Response to Campbell and Wallace
Martin Benjamin
I’m grateful to Courtney Campbell and James Wallace for their thoughtful comments and criticisms. My response centers on Campbell’s criticisms and draws on Wallace’s admirably clear and concise summary of my position.
Campbell has three main criticisms. First, he thinks I need some sort of external criterion to determine whether changes in our moral framework are changes for the better. Without some sort of fixed goal, he asks, how can we know whether alterations in the “ship of morality” make it more seaworthy or whether changes in its direction take us closer to our destination? Second, he questions whether my conception of ethics has a “critical edge.” Without such an edge, he suggests, it may incapable of “genuine moral critique, of saying that a particular act or practice is ‘wrong’.” Finally, Campbell thinks there may be a serious inconsistency between my personal support for physician-assisted suicide and my account of what makes for a meaningful life. In responding to these criticisms, I address, in passing, Campbell’s questions about: (1) whether the world is really hazardous; (2) the idea that some things are so certain “they go without saying;” and (3) Wilfrid Sellars’ coherentist conception of philosophy.
Underlying Campbell’s first criticism is a hankering for some sort of mind-independent telos or foundation for philosophical inquiry, particularly as it relates to ethics. Yet much of the book is devoted to showing why such a metaphysical touchstone is, for practical purposes, either nonexistent or useless. To say there is no specific, mind-independent goal of practical philosophical inquiry is not, however, to say there is no goal or criterion at all. There is indeed such a goal, but it is general rather than specific, mind-dependent rather than mind-independent.
As biological beings in a ever-changing world we are constantly at risk of pain, suffering, and death. Whether the threats come from nature (e.g., accident, disease, floods, hurricanes, tornadoes) or from other human beings (e.g., murder, rape, war, genocide, terrorism), the world is indeed a hazardous place for vulnerable biological organisms like ourselves. This, it seems to me, is obvious. I’m therefore surprised that Campbell thinks it needs amplification. A glance through the first section of any day’s New York Times tells part of the story. So does a review of how much we spend on national defense (including defense against terrorism), fire protection, police protection, and preventive, acute, and chronic health care. Over 86 million people were killed by war in the 20th Century, millions of people have and will continue to die from AIDS, and the potentially disastrous effects of bioterrorism and global warming loom on the horizon. As I write, medical scientists are breathing a collective sigh of relief over having apparently contained SARS. In the light of these and other common observations, Campbell’s claim that the book doesn’t succeed “in indicating how this actual world is a ‘hazardous’ or ‘hostile’ habitat for humanity” seems to me Panglossian.
A goal of much practical knowledge is, therefore, survival in a hard-edged world -- not survival on any terms, but meaningful survival. Meaningful lives, as I explain in chapter 8, are lives that become part of one or more valuable projects that began before we were born and won’t be completed, if ever, until long after we are dead. Doctors, for example, give meaning to their lives by becoming part of the centuries-old project of medicine. In medical school they acquire knowledge, skills, and techniques that took thousands of years to accumulate. No individual or no individual generation could produce, from the ground up, the complex combination of knowledge and skill that constitutes modern medicine. After completing their formal medical education doctors do what they can to relieve pain and suffering and forestall death. Many of them also try to improve on what they learned as students and to pass their new knowledge onto the next generations of doctors who will thereby be more effective in relieving pain and suffering and forestalling death than their predecessors. The worthy project of medicine is, as a whole, bigger and more important than the life of any single physician. Still, in becoming part of this project -- in resisting (premature) death and disease and linking medicine’s past with its future -- the lives of physicians acquire meaning and value that transcends or outlives the self.
There are many ways of outliving the self apart from become a doctor or nurse or other health professional. Many of us do it as parents -- in learning certain values and ways of life from our parents, improving on them in our lifetimes, and then passing them on to our children, who, we hope will improve them further and pass them on to their children, and so on, long after we are dead. As democratic citizens each of us can do the same in trying to build a more just society. We learn from those who preceded us (for example, Socrates, Kant, Mill, Elizabeth Cady Stanton, Gandhi, Martin Luther King, Jr., Cesar Chavez, and John Rawls), we try to make our society more just during our lifetimes, and we raise our children and support forms of education and social organization that increase the likelihood that the struggle for social justice will continue and be more widespread and successful after we are gone. We can also give our lives meaning and “outlive the self” as teachers, scientists, architects, firefighters, artists, engineers, social worker, and so on.
There is, therefore, a very general goal to which we may appeal in altering our “ships” of knowledge and of morality -- meaningful survival. Changes likely to contribute to meaningful survival are justifiable; changes likely to subvert it are not. Yet because the world and our knowledge are constantly changing, we cannot put our course on automatic pilot -- there are no unchanging moral norms or principles that lead to meaningful survival. As James Wallace aptly puts it in his review:
The world, including the social world, is continually changing, so we are often confronted with unprecedented practical problems -- problems for which our existing practical knowledge has no ready solution. We must adapt and extend our know-how to resolve such problems, and this sometimes involves altering moral norms. Thus morality, a part of practical knowledge, is also a moving, changing thing -- a response to changes that are often unpredictable. How then could there be unchanging correct practical norms somehow established ahead of time? Even if there were such norms, how would we recognize them amid all the alternatives that exist in moral philosophy and in various human communities? The pragmatist’s idea that all practical knowledge, including moral knowledge, is the precipitate of long human experience with every-changing practical problems avoids the problems in trying to explain the source and authority of independently existing unchanging norms. It also can serve as the basis for understanding how we should try to resolve the difficult, unprecedented problems of life.
Like practical knowledge, the goal or criterion of meaningful survival is neither prior to nor independent of human thought and action. The sort of “independently existing unchanging norms” that Campbell seems to want do not exist -- at least for finite, vulnerable, language-using, human animals like ourselves. But not to worry. Ethical inquiry can get along quite well without them.
Campbell’s second major criticism turns on whether my conception of ethics has a “critical edge”; whether it is “capable of genuine moral critique, of saying that a particular act or practice is ‘wrong’.” This, too, I find somewhat puzzling. In the book I provide reasoned criticism of a number widely shared views in bioethics. I argue against an absolute prohibition on embryo research, against an absolute prohibition on physician-assistance in dying, and against classifying individuals in permanent vegetative state (who can breathe without mechanical assistance but are nonetheless totally and permanently unconscious) as alive. The last conflicts with law in all 50 states. If this isn’t displaying a “critical edge” -- criticizing conventional wisdom -- then I don’t understand the term ‘critical edge’.
In criticizing widely held positions in bioethics I do not, as Campbell implies, simply assert that their wrongness “goes without saying.” I give what I think are good reasons for my views. I introduce the expression ‘goes without saying’ in other parts of the book to characterize the kinds of certainties that Wittgenstein maintains underlie our system of knowledge and belief. Examples of such certainties include: ‘I have two hands,’ ‘I have a body,’ ‘The earth is very old,’ and ‘The floor will not fall from under my feet when I get up from my chair.’ These and similar certainties, Wittgenstein argues, so basic we rarely, if ever, have occasion to state them. They are not first and foremost propositional -- not matters of ordinary propositional knowledge and belief. Rather they are manifested in what we do and constitute the “hinges” on which our (fallible) system of knowledge and belief turns. We have to stretch our imaginations to think of contexts in which these certainties would be explicitly formulated as propositions and meaningfully be uttered. They are so basic, they “go without saying.” Someone who seriously questions them has, in a sense, become unhinged.
I then extend Wittgenstein’s (pragmatic) conception of epistemological certainty to our system of beliefs about right and wrong. Like ‘I have two hands’ or ‘I have a body’, beliefs like ‘It’s wrong to cut people’s arms off to see what they’d look like without them’ or ‘It’s wrong to drop little children down deep wells to hear what it sounds like when they hit bottom’ function as certainties in our moral framework. They are the nonpropositional hinges on which our entire system of moral knowledge turns. If these actions aren’t wrong, nothing is. It’s not worth arguing about them and my hunch is they are so basic they have never explicitly occurred to you before now. Even so, you were nonetheless certain of them. Their wrongness “goes without saying” and our entire system of moral beliefs turns on them. Anyone who seriously or honestly doubts the wrongness of cutting off people’s arms to see what they’d look like without them or dropping infants down deep wells to hear what it sounds like when they hit bottom has become morally unhinged. Arguments will not convince such individuals to change their minds because they’re no longer connected to the framework in which moral arguments do their work.
I draw on Wittgenstein’s conception of certainty to reject both epistemological and moral skepticism. I do not, however, use it to support embryo research, physician-assisted dying, or my contention that individuals who are totally and permanently unconscious are dead even if their functioning brain-stems can support years of vegetative life. On the contrary, I develop arguments for these conclusions -- arguments that employ the method of wide reflective equilibrium (WRE), a coherentist approach to ethical reasoning and judgment that, I think, can be traced at least as far back as Socrates. WRE is a version of Wilfrid Sellars’ coherentist conception of philosophy: “an attempt to understand how things in the broadest possible sense of the term hang together in the broadest possible sense of the term.” This is what provides the critical edge to philosophical inquiry in general and ethical inquiry in particular. Ethical principles, judgments, or practices are criticized by exposing conflicts between moral rules and principles, particular moral judgments, and relevant background beliefs and theories about the world. Aggressively employing the method of WRE -- extending it and repeatedly testing received convictions in the light of new knowledge and changes in the world -- is what gives philosophical ethics its critical edge.
It’s hard to argue against Sellars’ coherentist conception of philosophy without (unwittingly) employing it. So while Campbell questions its adequacy in the first part of his review, he later relies on it in criticizing my personal support for physician assisted suicide (PAS). My qualified endorsement of PAS in chapter 6, he argues, doesn’t “hang together” with my account of what makes lives meaningful in chapter 8. His argument, in short, is that PAS is incompatible with the one of the most important, identity-conferring values and virtues of medicine -- sustaining and prolonging life. If physicians are sometimes permitted to hasten death, the result will be a deep fragmentation of the identity and integrity of medical practice. And insofar as physicians hope to give meaning to their lives by becoming part of the practice of medicine -- serving as connecting links between medicine’s future and its past -- they will be left, as Campbell puts it, “floundering on an ocean of meaninglessness.”
This is a serious concern. I agree that changes may sometimes be so radical as to hopelessly fragment a social practice, undermining its identity and integrity and, hence, its capacity to enable its practitioners to meaningfully “outlive the self.” I agree, for example, with Campbell’s suggestion that the corporatization of higher education may be having such an effect on the traditional notion of what it means to be a teacher or professor. I worry, too, that the corporatization of medicine threatens to have the same effect on what it means to be a physician. The imposition of the values of the market in areas in which they are entirely inappropriate is one of the most worrisome features of contemporary life. But the highly restricted practice of PAS (as exemplified in Oregon) does not, to me, seem to pose the same threat to medical practice as the encroachment of market logic. Change is not synonymous with disintegration. Nor is holding fast to tradition in the light of changing circumstances always a virtue. The Hippocratic Oath, remember, forbids surgery. But physicians were able to incorporate surgery into medical practice without thereby sacrificing their identity and integrity as physicians. Whether medicine can also accommodate a limited amount of PAS is an open question. Some, like Campbell, Leon Kass, and Willard Gaylin, say no. Others, like physicians Timothy Quill and Howard Brody, say yes. An article by Brody and Franklin D. Miller argues that “The practice of voluntary physician-assisted death as a last resort is compatible with doctors’ duties to practice competently, to avoid harming patients unduly, to refrain from medical fraud, and to preserve patients’ trust. It therefore does not violate physicians’ professional integrity” (“Professional Integrity and Physician-Assisted Death,” Hastings Center Report 25 [May-June 1995], pp. 8-17). Personally, I’m inclined to side with Quill, Brody, and Miller, but I think Campbell is right to raise the question and I’m grateful for his doing so. I should have addressed more directly and at greater length in the book. It’s a variation of the more general question about how individuals, institutions, and social practices may retain their identity and integrity while accommodating change. I make a start at answering this question in chapter 3, “Integrity,” of my Splitting the Difference: Compromise and Integrity in Ethics and Politics (University Press of Kansas, 1990).
Martin Benjamin
Department of Philosophy
Michigan State University