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Hi Everyone I am interested in the exchanges between Gregor and Erik (and others) over ethics. I am working for a systems advocacy organisation (QAI) that does advocacy for "the most vulnerable people with disability" in Qld Australia. I do what is known as bioethics advocacy work. Naturally enough I spend a great deal of my (thinking) time thinking about ethics frameworks. Those of you working in this area of ethics will no doubt be aware that most of the ethics practised is usually just a glossy justification for abuse and the eventual elimination of those named as "having disability". Hence the concern over the writings of Singer, Kuhse, Fletcher, Harris, James Rachels, Stuart Rachels, and other utilitarians. One problem is that "quality of life" ethics is foundational in secular utilitarian decision making, and justifies treating some people as having greater value than others. Another problem is that "sanctity of life" ethics has become the well meaning face on religious utilitarian decision making. According to a Catholic bioethicist I know, Catholic morality is teleological. In Catholic hospital settings, teleology translates into utilitarian practice, not altruism, as is commonly supposed. Here lives are eliminated also, but they are not eliminated because they are not valued. They are eliminated because eliminating them is the "unintended" consequence of decisions that "on balance" provide the most benefit. So neither formulation provides a satisfactory basis for ethics as people with disability are always disadvantaged by utilitarianism. (They are the "minority" that the "greatest good for the greatest number" does not cover.) Deontological principles do not always help either. Deontology presupposes that the subject is rational and autonomous (or is making sufficiently "normative" headway in that direction). Those of us who cannot always claim to be so are inherently disadvantaged here. The alternative to principalism (whether it be deontological or teleological) is a process approach to ethics. However it must be a process that declares itself. One of the problems with principalism is that it espouses impartiality. In medical settings impartiality becomes partiality against the lives of people with disabilty. (I have written a paper on this which I delivered at the Aust. bioethics conference in Hobart in 1998.) The partiality I espouse is on the side of the vulnerable and the oppressed. This entails that people with disability, if they are to use this approach will have allies in the feminist movement for example. There are some very interesting writings by disabled women that have great relevance to bioethics for instance. There is an unavoidable transition here in ethics towards relativism and away from absolutism. This simply means that we speak our stories from a limited perspective. Yet we do not countenance abuse and oppression. Neither do we allow ethics formulations that justify the "unintended" harm to people with disability. Lack of intention is no excuse, and therefore the doctrine of "double effect", for instance, is looked on with suspicion. If we adopt a process ethics however, we have made a critical transition from the purely theoretical level to the engaged level. There cannot be process ethics without engagement, and therefore commitment. We will discover opposition from people espousing an ethics that requires detachment, the view of the "archangel", as RM Hare put it. I have a couple of discussion papers ready if anyone is interested. One is entitled "Collaborative process ethics in the lives of people with disability." The other is entitled "Genetic counselling and the search for an ethical process." David Turnbull Bioethics Advocacy Worker Queensland Advocacy Incorporated At 12:34 3/09/99 +0800, erik leipoldt wrote: >Hi Gregor, > >Why is "the demise of the sanctity of life ethics not the angle to be used >by disability groups"? If any disability group had sanctity of life (or >any other articulated ethics) as their value base I cannot see why they >should not advance arguments based on their beliefs. I can see political >reasons why one would think disability groups should not argue on sanctity >of life ethics, including not wanting to be (further) marginalised as >'right-to-lifers' and 'religious nutters'. However that is not to say that >sanctity of life ethics is necessarily out of date, indefensible or not >good ethics. Secular arguments may be more comfortable and >non-metaphysical, if you like, but are no more or less valid than other views. > >The difficulty with saying that we can use "the replacement of sanctity of >life ethics by quality of life as determined by others", if I understand >you rightly, is that no alternative view is put up. We have to have something! > >Currently we have (understandable) confusion. Unless the "disability >movement (and, after many years I still do not really know what that >means), and others wanting to address end-of-life issues, develop a >coherent value base around end-of-life matters it will not be successful in >countering views such as Singer's and Fletcher's. I see that disability >organisations are themselves torn between a choice argument in favour of >women who want an abortion and wanting to oppose euthanasia on utilitarian >grounds; between seeing end-of-life issues as 'private matters' or as >impacting on the wider (disability) community; between a belief in >individual autonomy (independence) and belief in importance of >relationships and interdependence; between a purely social disability >construct and relevance of dependency and vulnerability and so on. > >It will be important to reflect on who may eventually pay the real cost of >this constipation. > >So there is a big task here to come up with a comprehensive value base from >which end-of-life issues can be dealt with from a disability perspective, >without expecting that necessarily everyone will agree with it. In doing >this we may in the end find we come up with nothing 'new' but will be more >grounded for having done so. > >Maybe an international (e-mail) working group could work on this and draft >something up. For a start, I found the following article on various >ethical frameworks helpful: Velasquez, Andre, Shanks, Meyer. "Thinking >Ethically: A framework for moral decision making. >http://ecco.bsee.swin.edu.au/studes/ethics/Framework.html > >Erik Leipoldt > >At 07:11 02/09/1999 -0600, you wrote: >> >>Hi Michael, >>indeed the demise of the sanctity of life ethics is not the angle to be >>used by disability groups. THe pro life groups can do that. But the >>replacement of that ethics by quality of life ethics as determined by >>others that is an angle we can use >>And other groups can use other angles e.g. that Singer says that the >>fetus/embryo is human life (see my quotes send before) and therefore women >>already put forward the idea not every human life is equally worthy of >>protection during their abortion rights campaign (women rights against >>fetus rights)and therefore that that has an impact as to how we have to >>look at infanticide that line of thoughts should be of interest to >>women/feminists. > >>PS BTW we should not loose sight of that Singer is only one with these >>views. > Queensland Advocacy Incorporated, Suite G2, Ground Floor, Brisbane Transit Centre, Roma Street, Brisbane Queensland 4000 Australia Telephone: +61 7 3236 1122 Fax: +61 7 3236 1590 Email: [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%