Tuesday, March 20, 2018

Cost-Benefit Analysis And Informed Consent Both Seem Neutral But They're Totally Different

Because I'm interested in value pluralism, I spend a certain amount of time thinking about two seeming alternative approaches to complex ethical situations, namely efficiency and informed consent.

As I see it, in contexts of value pluralism, making ethically complex decisions often requires making trade offs among values and figuring out what to do in cases of moral conflict. For example, we might value autonomy, benevolence, justice, honesty, and fidelity -- and these might recommend different actions in different circumstances. If you have to lie to keep a secret that you've promised to keep, honesty might entail telling the truth, while fidelity and keeping commitments might entail lying. We might make different judgments about which value matters more in a given case, and those decisions might be highly context-sensitive. Crucially, those judgments require judgment: someone has to make a decision about what they think matters and why.

One of the knocks on this kind of pluralism is that because it relies on ethical judgments, it is arbitrary and subjective. Someone has to make a moral judgment. How? And based on what? If you want to see why I think that these criticisms are misplaced, you can read my book. The point of this post has to do with the potential alternatives. Very broadly speaking, two alternative ways to approach decision-making are through cost-benefit-analysis and informed consent. Those aren't ethical theories, but they are informal descriptions of methods people use. What's interesting to me is that while these are often simultaneously treated as impartial, objective, and commonsensical, they're also really deeply different.

As everyone probably knows, cost-benefit analysis means adding up the costs and benefits and generally choosing the action that maximizes the benefits at the least cost. Costs and benefits can refer to money, or they can refer very generally to well-being and preference satisfaction, or to something else. If you're trying to decide where to build a new road, you might add up the costs and benefits and see which proposal looks best.

Informed consent may be most familiar to us from medical ethics, but it is in play in any system in which rights and voluntary exchange are seen as the relevant ethical components. When we round up people for testing a new medical treatment, we don't use cost-benefit analysis and then choose the best people and make them do it; we recruit people and ask them to give their informed consent. Presumably, that's because we think people have a right to control what happens to an in their bodies.

These two ways of approaching issues are really different. One focuses on what's best for the group, and doesn't pay much attention to individual rights. The other focuses entirely on individual rights, and doesn't pay much attention to what's best for the group.

In regular life, I expect most of us shift smoothly from one to the other as seems appropriate. If you're thinking about the social norms around deciding whether or not to have sex, it would be strange to use cost-benefit analysis. What if person A really really wanted it and person B mostly didn't? Could CBA could yield the conclusion that B had to go along with it? Typically, we use the autonomy-decision-consent framework there. If you're thinking institutionally, though, about questions like where and how a university should build new gym or dorm space, then cost benefit analysis may be just what you want. Would you really want to give each person a veto?

How do we know when to use the one and when to use the other? It's complicated, but roughly something like this: some areas of life concern basic rights and you have to use the autonomy/consent framework; others involve presumed cooperation and you expect to use the CBA framework. When? It's based on institutional structures and also background judgment.

Sometimes, we use a mix of the two approaches. This CBC story describes a situation where a provincial government is deciding to close a small town because it is too expensive to supply the town with resources. The way the system works, communities must volunteer to close and in a vote, at least 90 per cent of residents must be in favour of relocating; then if they do relocate, each resident receives between $250,000 and $270,000 to move to another town.

It's not CBA, since there's a consent requirement. It's not the consent-autonomy framework, because you might be in that 10 percent who doesn't want to move; also, I'm guessing CBA of some kind was used in arriving at the dollar range specified. It's a mix. Where did that "90 percent" come from? I imagine it's a number that seemed about right to someone, based on all the factors involved. It's a judgment.

So: if we use our judgment in deciding when to use the various frameworks, and if sometimes we use a mix of the two approaches that incorporates some group thinking and some individual thinking ... well, doesn't that mean we're always using the same kind of judgment calls that value pluralism makes use of?

These two ways of looking at things might seem objective or neutral, but the fact that they're so different ethically shows they're not really objective or neutral. They're value systems. That is not bad -- it's good! But as long as you're using a value system anyway .. why not use one that reflects the full multiplicity of values and represents accurately the complexity of ethical decisions? It sometimes seems uncomfortable for decision-processes to rely on judgment and values, because then we have to ask, "Whose judgment and values"? But I think any way of making complex choices relies on judgment and values. So that question is, in some sense, always with us, even when we can't see it clearly. 

Tuesday, March 6, 2018

Frankenstein And Feminist Ethics

Mary Shelley
I've always had a thing for Mary Shelley. I love the book Frankenstein, and have always thought it a seriously philosophical work -- nothing like the monster movies that came later. Shelley's life, full of adventure, literature, politics and parenting, was incredible.

So I was excited to read Jill Lepore's New Yorker article contextualizing some of the history of Frankenstein. I already had the opinion that the book is more about motherhood than about science, but it was cool to see everything assembled in a tidy package. As I wrote about before, if you've read the book, you know that what changes the creature from a kindly awkward creature into a violent monster is that his creator despises him. He has no one to love him. He has no mother. This leads to the violence that ruins the lives of everyone in the story. Lepore talks about Shelley's miscarriages and how many infants she gave birth to who died soon after being born -- basically, "eight years of near-constant pregnancy and loss."

I learned two new things about Frankenstein. One is that the story wrapped within a story wrapped within a narration allows the novel to depict different perspectives all at the same time. Lepore says it's like nesting dolls. and because of this, people debated whether the politics of the book are revolutionary or counter-revolutionary.

A second, more interesting, thing is that the creature's account of his eduction closely follows the conventions of the slave narratives of the time and that the creature's experience was understood to implicate the institution of slavery.

You may remember that the creature, on being chased out of the lab and roaming the countryside trying to find warmth, shelter, and companionship, then listens to a family through a hole in the wall and later comes upon books by Milton, Plutarch and Goethe. This is how he learns to read and write and think in language. I learned from Lepore's piece that despite Sir Walter Scott finding this "preposterous," it actually echoes stories like that of Frederick Douglas, who learned to read by trading with white boys for lessons and later from reading books. I had no idea that Shelley and her contemporaries were following debates over abolition, or that the relationship between the creator and his creation was widely seen as a parallel for the United States and slaves who, if freed, were sure to seek vengeance. Now I want to read Elizabeth Young's Black Frankenstein.  

One thing Lepore doesn't discuss, that I've always wondered about, is the relation between the motherhood themes of Frankenstein and the philosophy of Shelley's father, William Godwin. Shelley was the daughter of Godwin and philosopher Mary Wollstonecraft, but Wollstonecraft died soon after giving birth, so she was raised by Godwin (and, eventually, a stepmother). Godwin was a utilitarian and a famous impartialist -- meaning that ethically we ought to treat each person as equally deserving of our moral consideration.

I learned from reading Peter Singer that Godwin proposed a thought experiment: you are outside a burning building and inside is a famous author and also your father, who happens to be the author's valet. The author writes the kind of books that bring moral uplifting and happiness to many people. You have to decide whether to save the author or your father. Godwin said you should save the author, because morality requires impartiality, and impartially the author will bring a greater amount of happiness and well-being to the world than your father ever would.

I don't know much about Godwin, but doesn't that sound like the opposite of the themes of Frankenstein? Part of the point of the book is that without that deep and highly partial love that a parent can give you, you cannot develop into a proper human (or, proper creature in this case).

I'm not saying utilitarianism is pro-monster, obviously. It's more a question of how love fits into it, and how caring is essential to ethical life. Shelley's perspective fits with contemporary feminist ethics and ethics of care, but now I'm curious of what she thought of her father's philosophy.

In the end, one of Shelley's children lived, and after a serious of difficulties, Shelley devoted her later life to bringing up her son, educating him, supporting him and her father, while traveling and writing. Along the way, she helped all kinds of people, especially women whom society disapproved of. We love you, Mary Shelley!