Ethical Dilemma

The Golden Mean and Aristotle’s Virtue Ethics

A key ethical approach originated with the Greek philosophers of ancient times. Twenty-three centuries ago, Athens was alive with great teachers whose lives overlapped. Socrates was teaching about good character even as he was tried and executed for perceived manipulation of young minds. His trial was witnessed and documented by Plato. Plato learned from Socrates' trial that good moral character is essential for justice to prevail. Plato proposed a list of four cardinal virtues: wisdom, courage, temperance, and justice. Aristotle later expanded the list. Their shared emphasis is that virtue consists of habits of character so that a virtuous person matures to live an ethical life.

Virtue ethics concern ideal traits and what those traits look like in practice, why a specific moral ideal applies in a situation, how to express that moral ideal there, etc.

These virtues of character are not natural in origin; they are developed as habits through intentional and repeated practice. Moreover, they are never perfected, but only approximated, and they always remain elusive and vulnerable to loss.

Aristotle's list of virtues included eleven items and another list of personal vices to be overcome through similar practice and development of habit. Seeing both the good and the bad in virtues, Aristotle developed The Doctrine of the Mean, a kind of schematic of virtues to be contrasted with an excess of the chosen virtue and the deficiency of it.

It is easy to misunderstand what is meant by "excess" and "deficiency." These are not quantitative words to imply too much or too little of a virtue. Excess and deficiency indicate aberrations of the virtue, something about the virtue as a distortion. The most common and classic example is courage. The excess is foolhardiness and the deficiency is cowardice. Both foolhardiness and cowardice can get you killed in situations of confrontation or danger. Most importantly, they are extremes of the concept of Courage calling upon reason to bring them back to the Mean, the center of the virtue. Thus, life is a constant struggle to find the mean, develop practiced habits toward achieving the mean, and always remain close to the mean with any given virtue.

The Doctrine of the Mean is best read in Aristotle's Nicomachean Ethics. Being an ancient scheme of understanding, Aristotle's virtue ethics fell out of favor among rational theories in recent centuries, but it is resurging. This resurgence is now most commonly found in character development literature for the corporate world, in the ethical standards of professional societies, and in the core values statements of organizations.

Aristotle regards the virtues—like justice, courage, and temperance—as complex rational, emotional and social skills. You have to strive for a happy medium rather than becoming a workaholic.... remember to intersperse fun with work... equal it out...enjoy your family and instill in yourself a solid work ethic.

If you remember nothing else about this lesson, remember this: ethics come from the virtues and from learning to apply the virtues evenly and calmly.

Health Care Ethics

Health Care ethics is an arena where being virtuous can be important. Informed consent verifies that the patient has knowledge of and agrees to treatment. It is also a way to document possible results of a procedure or operation prior to it being performed. One cannot condone something if they are not cognizant of worst-case scenarios. This issue most often arises in the relationship between a patient and his/her doctor. The doctor will detail for a patient the pros and cons of what is being offered medically. The patient often may have to sign a form indicating that they are consciously and deliberating acquiescing to a procedure. Informed consent is not a matter of the virtue of generosity, but rather a proper respect of our rights

The patient though must decide. The patient must be of right mind and capable of making his/her own decision. They must be responsible for themselves. In this way, the patient must have autonomy (the ability to decide and to give oneself the law—a rule for operating). Their autonomy must also be respected. We should not make decisions for other adults. Children are not yet considered autonomous beings. They are not of the right mind and responsible for themselves. Their parents decide for them. Respecting personal autonomy and giving patients control is part of the virtue of compassion.

Even with proper precautions, best intentions, and skilled technicians, things might still go awry. Sometimes health care workers make mistakes. If a patient is injured during a procedure (whether deliberately or accidentally), that patient can sue the health care worker, medical institution, and others involved. It is often difficult (if not impossible) to determine intent. A health care worker may have wanted to cure a patient. However, that doctor or nurse for instance may have forgotten something or made an error. If they did so out of being tired, they may make themselves and the institution they work for become liable for the damage done to the patient. It may not feel right to be held liable for something done by mistake; however, even if one can argue ethically for a lack of fairness in such a circumstance, legally that idea might not hold. Not committing errors is a matter of integrity, a key virtue.

Patients want to control what is done to them. They do not want doctors to attempt anything experimental unless the patient has authorized such an approach. Patients feel more comfortable with health care matters when they feel like they are deciding what will be done. Patients also want to know that their decisions are private. They expect health care workers not to share anything about their decisions, health status, or results with anyone else. A requirement to protect privacy might also be something that follows from treating others with integrity. A right to privacy might be enshrined in law.

We can also ask if one has a right to protection from disease. On the one hand, one might think it is the patient's personal duty to protect him/herself by practicing good hygiene and maintaining a proper diet and physical state. One might also argue that undergoing all needed vaccines is also a personal responsibility of the patient. For example, in October or November, one would expect each person to choose of their own free will to have the flu vaccine administered to them. However, we cannot always expect each individual to take care of their own health even if it is in their own self-interest to do so. Often due to misinformation, religious views, or other factors, people do not take steps on their own to prevent themselves from becoming diseased and thus spreading it to others. In such cases, if we have a right to protection from disease, then is it morally correct to force everyone to become vaccinated as is the general requirement to attend public elementary schools in the US? Are vaccinations and protection of disease a matter of the virtue of prudence or perhaps respect or something else?

War, Terrorism, and Torture

The events of September 11, 2001 changed America. Terrorism struck the United States on a larger scale than before. The events were the catalyst for a war in Afghanistan (that lasted more than 18 years) and a war in Iraq. However, war has its own rules. The Geneva Conventions (1949) were a set of protocols agreed to by the nations of the world for conducting war in an ethical manner. Part of those rules were that unarmed civilians would not be targeted deliberately and intentionally; terrorism, of course, does that. Terrorists and other bad actors use unarmed civilians as human shields. If the terrorist is trying to hurt unarmed civilians and hides behinds other unarmed civilians, is it moral to target those terrorists? After all, if one targets the terrorists, one will hurt the human shields even though one's intention is to only harm the terrorists and prevent harm to the unarmed that the terrorists are targeting. It is virtuous to protect others (we show courage). Many believe that terrorists are guilty of the vice of cowardice.

As you can see, terrorism raises ethical problems. Another one related to it is torture. Many feel that torture violates a basic right to dignity (think here of Kant's second formulation). Yet, many also think that torturing terrorists is morally justified if the terrorist to be tortured knows of a terrorist action about to be performed. They call such a terrorist with knowledge of an imminent attack a 'ticking bomb'. One might say the virtue of honesty would call on the terrorist to disclose the imminent attack. However, terrorists do not practice this virtue. The terrorist may say they are not totally lacking in virtue. Through a commitment to his cause, the terrorist might say they show diligence or perseverance. Can one show virtues when committing terrorism or enduring torture?

Many say that solitary confinement is torture. One justification for punishment in prisons has been that it will give prisoners time to reflect on their vices and how to in exchange develop virtuous activity. But does time isolated on one's own enable one to think about the nature of their vice? And, does reflecting on vice instruct one on its own about what it means to be virtuous? Solitary confinement can cause grave psychological damage. Even if prisons offered courses in the ethics of virtue, when one is confined on one's own, one has no ability to practice virtuous behavior in relation to another. For example, many say generosity is a virtue and shown via charity. No one can develop such a virtue if they do not have anything to give and none to give to.