Doing Ethics

When my dad at age 90 suffered a stroke that left him paralyzed on his left side and unable to swallow, but alert and able to talk, he chose to have his IV removed in order to let nature take its course. He said that he had lived a full life, was ready to die, and didn’t want to be kept alive by machines when his body couldn’t care for itself.

His death took four days. He was not on medication for pain, and by the second day he was unable to speak. By the third day he was unconscious. About thirty minutes before he died, his breathing slowed, with a long pause between each deep breath. I recited psalms and prayed for him, until he was still.

At his memorial service I shared with other family members and friends of my father that I was moved by the way my father faced death. He wasn’t afraid or depressed. He was grateful for his family and for the years he had lived, and he saw accepting his death as a way of expressing his gratitude for the gift of life.

In the university ethics class I teach, I mention my father’s death when we discuss health care, because it illustrates the right of a patient to withhold consent for medical treatment. In the 1990 Cruzan decision the US Supreme Court upheld this right, citing a “liberty interest” in the 14th Amendment of the Constitution and the common-law tradition supporting the right not to be touched by another person without consent or legal justification.

International law also supports the right of informed consent, which creates a duty for those providing health care to adequately inform patients of their condition, possible treatment, and their right to consent or decline treatment.

The story of my father’s death illustrates why Catholic moral teaching requires only health care that offers a reasonable hope of benefitting a patient and is not excessively expensive, painful, or inconvenient. This “ordinary” care is distinguished from “extraordinary” care. Catholic teaching supports using medication for a terminally ill patient to reduce suffering even if this may shorten the patient’s life. For medication is ordinary care and, if it hastens death, this unintended consequence does not outweigh the duty to reasonable means that are not excessively expensive to alleviate suffering.

My father was not Catholic, nor am I. But as a senior now, I support limiting health insurance to coverage for ordinary medical care, and I urge other seniors to do the same for the sake of the common good. We can help those who are younger overcome their fear of death by facing this fear ourselves. We should support health care as a human right for all, which is Catholic teaching and international law as well, but we should also affirm our right to decline medical treatment. And when treatment is very costly and offers only a short-term benefit, why not affirm life by accepting death?

With hope...Bob

Labels: death, health care

President Obama's speech at Notre Dame's graduation included a call (and a pledge) for open hearts, open minds, and fair-minded words when we address our differences and look for ways of working together.

In that speech Obama reflected on his work as a community organizer in Chicago where he was "touched by the words and deeds of men and women" he worked with from many Catholic parishes. "I'd like to think," Obama said, that in our community service "we touched the hearts and minds of the neighborhood families whose lives we helped change. For this, I believe, is our highest calling."

Obama's fair-minded words at Notre Dame about the moral debate over abortion offer us a model for doing ethics. Finding common ground and making real progress in addressing moral issues and creating greater justice requires respect for those with whom we differ. And "fair-minded words" are one way that we manifest this respect.

With hope...Bob

Labels: abortion, obama

In an op-ed piece published in The Washington Post on March 2nd, E. J. Dionne Jr. argues that Obama is right to try to correct the growing economic inequality in the US. Dionne quotes Peter Orszag, Obama's budget director, who points out that: "Over the past two or three decades, the top 1 percent of Americans have experienced a dramatic increase from 10 percent to more than 20 percent in the share of national income that's accruing to them."

"The ethical measure of an economic policy," I argue in Doing Environmental Ethics, "is its contribution to the common good. This not only requires political decisions that protect the environment, but also economic policies that ensure a fair distribution of the economic benefits that are realized."

Obama's budget calls us to work for greater economic justice in the US.

With hope...Bob

Labels: economics

In Obama's recent interview with the Al Arabiya news network he said, "The language we use matters." This might be understood to mean simply that we should try to be as persuasive as possible in promoting our ideas. But in the context of this interview about relations between the US and Muslim nations, Obama is affirming a commitment to respecting others even when we may disagree with them.

Labels: virtues

In my first blog on hard choices I noted President Obama's assertion that the economic crisis wasn't simply the result of "greed and irresponsibility on the part of some," but a consequence of "our collective failure to make hard choices and prepare the nation for a new age."

Hans Morsbach, my brother-in-law and a successful businessman, responded with this comment: "Greed is a big part of the problem. The system allowed financial expert to collect commission on services of no value. Experts bundled mortgages of which they should have known that they were of less value than their label suggested. They did not care and just collected the service fee. When the bubble burst, they had their money and the taxpayers had to bail them out."

"Much of the blame rests with the SEC and Bush's failure to regulate. He preferred to think that no regulation was necessary as the free market would do it. He was wrong. Financial executives made millions (which are not recoverable) and the taxpayers pay the unearned income of the financial experts and also the shortfall of the value of mortgages mislabeled. The 'system' worked as the investment houses made money all along. It is like the Ponzi scheme which works smoothly until the market forces expose the problem."

I agree with Hans. Our economic system will not be responsible and just without effective regulation by the federal government. Ethics requires enforceable rules as well as encouragement and recognition of good conduct.

With hope...Bob

Labels: economics

Affirming that “our ideals give us the strength and moral high ground” to combat terrorism, President Obama today signed executive orders that will end the CIA's secret overseas prisons, ban coercive interrogation methods, and close the Guantanamo detention camp within a year.

I applaud the President's commitment to the rule of law. A chapter in Doing Ethics in a Diverse World is devoted to the war against terrorism and explains that the right not to be tortured is a human right under international law. The chapter also presents character and consequential arguments against the use of torture.

So, what should we do with the "bad guys" now being held in secret CIA prisons and at Guantanamo? Apply the rule of law. A prisoner of war is protected by the Geneva Conventions as well as US law. Anyone detained for allegedly committing a crime should be presumed innocent and tried in a court of law.

With hope...Bob

Labels: rule of law