge enhances therapies for hereditary disease, on the other hand, it poses problems about the potentially exploitative use of resources and genetic information. The attempt to sequence the entire human genome raises ethical questions whether the risks of exploitation outweigh the benefits of knowledge.

Genetic alterations passed on to future generations through so-called germline therapy raise further problems regarding consent while, at the same time, ‘improving’ human genetic potential for future generations. Do we have an obligation to present generations to relieve suffering by seeking treatments for genetic disease or do future generations have a right to an unmodified genetic inheritance? Equally, the advantages of genetic screening can be outweighed by the costs of stigmatization on the basis of a person’s genetic make-up. Such individuals might find themselves unemployable or uninsurable. There also arises the question whether the very existence of genetic screening can exert pressure on individuals with regard to their reproductive decisions, thus impairing their autonomy. How can genetic public health be fostered without practicing eugenics? Arguments about the moral urgency of relieving suffering also conflict with arguments about human dignity that discredit the production of ‘designer babies’ (Annas and Elias 1992).

The incorporation of foreign genes into the genome of an organism is commonly discussed in connection with animals and plants. One dilemmatic issue concerns the interests of the host organism (particularly in the case of animals), the consequences for human health and for other species, and the risks of releasing genetically engineered organisms into the environment.

A related issue has been the matter of justification of treatment. Animal experimentation poses the question whether animals have moral status to the detriment of life-enhancing research results for humans. As subjects of genetic engineering, for example, farm animals have suffered from unintended deleterious effects, while research animals have suffered the consequences of being intentionally bred for propensity to develop debilitating diseases. A further important issue is related to the question whether an agent who had moral status can cease to have that status. The human cases of the brain dead, anencephalic infants, and those in a permanently vegetative state are cases in point. If so, then the case of xenotransplantation or the transplanting of animal organs into humans is affected. The interlocking questions of moral standing, justification of treatment, and loss of moral considerability can thus cause conflicts as to which consideration should be given more weight. Ethical dilemmas in research are thus a challenge to those within and those outside research, to debate whether research practices and their effects are right and just.

2.3 Limits To The Application Of Moral Principles

Moral rules and principles do not only have to be adapted to the specific circumstances at hand. They also have to be questioned in light of practice. However, in many of the cases that feature in research ethics, often times we do not agree in our moral principles or the moral theories by which they are justified. Even if the application of principles to cases can be specified and thus epistemic dilemmas resolved, there are limits as to what the application of principles can do to resolve dilemmas: the basic problem of dilemmas remains at least in one respect. There is no agreement as to how to balance between various conflicting moral principles in order to decide which predominate in a respective case. Intuitions vary widely, and various normative theories like utilitarianism, Kantianism, contractualism, virtue theory, and feminist ethics usually remain at odds with each other. It seems desirable to take into account as many considerations as possible on the level of principles themselves in order to highlight the various ethical implications of a case at hand. Not only questions of utility, but also questions of integrity and care can thus be given more weight. Further work, however, needs to be done at the level of ethical theory itself to set out how various principles derived from different normative theories can be balanced.

Bibliography:

  1. Annas G J, Elias S (eds.) 1992 Gene Mapping: Using Law and Ethics as Guides. Oxford University Press, New York
  2. Beauchamp T L, Childress J F 1994 Principles of Biomedical Ethics, 4th edn. Oxford University Press, New York
  3. Chadwick R F 1992 Ethics, Reproduction and Genetic Control. Routledge, London
  4. Collingridge D 1980 The Social Control of Technology. St. Martin’s Press, New York
  5. Erwin E, Gendin S, Kleiman L (eds.) 1994 Ethical Issues in Scientific Research. Garland, New York
  6. Gowans C W (ed.) 1987 Moral Dilemmas. Oxford University Press, New York
  7. Mason H E (ed.) 1996 Moral Dilemmas and Moral Theory. Oxford University Press, New York
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