This last Friday New Wine, New Wineskins had bioethicist Robert Potter on-campus to help us think through what it means to do ethics, especially in regards to making healthcare decisions. Robert was a medical doctor for many years and has his Phd. in ethics and theology so he’s no lightweight in this area. And he wears bowties so you know he’s smart.
I wanted to reflect a little on his discussion with us. Much of the below material comes directly from his work.
What Does Ethics Do?
Robert started us out by asking “What does ethics do?” Well, for some ethics is the study of what people think is right and wrong. When we do ethics we’re attempting to describe how people go about deciding about actions and values. This type of thought tends to be judgment-free. It’s good and necessary study, but it’s not what Potter is after.
For him, ethics is a “practical tool for preventing, solving, and coping with life problems.” When we’re doing ethics we’re doing something can and will change the world around us. How we go about choosing between right and wrong actions has material results. If we’re gonna get ethical then we’re attempting to deal practically with life problems.
Preventing, Solving, and Coping with Life Problems
The role of an ethicist is to prevent, solve, and cope with life problems, Potter told us. When we do ethics we consider the future, present, and past problems of life. First, we must be responsible for the future and seek to prevent life problems. Second, we have to solve the problems that we can’t prevent, didn’t know were coming, but are here now. Finally, in ethics we have to think about how we’re going to deal with life problem that came before or that we’ve already gone through. We have to circle back and cope with the things that have gone wrong.
In an ethical situation where multiple parties and values are involved, ethicists have to help those whose values did not “win out”. Life is complicated. People disagree. They’re are going to be those who don’t feel appreciated or like their concerns were taken care of. When this happens ethicists help people cope.
Facilitate, Mediate, Advocate, Comfort
How do ethicists prevent, solve, and cope with life problems? Well, Potter thinks that ethicists do so by acting in four roles, and by asking three ethical questions. First the roles and then the questions.
Ethicists act as facilitators, mediators, advocates, and comforters.
People need the space and listening ear to make decisions. They also need questions from outside to deepen thinking. Ethicists provide that safe space, listening ear, and inquisitive spirit as a “facilitating guides” in moral deliberation.
When there is a conflict of values people need dialogue. Sometimes we can’t think of some of the options that might come before us. Or we don’t know how to respond. Ethicists start dialogue between parties, can identify options, and help people create responses to an ethical dilemma as “mediating helpers”.
Sometimes we need people to stand in for us. A policy might effect us in the way it wasn’t meant to. Harm might happen that could have been prevented, or after harm has happened in needs to be corrected. Ethicists work to change policy, performance, and outcomes that might cause harm, or to prevent/correct harm in other ways, as “advocating voices”.
Finally, life problems often present moral distress and suffering. Ethicists can help share this moral distress, stand in solidarity, and look towards better solutions in the future as “comforting presences”.
Three Ethical Questions
After detailing the four above roles of ethicists, Potter detailed three questions that we must ask as we encounter life problems.
1. “What is going on here?”
2. “What ought we to care about?”
3. “What is the fitting response to what is going on?”
Potter talked about how often in moral dilemmas and upon meeting life problems we only focus on the first and last question. In the medical field these questions are thought about as “diagnosis” and “treatment”. What’s missing is an element of contemplation and explication. Once we know what is going on we can form a fitting response to it. But we have to be careful not to miss the middle question: “What ought we to care about?” We might be able to identify what is going on in a situation, but without asking what we should value we might have an inappropriate response. By making explicit what we should value in a situation we ensure that our response is appropriate. Often it is in the explication of values that we find disagreement. Part of our “fitting response” has to take into account the people whose values weren’t given priority.
Rocks and Hard-places
The bulk of our time with Potter was spent going over several case studies in light of the above. As an MD and ethicist Potter has been involved in a number of ethical dilemmas, especially at the end of life. It was incredibly helpful to walk through the cases with him. What came to light is that dealing with life problems is not easy. We need to be informed, thoughtful, inquisitive, and realize that there are so many factors to consider. People’s values are going to come into conflict. We’re going to run into blind-spots. Rocks and hard places.
But as Christ followers are we willing to take the time, effort, and energy to help people as facilitating guides, mediating helpers, advocating voices, and comforting presences? I think it’s what we’re called to. Importantly, we have to be willing to do so beforehand, and be prepared. This means leaning into the Scriptures, being in prayer, attending to wise voices, seeking out the margins, considering others values, etc. Ethics is a practical tool. The more we delve in the better at it we’re going to be. Are we willing to explore the hard questions?
In light of the above, I’ll leave you the way Potter left us, with some much-needed but difficult questions:
“Which is more important? To live a difficult life, or to let life stop? Does the Christian ethic allow for death? Should we protect life at all costs? Can we protect life and at the same time increase suffering?”