How I Think About Ethics

It looks like all of those who responded are conscious of the ethical aspects of the decisions they make. The question then is: “how do we make our ethical decisions?” Some depend on their intuition—making a decision based on the ‘gut’. That usually provides good guidance, but may miss key nuances and can be sidetracked by emotions or other issues that might not be obviously relevant. For example, if you are tired, hungry, angry, or annoyed, you may have a different response than when you are happy. Another option is a strictly rational analysis—applying strict rules or principles. But this approach also can miss nuances related to emotion or unanticipated factors. Perhaps the best combination is using the two approaches to complement each other—think about it, categorize the issues, identify what is at stake, perform some analysis, and use your innate moral compass to find the right path. I think that the study and application of ethics is beneficial for two broad reasons. The first is that it helps us think about ethical problems by identifying what is at stake, and then what we value. It can provide words and categories to organize our thoughts. The second benefit is that employing an ethical analysis can keep us from a wrong decision. For many situations there may be a number of differing ‘right’ decisions, but there are also decisions (and ways of going about the process) which should be considered wrong. Taking the time to organize and think about it may not get you to THE right decision (since frequently there isn’t just one), but will help keep you from making the wrong one. There are many systems of how to think about ethics. Those of us who went to medical school in the US probably learned of the four principles—autonomy, non-maleficence, beneficence, and justice. These are important and useful, but sometimes difficult to apply (and frequently autonomy trumps the rest). There are also philosophical approaches that emphasize the correctness of an action (deontology) or the benefit of the many (utilitarian). I find it more useful to think about duties. Instead of someone having rights so that they can demand or expect that I act a certain way, I think it is better to ask: what are my obligations? This means I have to find the right path regardless of what someone else expects or demands. And in order to figure out what those obligations entail, I ask: how would someone who models great virtues act in a given situation? We can think of many virtues that we should emulate—for example kindness, caring, and honesty (and many more). If we break down a problem into what is at stake, think about how a virtuous person would act, and then consider ourselves obligated to act similarly, we will be well on our way to finding answers to our ethical problems. In this and coming issues, we will have more polls with more issues to discuss. Please respond to the polls and email us at ethics@spine.org with your comments, questions, and suggestions for issues to address.