Bio Ethics PHi 324

THIS CHAPTER INTRODUCES the virtue-based ethics that Aristotle first developed in the fourth century B.C.E. and Aquinas retrieved in the thirteenth century. It will explain the starting point and then the three primary ideas of this ethics: happiness, moral virtue, and prudence. The starting point is the deeply rooted desire of human beings to achieve what is truly good for themselves; selves; the best good is happiness, the best chance of achieving personal happiness is developing authentic moral virtue, and the best way to decide what will develop moral virtue is prudence. This chapter develops these four topics. Before we begin we need to make a preliminary remark about terminology. In this book the terms "ethics" and "ethical" will be used interchangeably with "morality" and "moral." Some authors distinguish ethics and morality, but we will not make that distinction. Both words share a common etymology: What the Greek language called "ethics," the Latin language tended to call "morals," and both roots now appear in our English language. Also, it will be helpful to note that what the Greek language called the "character excellences," the Latin language called the "moral virtues," thus showing how the moral virtues pertain to what we often refer to as character integrity or good character. In addition to the moral virtues philosophers writing in both Greek and Latin identified an "intellectual excellence" or a "cognitive virtue" that also plays a major role in virtue ethics. THE GOOD WE SEEK Ethics begins, according to the ancient Greeks, when a person wonders how her life should be lived. How should we be living? What should we be trying to achieve? What should we be aiming for in our lives? These questions are the existential and practical questions almost every thoughtful person inevitably asks. Aristotle's answer begins with the opening sentence of his Nicomachean Ethics: "Every skill and every investigation, and likewise every activity and choice, seem to aim at some good; hence the good has been well described as what all things aim at." No reasons can be given to explain why "every activity and choice seem to aim at some good." That they do is simply, for Aristotle, a given of our experience. Although the immediate aim of our actions and choices is a particular good, we can also think of aiming at an overall good for our lives as a whole. This overall goal is the subject matter of ethics. Ethics clarifies this overall goal and then shows what feelings and behaviors are likely to achieve it in our particular lives. And what is the overall goal we desire above all for our lives? It it nothing less than making our lives, as a whole, good lives. We do not simply desire life-we desire a good life. We do not simply want to live-we want to live well. We do not simply want to be-we want to flourish. Recognizing that the best good we can aim at is making our life as a whole a good life is the starting point of this virtue-based ethics. Aristotle called this starting point the first principle of ethics. Be careful of the word "principle" here. It does not mean what the word "principle" means in modern ethics, in which principles are understood as action-guides deduced from a moral theory or induced from a line of previous moral judgments in similar cases. The first principle in the ethics of the good is the absolute beginning, the foundation whence all else is derived. We cannot prove this first principle; nor can we give any reasons for it. There are no proofs or reasons for first principles. The word "principle" (principium in Latin and arche in Greek) means beginning, and no reasons can be given to establish the "beginning." If there were reasons for a beginning, the reasons would come logically before the beginning, and then the beginning would then no longer really be the beginning. Both Aristotle and Aquinas agreed that first principles of reasoning are not provable but self-evident. They are self-evident because we soon realize we cannot reason if we do not accept them. Aristotle was the first philosopher to develop first principles in both theoretical reasoning (the reasoning in what he called science-physics, mathematics, and theology) and practical reasoning (the reasoning we use when we are making or doing something). The best known first principle of theoretical reasoning is the principle of noncontradiction: You cannot think something both is and is not at the same time. You cannot, for example, think something is both a square and not a square; that is, you cannot think

something is a square circle. The principle of noncontradiction is so powerful that Christian theologians did not hesitate to say it restricts God. The God of Christian theology is all-powerful, but He cannot create a square circle or a circular square. The first principle of any practical reasoning is the principle of the good-our choices aim at something we perceive as good. The first principle of the practical reasoning known as ethics is that our choices aim at whatever is good for our lives, whatever helps us flourish as human beings. This ethical good is intensely personal. The "good" Aristotle and Aquinas are talking about in ethics is your good and my good. Aristotle and Aquinas are trying to show their audiences what makes their lives good lives. Hence, if you join their audience, it is your good, your living well, that is meant when they speak of "the good." It is also a shared good, the common good, because both philosophers considered human beings not only personal beings but essentially social beings as well. People do, of course, disagree on what above all makes a life good. Some say the overall good in life is money and property, others say it is pleasure, some say it is power, and still others say it is honors and recognition. Certainly money, property, pleasure, power, honors, and recognition are good, but are they the best goods we can aim at or desire for our lives as a whole? To answer that question ask yourself whether a person could achieve these goods and still not be living a life you would consider good overall. Certainly money, pleasure, power, honors, and recognition are desirable goods, but they are at least arguably not the most desirable goods achievable able in a human life. The first moral philosophers thought that the most desirable overall good was something else, and, despite variations in their accounts, they generally agreed on what it was. They called the best good we can desire for our lives eudaimonia. The word has no exact equivalent in English-literally literally it means something like "good fate," but "happiness," or perhaps "flourishing," is probably the best translation. The Greek ethicists began with the idea that the overall good any thoughtful person would desire for his life is his happiness. A human life is successful if it is a happy life. HAPPINESS Happiness, of course, is a very general and vague term that can be understood in many different ways. Hence the challenge now is to explain what is meant by happiness. And the challenge is a demanding one for two reasons. First, human life is complex and supports many different ways of achieving happiness. And second, happiness is somewhat paradoxical in this sense: We achieve happiness not by aiming at it directly as if it were a concrete objective but by pursuing the concrete feelings, behaviors, and habits that make a life happy. We begin our explanation ofhappiness by saying what it is not. What Happiness Is Not First, we do not equate happiness with feelings of pleasure and the absence of pain. Pleasure may well accompany happiness, but this is not necessary, and as is well known pleasure can mislead us about what is truly good and thus undermine our happiness. And the presence of pain, although unpleasant, does not necessarily indicate that we are doing something bad. The identification of happiness with feeling pleasure and avoiding pain has a long history going back at least to Epicurus (342?-27o B.C.E.) and his famous cloistered garden outside the walls of Athens. In modern times Thomas Hobbes and Jeremy Bentham, both important political philosophers, were leading proponents of reviving this notion. But feelings of pleasure cannot be equated with happiness understood as what is truly good for ourselves, because pleasure often distracts us and sometimes leads us toward what is not truly good. Second, we do not equate happiness with the satisfaction of whatever desires a person might have. Happiness is not getting what we happen to want at the moment but achieving a good life. Sometimes a particular thing we want is not good for us, and getting it will not bring us happiness despite our thinking that it will. Third, we do not equate happiness with whatever a particular person believes it to be. A person might believe happiness is living promiscuously and so live this way, but his belief that he is happy does not provide the happiness of which we speak because such a life is not truly good for human beings. The word happiness designates what is truly good for a person, not what the person believes is good or brings happiness. In an ethics of happiness, the simple fact that someone declares he is happy is not enough for us to say he has achieved happiness; it must also be shown that he has achieved what will truly bring happiness-that is, a good life. It is always possible for people to think that they are living fulfilling lives when in fact they are not. People afflicted with Down syndrome, for example, often seem more happy and content in life than many other people, but no Greek moralist would have said such a life was a good life, something any rational person would deliberately seek. Happiness Is Agent-Centered Making personal happiness the starting point and goal of ethics could easily suggest something close to narcissism, egoism, individualism, or a crass "looking out for number one," but it should not. Any understanding of personal happiness implying selfishness is incompatible with a credible morality. Sensitivity to this threat of egoism or selfishness is at least partly the reason why many modern moral philosophers and theologians have proposed something other than personal happiness ness as the foundation of ethics-perhaps rights, or principles, or an altruistic Christian life of self-sacrifice. sacrifice. These modern theories are so influential that many people have forgotten the blunt appeal to personal happiness in earlier philosophical and religious ethics. Although the ethics of Aristotle is typical and perhaps the best-known ancient morality grounded in personal happiness, his understanding of ethics was not unique in the earlier centuries. Just about every philosopher and religious leader of the time proposed personal happiness as the goal of morality. Consider two examples, one from Plato (427?-347 B.C.E.) and one from the Christian tian scriptures (ca. 6o-ca. ioo). In the beginning of Plato's The Republic, a man named Thrasymachus insists that there is no good reason for being ethical or just: "The just man is always a loser, my naive Socrates. He always loses out to the unjust" (343D).

human being she was before the others were removed. Since human existence is a coexistence, if the existences of others are undermined, so is mine. Human being is social being; my being is a being-with-others. Once we understand ourselves not as discrete atomic entities related to others by some kind of social contract we decide to embrace, but as existentially interconnected with others in the very being we call human being, then the tendency to understand an ethics advocating personal fulfillment ment and happiness as selfishness is derailed. If my life is always a life-with-others, then my happiness and flourishing is always entwined with the happiness and flourishing of others. If my existence is a coexistence, then it is impossible for me to flourish at the expense of others. Treating them unjustly or insensitively undermines my good as well as their good. Understood in the framework of its origination, where human beings were thought of as essentially social beings, an ethics of personal happiness is anything but an ethics of selfishness. The happiness of any human being is the happiness of a social being, not of a discrete individual. This is why, for Aristotle, the study of ethics-how I go about making moral decisions-is only a phase in a larger study, a study he called politics. This can be difficult for the modern mind to understand because the modern approach (whether influenced by the liberal political philosophies extolling individual rights and liberty but neglecting community or by the more conservative political philosophies extolling family and communitarian munitarian values but neglecting the important modern values of liberty and self-determination) assumes the dichotomy of self and others, of individual and community, and then opts for one over the other. But it is anachronistic to place the ethics of personal happiness developed by Aquinas or Aristotle in the modern conceptual framework that dichotomizes the individual and her societies and then to criticize it. The familiar dichotomies of egoism and altruism and of self and community were, in the forms we experience them, unknown to earlier moralists. They never hesitated to claim that acting for the sake of virtue was acting in our own best interest. Nor did they hesitate to claim that acting for the good of others was also acting in our own best interest. They simply assumed that human beings are political beings, that human existence is always a coexistence with others in communities. Hence an ethics of the good retrieved from Aristotle and Aquinas is not an ethics of the liberal self striving primarily for his happiness, nor is it an ethics of the communitarian self striving primarily for the common good; it is both. Living well has both individual and communal dimensions. sions. Speaking of my good is also speaking of the common good; speaking of my happiness is also speaking of the happiness of others; speaking of my flourishing is also speaking of the flourishing of my communities. Happiness Is a Collective Term We have said that the happiness we speak of in ethics is not simply pleasure, nor is it the satisfaction tion of whatever desire we happen to have, nor is it whatever we happen to think it is, nor is it anything selfish. What, then, is this personal happiness? What can we say about it? We can begin by saying that happiness in ethics is a collective term describing the right balance and coordination of all the important goods in a person's life. That is why it was described by Aristotle as the "complete" good. An analogy may help us to understand how a collective term is used. A rope is composed of, let us say, a thousand strands twisted together. The rope is not something added to the strands. We do not have a thousand and one things-the thousand strands and one rope-but the strands themselves constitute the rope. In a similar way, our happiness is not some additional good that comes as the result of achieving other good things in life. It is, rather, the life we call good because it combines successfully all the important elements and strands that constitute the human good. Happiness is not the reward gained after a life has been lived well but the good life itself. The good things in our lives come from two sources: luck and choice. Under luck we include any good thing we receive apart from our own effort. Some people prefer to speak of "blessings" instead of luck. By luck or blessings we may have inherited good health or happen to live in peaceful times with an abundance of friends and wealth, for example. Good luck and many blessings ings will certainly contribute to our personal happiness, but they are not the crucial factors. Luck will not by

itself bring us the personal happiness envisioned in ethics, and its absence will not preclude this happiness. Something else is much more important. The second and more important source of our happiness is the particular goods we choose to pursue as we live our lives. Aristotle noted but never organized, at least in the texts we have, the various good elements composing a happy life. Some later commentators did attempt some organization, however, and their schema is helpful. They identified three categories of goods according to the importance of their contribution to happiness. The categories are clear enough, although translating the ancient terms into English is somewhat awkward. The categories of goods constituting happiness, beginning with the most valuable, are these: •Noble goods •Potential goods •Useful goods Noble Goods These are the essential feelings, behaviors, and habits creating a happy life. By "behaviors" we mean actions as well as omissions (things you could do but choose not to do). By "behaviors" we also mean both private actions and omissions as well as a whole range of social actions and omissions sions with other people, interactions ranging from intimate love and friendship to all forms of social, political, and commercial relationships. Finally, by "habits" we mean acquired dispositions for feeling and behaving in certain ways. We develop these habits through constant repetition of the feelings and behaviors. The feelings, behaviors, and habits called the noble goods are the principal ingredients of happiness. We choose them for the sake of our happiness and, since they are also valuable in themselves, for their own sake as well. The Greeks called these feelings, behaviors, andhabits "excellent." The subsequent Latin word for them was virtutes, the etymological origin of the English word "virtues." The essential noble goods are the virtues. The ethics of happiness is a virtue ethics. Potential Goods These are goods providing us with opportunities to pursue the all-important virtues. They were called potential goods because they have the potential for contributing to the virtues and to happiness. ness. Some examples of potential goods are health, financial resources, pleasure, religion, art, music, science, charitable work, and almost any legitimate occupation. These are all goods that foster opportunities for virtue and happiness. These potential goods share one similarity with the virtues-we tues-we seek them for their own sake as well as for the sake of higher goods. They differ from the noble goods or virtues because, according to Aristotle, you need all the virtues for happiness but you do not need all the potential goods. Useful Goods These are goods sought not for their own sake but only for the sake of other goods, either the noble goods (the virtues) or the potential goods. An example of a useful good is an antibiotic: We do not take an antibiotic for its own sake but for the sake of a more valuable good-our health. Tools are another example: We do not buy a lawn mower for its own sake but for the sake of cutting grass. Useful goods are like tools that we need to accomplish something valuable. We do not seek them for their intrinsic value but for some other good we desire. Once we distinguish the major kinds of good, we can see how happiness, the most desirable good in a human life, is actually composed of several different categories of goods. Of these the most important are the noble goods (the virtues); then come the potential goods and finally the useful goods. The virtues play the major role in our happiness, but they need support from some potential and useful goods. Today the word "goods" seems a little awkward for the ideas just presented. It might make things more clear if we use the word "value" and recast the schema in terms of a hierarchy of values. The goal of life is happiness-making our lives truly good lives. The highest values are the virtues, and they are valuable both because they are the principal elements in happiness and because they have intrinsic value as well. Next in line after the virtues are things humans value for their potential to contribute to happiness and virtue as well as for their intrinsic value. Finally, at the lowest level, are the utilitarian values valuable only for their contribution to the higher values. Ancient commentators on this schema of goods and values all agreed that the best good we could pursue in a

itself bring us the personal happiness envisioned in ethics, and its absence will not preclude this happiness. Something else is much more important. The second and more important source of our happiness is the particular goods we choose to pursue as we live our lives. Aristotle noted but never organized, at least in the texts we have, the various good elements composing a happy life. Some later commentators did attempt some organization, however, and their schema is helpful. They identified three categories of goods according to the importance of their contribution to happiness. The categories are clear enough, although translating the ancient terms into English is somewhat awkward. The categories of goods constituting happiness, beginning with the most valuable, are these: •Noble goods •Potential goods •Useful goods Noble Goods These are the essential feelings, behaviors, and habits creating a happy life. By "behaviors" we mean actions as well as omissions (things you could do but choose not to do). By "behaviors" we also mean both private actions and omissions as well as a whole range of social actions and omissions sions with other people, interactions ranging from intimate love and friendship to all forms of social, political, and commercial relationships. Finally, by "habits" we mean acquired dispositions for feeling and behaving in certain ways. We develop these habits through constant repetition of the feelings and behaviors. The feelings, behaviors, and habits called the noble goods are the principal ingredients of happiness. We choose them for the sake of our happiness and, since they are also valuable in themselves, for their own sake as well. The Greeks called these feelings, behaviors, andhabits "excellent." The subsequent Latin word for them was virtutes, the etymological origin of the English word "virtues." The essential noble goods are the virtues. The ethics of happiness is a virtue ethics. Potential Goods These are goods providing us with opportunities to pursue the all-important virtues. They were called potential goods because they have the potential for contributing to the virtues and to happiness. ness. Some examples of potential goods are health, financial resources, pleasure, religion, art, music, science, charitable work, and almost any legitimate occupation. These are all goods that foster opportunities for virtue and happiness. These potential goods share one similarity with the virtues-we tues-we seek them for their own sake as well as for the sake of higher goods. They differ from the noble goods or virtues because, according to Aristotle, you need all the virtues for happiness but you do not need all the potential goods. Useful Goods These are goods sought not for their own sake but only for the sake of other goods, either the noble goods (the virtues) or the potential goods. An example of a useful good is an antibiotic: We do not take an antibiotic for its own sake but for the sake of a more valuable good-our health. Tools are another example: We do not buy a lawn mower for its own sake but for the sake of cutting grass. Useful goods are like tools that we need to accomplish something valuable. We do not seek them for their intrinsic value but for some other good we desire. Once we distinguish the major kinds of good, we can see how happiness, the most desirable good in a human life, is actually composed of several different categories of goods. Of these the most important are the noble goods (the virtues); then come the potential goods and finally the useful goods. The virtues play the major role in our happiness, but they need support from some potential and useful goods. Today the word "goods" seems a little awkward for the ideas just presented. It might make things more clear if we use the word "value" and recast the schema in terms of a hierarchy of values. The goal of life is happiness-making our lives truly good lives. The highest values are the virtues, and they are valuable both because they are the principal elements in happiness and because they have intrinsic value as well. Next in line after the virtues are things humans value for their potential to contribute to happiness and virtue as well as for their intrinsic value. Finally, at the lowest level, are the utilitarian values valuable only for their contribution to the higher values. Ancient commentators on this schema of goods and values all agreed that the best good we could pursue in a

virtue and intellectual virtue. The inclusion of an intellectual virtue in virtue ethics is absolutely crucial; in fact it is the intellectual virtue, what Aristotle called phronesis and Aquinas called prudentia, that is the action-guiding norm in virtue ethics. We cannot stress the intellectual decision-making virtue in virtue ethics enough because many contemporary accounts of virtue ethics either ignore the intellectual virtue or reduce it to a secondary role. Although we will explain them separately, they always work together in practice. A degree of moral virtue is necessary for the relevant intellectual virtue, prudence, to function well, and a degree of prudence is necessary for morally virtuous decision making in each particular situation. Every moral virtue presupposes prudential reasoning, and sound prudential reasoning presupposes the person has already developed some level of

The moral virtues are the excellences of a person's character-the feelings, behaviors, and habits that contribute to character integrity and thus contribute to his living well, living a good life. As previously noted, "moral virtue" is synonymous with "character virtue" or "character excellence." This section will explain five moral virtues that play a major role in traditional virtue ethics: temperance, ance, courage, justice, love, and pride. The section that follows it will explain the intellectual virtue that plays the normative role in virtue ethics: prudence. Emergence of the Moral Virtues The different moral virtues originate in various natural inclinations or tendencies that have evolved in human beings over time. We will live well by embracing these natural inclinations and cultivating vating them so that they will enrich rather than impoverish our lives. In other words the different moral virtues are nothing more than our natural inclinations shaped by intelligence so they will likely enhance rather than undermine our happiness. Aristotle's writings suggest five major natural inclinations in human life and give a name to the moral virtue appropriate for each: •Our inclinations to satisfy our appetites for eating, drinking, and sex •Our inclinations to act despite fears and risks •Our inclinations to seek close personal relationships •Our inclinations to seek working relationships with others •Our inclinations to seek honors and recognition First, we have natural inclinations to seek food and fluids when we are hungry and thirsty. We may also seek mood-enhancing substances such as alcohol, nicotine, and so forth. And we seek some form of sexual gratification. Second, we have a natural inclination to engage in activities despite the fears that accompany them. Sensing that we could never live a rich and fulfilled life unless we are willing to take some risks, we are inclined to take them. Third, we have a natural inclination to bond closely with others. We were born into a network work of relationships, some kind of family. And as we mature we naturally pursue personal relationships tionships as we come to realize a life lived without intimate connections is a life not well lived. Fourth, we also have a natural inclination to encounter others in less personal ways. We relate to other people every day, sometimes for the first and last time, sometimes over extended periods of time. All human lives are interwoven with various social, political, commercial, and professional encounters. Finally, we have a natural inclination for honors and praise, especially when we do well or bear up well under great challenges, adversity, sickness, or tragedy. We naturally seek recognition for our achievements. We want our success to be recognized and acknowledged. You can easily see how these major natural inclinations can hurt as well as help us live well. We know that not all eating, drinking, and sex; not all risky behaviors; not all relationships; and not all honors and praise contribute to our living well and flourishing as human beings. Of course, other natural inclinations exist as well-inclinations to anger and to aggression, for example-and these too can hurt as well as help us live well. When these natural inclinations spontaneously give rise to good feelings and behaviors-those those contributing to a good life-Aristotle called them natural virtues. We often see natural virtues in children when they share cookies or perform an act of kindness or carefully try something risky. Moral training can shape and strengthen these natural virtues. Spontaneous natural virtue and early moral training provide an orientation toward living well, but they are woefully inadequate for the complexities of adult life. For a mature moral life we need more than natural virtues and moral training-we need what Aristotle called the authentic moral virtues. Whereas natural virtues arise spontaneously and are shaped by training, the authentic moral virtues arise from intelligent choices guided by prudence. Whenever we deliberately and intelligently guide the feelings and behaviors arising from our natural inclinations, we are forming authentic moral virtues. Looking at the five major domains of life we singled out earlier, we can name five major authentic moral virtues: •Good management of eating, drinking, and sex is temperance. •Good management of risk taking is courage. •Good management of personal relationships is love or •Good management of general encounters with others is justice. •Good management of honors and recognition is pride. Aristotle's claim is that developing the authentic moral virtues gives us the best chance of achieving happiness in life. You probably recognize the first four moral virtues-temperance, courage, love, and justice-and have some idea of what they are. However, you are probably not familiar with the fifth moral virtue, pride. Yet Aristotle actually considered pride to be the most important moral virtue. Since his views on pride have often been neglected in the virtue theory tradition, we need to say something about it. Pride-The Forgotten Virtueintelligently our natural inclination to seek honor and recognition nition for our accomplishments in life. It is natural to want our achievements to be honored and recognized. But honor and recognition bestowed by others can be tricky. They may not recognize our achievements or they may misunderstand them or find them politically unattractive. Hence we cannot reliably depend on others to satisfy our natural desires for honor and the recognition of our achievements. The greatest accomplishment in life is to make the choices that will form our characters in an excellent way and thus be living a good and noble life. If we are making significant progress toward this goal, we would do well to recognize it and be proud of it and to accept recognition given by others if they honor us properly for our moral nobility. Actually truthful self-recognition is more accurate than recognition by others for two reasons. First, the bestowal of honors by others is unreliable-people bestow honors on others for many reasons other than honest evaluation of significant achievement. Second, those truly deserving of honor and recognition are often neglected because they lack political connections or clever public relations. The Greek word we are translating here as pride is megalopsychia, which literally means "greatness of soul." There is no exact English equivalent. Magnanimity is also a literal translation but does not tell us much. Some translate megalopsychia as dignity, which is fairly accurate. In any event, Aristotle tells us that this virtue is the capstone of a life well lived and that the person living a noble life should recognize the achievement because it is difficult to do and not many people actually succeed in living morally noble lives. A person with virtuous pride so esteems herself that she will not compromise her character for other goods no matter how enticing they may be. Pride is the virtuous self-respect and self-esteem that has been earned over time and tested by adversity and temptation. A person with this virtue has great moral dignity. Making pride a virtue is somewhat unsettling for many in the Christian tradition. This tradition, after all, suggested that pride was the first of the seven capital sins and encouraged people to seek the virtue of humility. But Aristotle's idea is this. If people have work to do-painting a picture, building a house, practicing as a nurse or a physician, writing a term paper, or whatever-experience experience suggests that they will do a better job if they take pride in what they do. Now the most important work in life according to traditional virtue ethics is becoming a noble human being, and we will do a better job at succeeding in this if we take pride in how we live our lives. Aquinas seems to have recognized the value of Aristotle's virtue in his Commentary on the Nicomachean Ethics, for he declined to oppose megalopsychia to humility and suggested that Christians could legitimately take pride in their moral achievement as long as they acknowledge God's help. Lists of Moral Virtues No canonical list of the moral virtues exists. The traditional moral virtues of temperance, courage, love, and justice appear in some form on just about every ancient list of moral virtues, but other virtues are often mentioned as well. Lists often vary with the same author. Aristotle, for example, gives various lists. His Rhetoric names seven moral virtues: justice, courage, temperance, magnificence, cence, dignity, generosity, and gentleness. The moral virtue of love is noticeably absent here, but he does define and discuss it at some length in book II of the same work. The Eudemian Ethics lists the seven moral virtues of the Rhetoric and adds love, respect for self and others, righteous indignation, truthfulness, solemnity, and patience. The Nicomachean Ethics also lists the seven moral virtues of the Rhetoric and adds love, truthfulness, and several other virtues for which Aristotle totle says there are no names. The lack of a definitive list of moral virtues is not a problem because the moral virtues in a morality of happiness do not play the role moral principles play in the various moralities of obligation. tion. Unlike action-guiding principles and rules, the moral virtues are not a stock of maxims that we apply to particular situations to determine what we ought to do. They are simply the ways of feeling and behaving that make up a good life, that is, a life of personal happiness. Any feeling, behavior, or habit contributing to a truly good life is an ethical virtue. In the health care field caring, empathy, sympathy, kindness, and so forth are important moral virtues. According to Aristotle, philosophical reflection shows that a life will likely be happy if it is composed of feelings, behaviors, and habits known as temperance, courage, love, justice, dignity, and so forth. In other words, the moral virtues give us the best chance of flourishing as human beings. You may disagree with Aristotle, but if you do, you will need to show that the chances of living a good and happy life will be better if a person feels and behaves in nonvirtuous ways. You will need to show how happiness will be more likely in a life lived without the moral virtues of temperance, courage, love, justice, and dignity. It is not easy to find intelligent arguments that support the position that a good life is a life constituted by the lack of moral virtue or by the vices contrary to them. The notion of authentic moral virtue is now beginning to emerge. Authentic moral virtue is rooted in our good management of our natural inclinations. Our natural dispositions become morally ally virtuous when we go beyond the formation we received in our youth and from our secular and religious culture and begin to deliberate personally about what we might do to live well and then choose this course. Only when we choose our behavior-choose to be

kind, just, loving, courageous, geous, and so forth-for the sake of virtue and not simply because it is a duty or obligation are we achieving authentic moral virtue and living a truly good human life. These chosen actions of virtue gradually build up our moral character, and the stronger our moral character, the more easily and often we will continue to choose truly virtuous behaviors. A reciprocal dynamic occurs whereby our good choices and our virtuous character mutually reinforce each other. Unfortunately the converse is also true: The more we choose contrary to virtue the more our character becomes bad, and the worse our character becomes the more we tend to make bad choices. Making good choices-choices that make our lives good and happy lives-about the feelings and behaviors arising from our natural inclinations is accomplished by the other virtue that we mentioned: prudence. This indispensable intellectual virtue guides every decision that results in authentic moral virtue. Prudence plays the crucial management role in traditional virtue-based ethics, and without the personal practice of prudential reasoning, there is no authentic moral virtue. As Aquinas puts it: "And thus the whole matter of the moral virtues falls under the single reasoning of prudence." PRUDENCE Two kinds of intelligence play major roles in the philosophy of Aristotle and Aquinas: theoretical intelligence and practical intelligence. Theoretical intelligence strives to know about the realities that exist independently of us. These independent realities comprise two domains. One domain embraces the beings our senses encounter, and the other embraces the beings our senses cannot encounter, such as human souls and the God or gods functioning as sources of motion. Knowledge about the sensible beings is of two kinds; it is either physics (natural philosophy) or, if it focuses only on the quantitative aspect of sensible beings, mathematics. (The Aristotelian separation of physics and mathematics lasted until Isaac Newton, building on the work of Copernicus, Kepler, and Galileo, showed in his revolutionary book of 1687, The Mathematical of Natural Philosophy, that physics is actually mathematical.) Knowledge about the nonsensible beings-souls and gods-Aristotle called first philosophy and theology; others later termed it metaphysics. The ideal of theoretical knowledge-the knowledge of given realities-exhibits several important characteristics. It is consistent-its major first principle is the principle of noncontradiction. tion. It is deductive-once its general principles are discovered by induction or set forth in theory, we can understand all the particulars covered by the principles and rules. It is universal-its truths hold everywhere and always. And it is necessary-if achieved, it allows its possessors to claim the certitude that comes only with knowing their truth is necessarily so. Practical intelligence, on the other hand, is not ultimately about realities that exist independently dently of us. It is about knowing what voluntary human activities will work in the world. These voluntary activities fall into two domains: We make things and we do things. Building a good structure or writing a good play calls for practical intelligence in making things, whereas directing a military operation well or treating a patient well calls for practical intelligence in doing things. The most important thing we can do is to make our lives good lives, and the practical intelligence for doing this is the intelligence we need in what Aristotle and Aquinas call ethics. This practical knowledge does not, indeed cannot, reflect the rigidity of theoretical knowledge. edge. The knowledge for knowing how to make and do successful things is not the same as knowledge edge about what is already made and done. Since ongoing situations are always changing and developing, practical knowledge is not so much consistent, deductive, necessary, and universal as it is variable, experiential, provisional, and situation specific. The moral virtues are the chief elements of a good and happy life, but they alone are not capable of directing us in ever-changing circumstances. They require on-the-spot intelligent management. agement. Aristotle called this intellectual aspect of every moral virtue phronesis, Cicero and Aquinas called it prudentia, and we are translating it as prudence. Prudence is the intellectual virtue that clarifies the overall good we are aiming at for our lives, and it manages our feelings, behaviors, and habits in each situation so that we will likely achieve a measure of this happiness. For many reasons that we cannot go into here, later modern European languages lost the ability to express the rich notion of phronesis and prudentia that we find in the ethics of Aristotle and Aquinas. The words prudence in English and French, and klugheit in German, simply do not convey what phronesis and prudentia meant in the older ethics. In fact the "prudent" person today is often not the morally noble person characterized by the phronesis and prudentia of the earlier ethics but rather an overly careful person bent on avoiding difficulties in his life. Such prudence, however, may in fact be unethical. In health care for example, some physicians, possibly influenced by legal counsel, think it prudent to avoid any behavior that might result in litigation. They never see that such prudence could be highly immoral in some circumstances-when it leads to medically unnecessary tests, for example. Modern authors discussing Aristotle's phronesis and Aquinas's prudentia therefore shy away from using the misleading English word "prudence." They employ instead phrases such as "practical tical wisdom," "practical reason," "practical rationality," "moral insight," "intelligence," and "non-scientific scientific deliberation."There are good reasons for using these phrases, but there are also drawbacks. One drawback is the confusion caused by the use of different English words to translate one Greek or one Latin word with a very definite meaning in ethics. Another is the fact that, in his Ethics, Aristotle takes great care to show that phronesis is not associated with wisdom, and thus the frequent translation of phronesis as "practical wisdom" is misleading. Moreover, Greek has common words for practical and wisdom (pratike and sophia), and this suggests that we should translate phronesis by another English word. Despite the problems associated with the word prudence in English, we will use the word to translate what Aristotle called phronesis and Aquinas called prudentia. The complex and rich meaning these authors gave prudence will, I hope, emerge in what follows. Prudence or prudential reasoning is, quite simply, how we figure out what choices are most likely conducive to our goal in any given situation. In ethics prudence is the deliberation we use to determine what will give us the best chance to achieve happiness (that is, to determine what is ethical or morally good). It tells us what to do in order to achieve a good life. What Prudence Is Not We begin by saying what prudence is not. It is not, as we explained earlier, a moral judgment deduced from general norms such as principles, rules, or rights. Prudence never reasons this way. It is much more imaginative, narrative, and creative. This does not mean, however, that any of the conclusions deduced from principles and rules are necessarily wrong or incompatible with those of prudence. In many cases the conclusions deduced from the ethics of principles and rights are compatible with those generated by an ethics of prudence. But the contrast we are making here between prudential reasoning and principle-based based reasoning centers not on conclusions but on the process of arriving at conclusions. Prudence does not make general principles or rights central and then proceed by deductive logic to a particular judgment. Recognizing this may leave some people uncomfortable because the logical certitude available with deductive reasoning is not available. Prudence simply does not provide vide us with the logical comfort we expect in deductive geometry, or in science, or with religious dogma. An ethics of prudence accepts this discomfort and, with Aristotle and Aquinas, acknowledges edges that in matters of concrete human behavior our knowledge is, at best, valid "only for the most part." Morality is simply not science. Galileo and Newton taught us how to measure physical bodies and how to predict a high tide or an eclipse or a sunrise a thousand years from now, but no historian or psychologist or sociologist or ethicist can measure human choice and predict future human action with such precision. What should make us uneasy in ethics is not that we do not have the certitude we think we have in modern science or thought we had in ancient metaphysics and theology but that so many people think we have, or should have, such certitude in the field of deliberate and free human conduct. This does not mean prudence is some form of guessing or little more than a matter of personal beliefs and opinions. We can certainly guess or sincerely believe or have a strong opinion that something is good or bad, and our guess, belief, or opinion might well be correct, but this is not prudence. The judgments of prudence are always supported by reasons. Feelings play an important tant role, as we shall see, but they do not replace the need for reasons. What we always have to show in an ethics of prudence is why we think something will indeed contribute to what is truly good. This is why, in the second part of this book in which we consider concrete ethical issues, we will always insist on reasons to support the ethical judgments we suggest. And the reasons are valid when they show that an action or omission truly contributes to living well. Adopting an ethics of the good employing prudence as the reasoning that directs our conduct means that we can never say a behavior is morally good or morally bad "because I believe it with all my heart" or "because that is the way I was brought up" or "because this is what civil or religious authorities say." Prudence, the intellectual virtue at the heart of morality, always supports its judgments ments with reasons why the behavior in question will, or will not, actually contribute to my human good. Aristotle and Aquinas always insisted that acting prudently is, in the last analysis, acting not according to mere beliefs, nor according to how I was brought up, nor according to the dictates of authority, but "according to right reason." Finally, we should not confuse prudence with a purely instrumental kind of reasoning, a reasoning concerned exclusively with the means needed to achieve a goal and not with the goal itself. In instrumental reasoning the end and the means are distinguished. Vacationing in the Caribbean is one thing; buying the ticket weeks ahead of time is quite another. The distinction between ends and means in instrumental reasoning becomes very clear when we have a good end and a bad means-we desire money, so we steal it. In prudence there is no sharp distinction between means and end. The behavior is not simply the means to happiness but happiness itself. The end, happiness, is embedded in the means. Happiness piness is not distinct from the virtuous activity that achieves it; happiness is living virtuously. Prudence is therefore a reasoning about the end as well as about the means. Prudence grasps the complete good of human life as well as the means to achieve it. We totally misunderstand Aristotle and Aquinas if we think their ethics is an instrumental reasoning wherein "the end justifies any means." In every case, prudence must grasp the end-living well-and show how the means will promote it. What Prudence Is Prudence is the deliberation and reasoning in any particular situation that determines what feelings and behaviors will truly promote my good or at least avoid the worse bad. But how does prudence determine what behavior is virtuous and reasonable? How do I decide what behavior makes my life a good life? Outside of tragic situations and excluding situations in which what I am contemplating is clearly contrary to a good life by definition (murder, for example), Aristotle suggests that prudence begins by recognizing that a good life is enhanced by striking a balance between feelings and behaviors

that are neither excessive nor deficient. Some behaviors, for example, contribute in a significant way to the biological aspects of the human good. The primary examples are eating, drinking, exercise, and sex. But if we eat too much or too little, we undermine living well. Just how much and what to eat will vary from person to person and from circumstance to circumstance, and prudence is needed to determine how much we should eat in any given situation. I know too much is not good for me, and obviously too little is not good. I also know circumstances play a role-I should not eat anything before major surgery. So I cannot simply say eating is good for me. What is good for me is eating reasonably, that is, eating well or virtuously. Eating is reasonable able when, given the circumstances, it is neither too much nor too little for me. The knowledge I need to figure out how much I should eat is primarily practical, not scientific, and it is circumstantial. tial. This example of practical knowledge in the matter of eating-which Aristotle and Aquinas considered a matter of the moral virtue known as temperance-gives us a preliminary idea of how prudence works. Prudence, recognizing that good behavior is undermined by excess or by defect, endeavors to determine just where on the spectrum between those extremes the behavior promoting moting my good will fall in the particular circumstances facing me at any given time. Prudence not only determines what achieves my good, it is also decisive. It directs me to behave in a certain way. This is what distinguishes prudence from what we called judgment. The processes of reasoning in prudence and in judgment are similar, but unlike judgment, prudence directs the person doing the reasoning to do, or not to do, something. The controlling role of prudence is clearly seen when it overrides what would normally be morally virtuous. Consider the following situation adapted from an ancient example in virtue ethics. A person borrowed a friend's rifle last week and promised to return it today. The friend comes to the house to retrieve his gun. Justice and promise keeping indicate the borrower should return it as promised. But now think of this. The owner is going after someone who has wronged him. You know he can be violent and may use the gun to threaten or even shoot at the other person, so you hesitate to return his gun. But he reminds you that the gun is his property and that you promised to return it today. He argues that keeping his property without his consent violates the moral principle of justice. He also points out that the great moralist Immanuel Kant insisted that everybody is bound by a strict moral duty never to break a promise. Obviously you cannot simply think of justice and promise keeping in this situation and then return his property. What more do you need to do? You need to figure out what would really be a good choice for you in these circumstances. Once you realize that giving a weapon to someone on the way to threaten and maybe shoot at another person is not the kind of action that is likely to make your life a good life, you know what decision is intelligent-the decision to keep his property without his consent despite your promise. By so doing you reveal how prudential reasoning is the controlling factor in virtuous decision making. The actual practice of prudential reasoning can be difficult at first. There is no clear methodology ology similar to the deductive method of deducing particular moral judgments from ethical principles. ples. Indeed some think that method is the enemy of the prudential reasoning needed in ethics. Fortunately, the person practicing prudence in any moral situation does not start from scratch. Before trying to determine what is right in a particular case, she has the benefit of three things. First, every person has a preliminary natural orientation toward a good life. Living things, including human beings, strive not only to live but to live well. Second, she has received some moral education from parents, from schools, from society, and frequently from religious organizations. tions. This moral education provides a preliminary apprehension of how to go about living a good life. Third, if she is reasonably mature, she has complemented her natural orientation and moral education toward a good life with a personal awareness that living well is the overall goal of life. When the practitioner of prudence is faced with a challenging concrete situation, these three background features have already provided a preliminary orientation. Now she must determine what behavior will achieve her personal happiness in the situation. Prudence will provide the answer to the extent it can be provided, so we must examine its features more closely. The Features of Prudence Aquinas lists eight features of prudence and three additional secondary virtues associated with it. His list is a compilation of features drawn mostly from Aristotle but from others as well. It is not intended to be exhaustive. It is a convenient way to organize the chief characteristics of prudence, as long as we do not mistake the list for any kind of highly organized methodology or for any kind of sequence such as we find in manuals telling us how to operate equipment or build something. Prudence is not like that. It is a way of thinking that cannot be considered a science, or a craft, or a technique, but only as a unique and somewhat disorganized process. The list that follows is, therefore, not to be taken as steps of a method to be followed every time we make a moral decision. It is simply a compilation of features embedded in prudence and largely unnoticed by the prudent person in the process of exercising prudence. Only through analytical lytical reflection on prudential activity does the list emerge. Not every feature on the list is of equal importance. Some features are rather obvious and simple, whereas others will require some explanation. And some features are debatable. With these remarks in mind, we now take up the eight features of prudence and the three secondary intellectual virtues associated with it. Memory We learn from experience, sometimes the hard way, what contributes to our fulfillment and what does not. What happened to us in the past can serve as plausible grounds or "quasiarguments," as Aquinas calls them, for figuring out what we should do in the present. Understanding This term requires some comment for a correct appreciation of its meaning. "Apprehension" might be a better translation of the Greek nous and the Latin intellectus but, since "understanding" is so often used, we will retain it. We shall have to be careful, however, how we understand this word, understanding. It is a highly technical term with a precise meaning for Aristotle and Aquinas. It refers to the ability to know something directly (that is, without a reasoning process). Aquinas says things known this way are "known per se." They are self-evident and obvious. They need no proof, no arguments, no reasons. Aristotle and Aquinas thought this understanding of the self-evident was the way we came to know two kinds of things: (r) the first principle of theoretical reasoning (the principle of noncontradiction) and the first principle of practical reasoning (our choices always seek what is thought to be good) and (2) the moral issues in the concrete situations we face in the course of a life. We have already seen how this

possible in the life after death. But Aristotle did not believe in life after death. What, then, can be said about an ethics of seeking our good when none of the available choices promotes a good life? Does the ethics of the good go on a holiday when this tragic situation arises? Suppose, for example, a person is dying of widespread and painful cancer. Realistically, these are his choices: (i) he may choose to remain alert as long as possible and thus experience great pain; (2) he may choose heavy pain medication and thus spend his last days so drugged that he loses all meaningful contact with reality; or (3) he may choose euthanasia or suicide and thus give up his life. None of these options leads to happiness. Living in pain or in a drugged state is not living a good life, nor is euthanasia or suicide, for that ends life. What, then, could an ethics of the good and personal happiness offer in tragic situations when achieving a good life and happiness is noThe answer to this question in Aristotle is important. In tragic situations where no choice will lead to happiness, an ethics of the good acknowledges an important corollary: When we can no longer achieve a good life, the best we can do is avoid what is contrary to a good life. In other words when none of our choices will promote our happiness, when all options are undesirable and unwanted, then we are reduced to choosing the less worse option. The ethical aim of our life is to live well and be happy; if living well and happiness are not possible, then all we can do is reduce the bad features in the situation as far as possible. Not choosing the less worse is immoral because it undermines an ethics of the good by promoting more bad than is necessary. The ethics of the good, then, is understood this way: Behavior is moral when we choose what promotes living well or, in tragic situations where living well is no longer possible, when we choose the less worse. Thus Aristotle, inlaws, principles, and rights. What constitutes a good life determines what the laws, principles, and rights will be and when they will be relevant; the laws, principles, and rights derived from moral theories or from a common morality, no matter how important, do not determine a priori what constitutes a good life. Happiness and Virtue A key notion in any ethics of the good is virtue. Virtue meant "excellence" in ancient Greek, and the word was used for both living and nonliving things: A machine can be excellent, or a horse, or a human being. Something is excellent when it is well formed and performs well. A machine is excellent if it is well made and works well; a horse is excellent if it is well formed and functions well. A flutist is excellent if she is an outstanding flutist and actually plays exceptionally well. A flutist is not excellent if she has mastered the instrument but does not play; nor is she excellent if she has not mastered the instrument but happens to play well in a particular concert. In the Iliad Homer called a soldier excellent only when the man was a courageous fighter and actually did fight courageously. A courageous soldier who does not fight is not excellent; nor is a cowardly soldier excellent who fights courageously only when stimulated by the wine he drank out of fear. From these examples we can see that excellence is related to a goal. If a thing is so formed and so functions that the goal is achieved, then it is an excellent thing. If the machine, the horse, and the flutist are so formed and so function as to achieve the goals appropriate to that machine, horses, and flutists, we call them and their performances excellent. The goal is the norm for excellence. lence. Only when we know what the machine, horse, and flutist are expected to accomplish can we judge whether their structures and functions are excellent. As we have explained, the goal of any human life considered as a whole is personal happiness. We say "considered as a whole" because the subsidiary goals are not those that concern us here. These are many and worthwhile and include, for example, graduation from school, earning a good living, developing loving relationships, having a family, being a good clinician, and so forth. But in ethics it is the overall goal of every human life that concerns us, and this, as we saw in the last section, is personal happiness. We can now define an excellent or virtuous human being as a person so formed and so functioning as to achieve personal happiness. Simply put, whenever our habits, feelings, and behavior are in fact achieving personal happiness, we call them excellent or virtuous. The virtues are those human qualities that promote personal happiness. Virtues are the feelings, habits, and behaviors constitutive of living well. Two kinds of virtue play major roles in the morality of happiness: moral

the first principle of practical reasoning, but now we need to note the second area where we have to rely on this direct apprehension called understanding-the immediate grasping of moral issues, what is significantly good or bad, in each concrete situation that we face in life. Understanding grasps directly the particular situation with its salient moral features. Prudential reasoning thus begins with two starting points grasped by understanding: the first principle (people seek their good) and the moral nuances embedded in the unique particular situation facing us. Learning from the Prudent In The Republic Plato advanced a famous theory: our communities should be run by philosopher-kings kings who master philosophy and ethics and then direct the moral lives of the citizens. The philosopher-kings opher-kings were the ethical experts. In some religious traditions a similar theory exists: the community munity should be run by theologian-authorities who master theology and ethics and then direct the moral lives of the believers. Aristotle and Aquinas proposed a fundamental revision to this model. They still embraced the idea that a special group provided moral direction, but membership in the group is not confined to philosopher-kings or theologian-authorities. Rather, the group is composed of experienced people who have actually achieved a high degree of moral success in their personal lives. The group comprises people who are in fact prudent or were prudent when they were alive. They are the people who actually live, or did live, good lives. These people are the ethically successful people; we recognize them as noble human beings. Aristotle called these people the phronimoi, the people who had mastered phronesis; Aquinas called them the "experts," the "elders," and the "prudent." We have all met these people in life. They are the people we recognize as being of high moral integrity; they are good, decent, and noble people. Some are rich, but many are poor; some are powerful, but many are weak or even exploited. Some are political or religious leaders, but many are not. We trust and admire these people of high moral integrity, and both Aristotle and Aquinas insisted we should learn from them. And how do they teach us? Not in a scientific or theoretical way and not by statements backed by whatever authority they might have. They do not give us principles, rules, laws, and regulations to follow. Nor are the particular behaviors they chose in their lives necessarily the model for what we should choose in our lives. We do not simply imitate their lives and do what they did. Rather, we learn from their ability to deliberate prudently. In the different situations of their lives they were able to figure out the behavior constitutive of a good life. They did this by prudence. So we want to learn from their example, from how they practiced prudence and went about perceiving the right thing to do in their lives. These good and noble people do not tell me what behavior is right in my situation; they teach me how to perceive the moral dimensions in particular situations and how to figure out what behavior is best suited to achieve happiness. The prudent people who serve as role models do not dictate what is the right thing to do; they offer advice and show us how to figure out for ourselves what is the right thing for us. They serve as examples. We want to study how they made virtuous choices in their concrete situations so we can make them in our own. Shrewdness This is the ability to grasp very quickly what is the right thing to do. The shrewd person has the ability to hit the mark, to get right to the point, to cut through all the irrelevant factors and see, while on the spot, what is really necessary to achieve the end. Shrewdness quickly grasps what we should start doing now, in this situation, to achieve our goal-a good life. Reasoning Reasoning consists of showing how certain feelings and behavior will truly achieve my good in the particular situation. My reasons will, or should, show how the behavior is better suited to my good than the other options available in the circumstances. And if my action causes bad things to happen to me or to others, then I must produce convincing reasons for the bad I cause. Consideration of Consequences We can call this foresight. Aquinas calls it "providence" because it is a foreseeing or seeing ahead. We know our actions have consequences, and so we look to these consequences and try to discern how they fit into our personal happiness. Prudence acknowledges that we must always consider the consequences of our actions and whether they will bring good things or bad things for ourselves and others. Consideration of Circumstances Prudence is about individual actions in particular situations, and hence many circumstantial factors are involved. Some of the circumstances are morally significant and should be a part of prudential consideration. Circumstances can sometimes make all the difference in the world. Something considered sidered good in one situation might not be good in other circumstances. Thus, to use Aquinas's example, it is good to treat another person kindly-unless she happens to be a suspicious and cynical person, for then the kindness may very well make her more suspicious and eventually disturb and upset her. The ethical person not only does the good thing but does it in the right way and at the right time. Virtue is living well and doing well, and this depends in large measure on circumstances. We have to look at all the circumstances to make a good moral decision because the virtuous mean always depends on the circumstances in which the moral agent finds herself. The major circumstantial factors affecting morality were well known in Greek, Roman, and medieval ethics. They revolve around who is performing the action, what kind of action it is, where it is being done, by what means it is being done, why it is being done, how it is being done, and when it is being done. Cicero and the medieval moralists often summarized these factors as follows: "who, what, where, by what means, why, how, when." Except for the "what," which refers to the action itself, and the "why," which refers to intention and purpose, all these factors are circumstances. Caution Moral situations are often not clear-cut.

possible counter moves to these moves, then its possible moves after these counter moves, and so on. After comparing thousands sands of alternatives, it picks the best move. This artificial intelligence is so powerful that good computer programs can now beat the best chess players. The beginning chess player, by the way, also relies on rational choice strategy. He compares the advantages and disadvantages of possible moves to find the best one. Of course his ability to compare moves and counter moves is far less than that of a computer. The expert player, on the other hand, relies chiefly on a recognition-primed decision approach. He perceives key patterns on the board, considers them rather briefly, and then makes his moves. He has neither the time nor the cognitive ability to calculate the huge number of possibilities implied by each move he could make. The computer, of course, can do all the calculations tions quickly, and that is why computers can now beat the best human players. You might think that this shows that a rational choice strategy is better than a recognition-primed primed approach for making decisions, but this is not so for at least three reasons. First, although computers with rational choice software can now beat chess experts, players using rational choice strategy cannot beat them. An expert chess player will inevitably defeat any human player using rational choice strategy. A rational choice strategy gains the advantage only when coupled with the incredible calculating power of computers. No human brain, not even the brains of expert chess players, can compare the advantages and disadvantages of the available moves as quickly and as accurately as the computer. When human chess players try to imitate the decision-making strategies gies of machines, they actually degrade their decision-making ability. Second, rational choice strategy works well when the environment is rule governed, as it is with games. When preexisting rules determine what moves can and cannot be made, a comparative analysis of options is feasible even when the options are numerous as they are in chess. But preexisting isting rules do not ultimately determine human choices in life. Humans make the rules as they go along, and important areas of life-relationships of love, for example-are never well managed by rules. Third, rational choice strategy is rather detached and unemotional. The comparisons tend toward calculation and quantification, and personal feelings do not play a major role. Making ethical decisions, however, is a very personal and often emotional affair, and the practical reasoning that we need to make them well is not primarily that of rational calculations. The recognition-primed decision model of recent naturalistic decision theory is very similar to prudence. Aristotle insisted that prudence only works well when the decision maker has already developed some level of expertise in the moral virtues. Virtuous habits provide the moral expertise that permits a person confronting a new situation to recognize the morally salient features and then to perceive rather quickly an appropriate response. A virtuous person seldom compares all the alternatives with each other and then calculates their relative advantages and disadvantages. Rather, she recognizes the morally significant features in the situation and then perceives a move likely to achieve her overall goal in life-happiness. Only beginners in ethics rely on a rational choice strategy. Without the expertise to size up a situation and readily see a promising course of action, beginners have to rely on comparing the advantages and disadvantages of all the alternatives. As people develop virtue in ethics, however, they rely less on comparative analysis and more on recognizing patterns and perceiving directly the choices in any developing situations likely to accomplish their overall aim in life-happiness. Modern psychological research thus suggests that Aristotle was on the right track centuries ago when he distinguished practical reason from rule-based deductive reason and insisted that practical reasoning is what we need for human affairs such as ethics, politics, military tactics, medical practice, and so forth. Practical decision making in ethics is prudence-a naturalistic decision-making sion-making process distinctly different from rational choice strategies. Prudence and Deliberation Aquinas makes a distinction between prudence and another virtue closely allied to it, deliberation. The difference seems to be this. A person well advanced in having acquired the moral virtues generally makes moral decisions more by experience, insight, and intuition than by deliberation, as we have just noted. However, when faced with the radically new situations that we so often encounter in bioethics today, even the person with a high level of moral virtue and decision-making expertise needs to deliberate carefully and dialogue widely. Strictly speaking, however, prudence is not deliberate; but deliberation is a virtue closely allied to it. Prudence and Formal Reasoning Understanding prudence as a natural decision-making process requiring virtue and practical expertise tise does not do away with all formal reasoning in ethical decision making. Prudence is not science or geometry, nor is it calculating the advantages and disadvantages of as many options as possible, but it often benefits from some formal reasoning. Usually this formal reasoning occurs after the decision maker has identified a tentative decision. To show how this is so, it will be helpful to note how formal reasoning plays a role in another form of practical reasoning-legal reasoning. Imagine a civil dispute for which both sides present documentation and testimony to the court. As the judge reads the evidence and listens to the testimony, her intelligence probably begins to formulate a decision in her mind. Her developing decision is shaped by her experience with the law and her expertise with cases as well as by her consideration of the evidence and testimony. Gradually a tentative decision takes shape. Only then does she begin formally gathering the legal reasons to support it from relevant legislation, regulations, and previous court decisions. When the judge writes her decision, however, she will cite these legal reasons as premises leading to her conclusion. Logically, this is correct. Existing laws, regulations, and precedents are important reasons that support judicial decisions. In actuality, however, the judge finally organized her legal reasons for the decision only after she made it. Her perception and reflection on the case, along with her experience with the law, first led to her decision. The formal legal premises appearing in her written decision as steps that led to her decision were actually developed formally only after she had reached a decision. In some cases the judge may formulate a decision and then be unable to support it with adequate legal reasons. If this occurs, she will reconsider the case, revise her conclusion, and then look for legal reasons in support of her revised decision. More probably, however, her experience and review of the testimony in the case will have led her to a conclusion supported by legal reasons, and she will write her decision accordingly. It is somewhat the same in ethical reasoning in difficult and complex situations. We perceive the situation in its complexity and see a good response. Only then, if we have the time, might we explicitly formulate the reasons for our decision. When we explain the decision, we undoubtedly present the reasons as coming before the conclusion, although in fact we developed them after it. Does this make the formal reasoning in prudence no more than rationalization? Are we simply making up reasons to give a veneer of respectability to our preferences? Not really, if the prudential reasoning is authentic. The reasons we develop after we make a tentative decision do play a role. Formulating the reasons serves as a check. When we are able to develop good reasons that show that our decision is likely to help achieve what we are aiming at above all-a good and happy life-we can go forward with added confidence. On the other hand when we are not able to develop good reasons for our decisions, we can abandon our conclusion and take another long look at the situation so that we can make a more reasonable choice. Prudence and Bad Moral Decisions Most people tend to call a bad decision one that results in a bad outcome and, conversely, a good decision one thatThe good is often mixed with the bad. Therefore, we have to be very careful as we make our way through the jungle of moral dilemmas. Caution rules out any kind of dogmatic or fundamentalist approach in ethics. Prudence always tiptoes along, for it recognizes the complexity and contradictory nature of many situations and knows that no simple answer is possible in difficult and complex cases. Listing these eight factors characterizing the intellectual virtue of prudence helps us to understand the virtue better. Prudence is a complex intellectual virtue embracing memory, understanding standing the first principle and concrete situations, learning from the truly prudent, shrewdness, reasoning ability, the consideration both of consequences and of circumstances, and an element of caution. Prudence and Feelings It has been noted with some reason that Aquinas's description of prudence is overly intellectual and neglects an important aspect of good prudential decision making-feeling. Traditional wisdom has long warned us about letting emotions and feelings disrupt our thinking. What we now realize more and more, however, is the disruption in moral reasoning that occurs when emotions and feelings are not part of thinking, especially thinking about living well and how to achieve it. Studies in psychology have shown how some people with normal cognitive abilities but who lack emotions because of brain damage consistently fail to make good decisions about living. Undoubtedly emotions and feelings can inhibit or overwhelm thinking and lead to poor decisions. But the lack of emotion also leads to poor decisions. Emotions and feelings can lead us in the right direction as surely as they can lead us astray, and they can help us create a happy life as surely as they can create unhappiness. Living without emotion and feeling is not living well, and choices without emotion and feeling are not morally mature. Emotion plays a major role in figuring out what it takes to live life well. Our longing for happiness-our primary goal-is primarily emotional although rational reflection certainly clarifies this goal. Emotions shape our deliberations and choices chiefly by conveying more rapidly than unemotional, detached reasoning the good and bad features of a situation. In some situations emotions and feelings give immediate and clear moral direction. If you see a child tormenting an animal for example, the unpleasant feeling you experience at seeing the animal being tortured will be the major factor prompting you to stop the child's cruel behavior. Emotions enable us to respond correctly to some situations without the slower processes of deliberation. ation. Emotions and feelings often apprehend the ethical features in a situation more quickly and sometimes more accurately than deliberation. Emotions and feelings obviously play a larger role in some areas of life than they do in others. They are significant features of decision making in matters of love, friendship, courage, and being unjustly victimized, for example, but they are less significant when it comes to matters of what we owe in justice. A major emotional attitude of great importance to prudence is caring. Caring about a person or a project is feeling a concern for that person or project to flourish and be successful. In the virtue-based based morality of personal happiness outlined here, we care for ourselves by helping ourselves grow toward a good and flourishing life. We care for other people-lovers, family, friends, communities, and so forth-and for projects by helping them flourish. And we care for animals and the environment ment by helping them flourish. Caring plays a major role in living well. If we care about ourselves, we will choose what is good for ourselves; if we care about our work, we will do it well; if we care about others, we will treat them well; and if we care about our political and social institutions, we will help make them good. Care is truly an integral component of prudential reasoning. Feelings, then, are an integral part of prudence. They shape its cognitive descriptions and evaluations and in turn are shaped by them. Prudence, as Aristotle observed, can be thought of either as desiring reason or as reasoning desire. Next we turn to the final stage of prudence-making and implementing a decision to feel or behave in a certain way. Prudential Decision Making Prudence not only perceives our moral goal (happiness) and the feelings and behaviors likely to achieve it but actually directs our feelings and behaviors. Prudence culminates in decisions to do whatever will likely make our lives truly good lives. Practical decision making has been the object of intense study in recent decades. Two major paradigms have emerged: one is generally known as rational choice, and the other is often described as naturalistic decision making. Rational choice strategies emerged from psychological studies of problem solving in controlled laboratory situations. Naturalistic decision making, on the other hand, emerged from observations of how experienced people actually make good decisions in real-life life situations. The defining feature of the rational choice strategy is that it is a comparative strategy-it lays out as many alternatives as possible and then compares the favorable and unfavorable consequences quences of each. Some authors suggest laying out all the alternatives together in what they call a decisional balance sheet. Others suggest that we compare only two alternatives at a time, pick the better one, and then compare that one with a third, pick the better one, continuing until the best alternative is found. Do these comparative rational choice strategies work? To a point, yes. Comparing alternatives tives can play an important role in some decisions, especially when the decision maker wants or needs to justify the decision to others or when he is expected to seek maximization in his decision making, that is, the best that can possibly be achieved. But is rational choice strategy the best way to make practical decisions in ambiguous moral situations? Probably not. Naturalistic decision making is more promising and supports Aristotle's ancient idea of prudence dence and choice. When researchers watched experienced people make decisions in real life rather than as subjects of controlled research in problem solving, they realized that they did not compare the many possible alternatives with each other to identify the best one. Rather, after assessing the overall situation, they perceived a possible solution and decided to try it. Instead of laying out all the alternatives and comparing them by weighing the advantages and disadvantages of each, they recognized key patterns as well as anomalies in the unfolding situation, imagined a solution compatible patible with their goal, and then evaluated it as they implemented it. They developed a situation awareness highlighting both familiar and novel features and then saw a promising response they could pursue. Instead of comparing the advantages and disadvantages of many alternatives with each other, they considered only one or a few options in light of their goal and then recognized what would likely achieve that goal. How do experienced people size up a situation and perceive a promising response so readily? They do so by what researchers call expertise. What happens is this: Experience provides the rise that primes the decision-making process by enabling the experienced decision maker to recognize nize quickly what is going on and what to do about it. Hence, one important version of naturalistic decision making is aptly called the decision model. This model emerged from decades of studying how people actually made good decisions in their area of expertise. As researchers watched firefighters, nurses, pilots, engineers, nuclear plant operators, and military commanders make good decisions and then discussed with them how they did this, they found that experienced people arrived at their decisions not by rational choice strategies but by a recognition-primed tion-primed decision strategy. Only beginners with little or no experience, or people whose decisions sions would be carefully analyzed by others, employed the laborious comparative analysis suggested by rational choice theory. One way to grasp the difference between a rational choice strategy and a recognition-primed decision strategy is to think of how a computer plays a game of chess. The computer uses a rational choice strategy. It considers all the possible moves, then the opponent's

out well for us. And some good decisions may have bad outcomes; for example, we may make a decision consistent with temperance or courage and actually things may not work out well for us. A truly good decision might bring tragedy, and a truly bad decision might not. There are no guarantees. All we can say is that over the long run, moral decisions made with intelligence and prudence are more likely to contribute to our happiness and living well than decisions not so made. What then is a bad practical decision? It is not one that happens to have a poor outcome but one that was poorly made. And what is a poorly made decision? In the practical decision making guided by prudence, a poorly made decision is one made by someone who lacks situational awareness ness and the virtuous experience needed to cope well with the situation. In other words the major causes of a poorly made practical decision are not, as rational choice theorists suggest, faulty comparative parative analysis of all the alternatives or psychological biases preventing us from thinking clearly. The major causes of bad ethical decisions are an inadequate awareness of what is going on and insufficient experience to handle it well so that the decision maker can achieve what he desires most-a good life. Prudence and Religion Religion is a complex and difficult topic. It is complex because so many religions exist in the world, and most of them encompass internal factions ranging from "fundamentalist" to "liberal." Also it is a difficult topic because many believers consider matters of religious faith to be inappropriate subjects for rational discussion and critical thinking. Moreover, the religions that trace their roots back to the God of Christianity, and Islam-present a unique challenge to the ethics of happiness and prudential reasoning. These religions teach that morality originates with God and obligates the religious faithful to obeythe divine law as presented and interpreted by religious authorities. A conflict thus exists between these religious ethics and the virtue-based ethics pioneered by Aristotle. A religious believer will be torn between two fundamental questions: Does ethics originate nate from his religion or from his humanity? Does the guide for living well come ultimately from divine law or from human intelligence? Does religious faith or human reason provide the primary insights about how one should live one's life? Religious believers do not agree on how to answer these questions. Some believers say that religious faith provides the norm for moral decision making. Others say that religious faith is important but does not provide the norm for moral decision making. Still others say that religious faith and virtue combine in complementary ways and together provide the norms for making moral decisions. Often, however, proponents of this last view tend not to consider religion and reason truly complementary-in controversial issues of human behavior, they give the last word to religious gious faith, not reason. The debate over whether morality and ethics ultimately come "from above" in some kind of religious revelation of commandments presented and interpreted by religious authorities or "from below" in some kind of rational or intelligent modification of the desires and inclinations inherent in our nature has existed for centuries and will likely continue for a long time to come. We cannot hope to solve it here. However, one way to look at the relation of the virtue-based ethics and religious faith is to encourage each person to ask whether religious faith is valuable in achieving his aim of living a good life. If he finds that religious faith is valuable for living virtuously, then it is one of the potential goods, which are, you may remember, goods that are valuable in themselves and valuable also because of their contributions to the virtues. Might religious faith be more than a potential good? Might it be what the virtue-based tradition called a noble good, that is, a moral virtue? Probably not. The moral virtues are the necessary components of a morally good life. If religious faith is a moral virtue, we would have to say it is necessary for a morally good life, which seems clearly false because it is not hard to find people who live truly virtuous lives without embracing any organized faith or religion. If religious faith is considered a virtue, and some theologians do so consider it, then it is best thought of as a theological virtue granted as a gift from God and not a moral virtue gained by intentionally and repeatedly choosing morally virtuous feelings and behaviors for their own sake and for the sake of personal happiness in life. This was the general position Aquinas adopted. He argued in the Summa Theologiae (I II QQ 62) that the theological virtues (faith, hope, and charity) are specifically distinct from the moral and intellectual virtues for three reasons: They have a superhuman human aim (God); they come as gifts from God (and not from our decisions and behavior); and knowledge of them comes from biblical revelation (not human reason). In evaluating whether and to what extent religious faith might be a value that contributes to living well, it is important to remember that religion is much more than a moral code. Religions point to something sacred; provide rituals of celebration, mourning, conversion, and forgiveness; offer faith in something transcendent, hope in times of despair, and love in the midst of obligations. Religions also preserve important traditions and practices and provide communities where morality is taken seriously and endlessly debated. All these religious elements may help people achieve their primary aim-living a good and happy life. To the extent that they do, it makes sense in a virtue-based based ethics to embrace them. In other words, the virtue-based morality of happiness can, but need not, include religion as a potential good in a well-lived life. It is not without interest to note that Aristotle, the architect of the morality of happiness presented here, acknowledged the importance of religion for good living. This is somewhat surprising prising because in his theoretical philosophy he described God as an unmoved mover who neither knew of nor cared about humanity. On the political level, however, he felt it important to acknowledge edge recognition of Greek religion. Apparently he thought that religious practices conducted by the priests contributed something valuable to the social and political well-being of the community. Aristotle also spoke of "the divine element" in us as the ultimate source of our desire for happiness and of our natural tendencies to seek the goods that compose it. Finally, he claimed that contemplation of "god" is the best of human activities and thus an integral part of human happiness. ness. The exact

meaning of these remarks at the end of the Nicomachean Ethics is a matter of much dispute, so it would not be wise to make too much of them. Still, the passages exist and are suggestive. It is important to note, however, that Aristotle never felt that the divine element in us or the god we contemplate would tell us how to live a good life. That is the job of prudence rooted in moral virtue. This concludes our sketch of prudential decision making in the virtue-based ethics of happiness ness initiated by Aristotle and retrieved by Aquinas. The cases in this book will bring you as close to prudential reasoning and ethical decision making as possible by examining dilemmas in health care from the various perspectives of the moral agents involved-the people who had to decide to do something, or to do nothing. Only after their perspectives have been considered will a general ethical reflection be introduced. The purpose is not to judge others but to consider what they faced so we can better make the practical decisions in our lives that will likely make our lives good lives and bring us the happiness we desire. Before looking at particular cases, however, we need to consider some preliminary notions. The next chapter looks at the language we use and often misuse in health care ethics. SUGGESTED READINGS For a splendid account of the beginning of the moralities of happiness in ancient Greece, see Julia Annas, 1993, The Morality of Happiness, New York: Oxford University Press. Helpful comments on this book by noted Aristotelian scholars Nancy Sherman, John Cooper, and Richard Kraut, with a response by Annas, appear as a symposium on the book in Philosophy and Phenomenological Research 1995, .fS 909-37- Although the assumption that happiness is the overriding good in life was widespread in ancient Greece, it was not universal. A notable exception was the Cyrenaic school. Influenced by Aristippus, one of Socrates' followers, its members claimed our ultimate good was pleasure, and if we seek happiness, it is only because it gives us pleasure. Unlike the Epicureans, who claimed happiness is pleasure, the Cyrenaics naics taught that happiness is a means to pleasure. See Terence Irwin, "Aristippus against Happiness," Monist 1991, 74, 55-82. We rely on Aristotle and Aquinas for the development of personal good or happiness as the central theme of ethics. The classical texts are Aristotle's Nicomachean Ethics, especially books i and 10; the Eudemian Ethics, books i and z; the Rhetoric, book 1, chapters 6 and 7; and the Topics, book 3, chapters i and 2. In the past decade a major movement in psychology inaugurated by Martin Seligman and known as positive psychology has reintroduced the ancient notions of eudaimonia and a set of virtues or "strengths of character" that enable people to achieve this happiness in their lives. Positive psychology's focus on happiness (rather than mental illness)