How do we determine our codes of ethics? Most people inherit ethics from religion or their families, but what does it mean to fashion a code of ethics for oneself, to take ownership of it? The past year and a half, I’ve been working in a research hospital, and I’ve spent many hours learning how to do ethical research on human subjects. I also read Atul Gawande’s book, Being Mortal, which every person should read (seriously, I cannot recommend this book enough). These things and lots of conversations with people and my own introspection have helped me to fashion my own ethical priorities, so I thought I’d share those with you all.
Autonomy, Accountability, Reciprocity
I think the foundation of ethical actions should be autonomy. This is primarily based on my biomedical ethics class and Gawande’s book. I would listen to case studies, week after week, where ethical decisions were murky and someone had to draw a line somewhere. And I often found that I was drawing the line at autonomy (if informed consent was present). And then I read Being Mortal, which is all about how we make decisions when we are near the end of our lives. Gawande tells stories of the elderly being put in senior homes where their lives were severely controlled and regimented, to the point of depression. Patients complained that their caretakers or children would take away all their sweets or knives or alcohol out of fear that would end their life while at the same time taking away the vitality of their life. And it dawned on me. “People should have the right to make bad decisions.” Again, informed consent is super important, because someone making a bad decision based on ignorance is not a useful or ethical manifestation of that. But if I know the bad effects of alcohol, I should have the autonomy to make bad decisions regarding it (not that I do, but that’s just an easy example). Autonomy is so central to our conceptions of personhood. That’s why slavery and rape and murder are so immoral and evil; they are each a stripping away of a person’s power over their own bodies.
And with having the right to make bad decisions for ourselves comes the fact that we are going to hurt ourselves and others at some point in our lives. It’s unavoidable. Which is why I think accountability and personal responsibility is also vastly important to ethical decisions. It means looking at my actions, really listening to the hurt person, and saying, “I did a bad thing, and that’s not okay.” It means apologizing, and I mean real, honest apologizing. Not the apologies that politicians give where it’s a vague “I’m sorry if I hurt people, but hey, look at all this good stuff I’ve done.” I would respect an “I did [x specific thing], and I didn’t mean to, but it caused real damage, and here is how I am working to make things better” so much more than claiming not to have done something bad at all. We don’t need to be afraid of accountability. Partially because I have a firm belief that most people hurt each other out of insecurity and ignorance than out of real malice. We usually think that owning up to our bad actions means we think we’re bad people. But that’s shame, and shame is toxic and not useful. We do bad things, but they are do not define us as bad people. And that’s what accountability is. And then accountability should also include the reformation step, the “here is how I have learned from my previous bad actions and how I am going to make things better (either for this person I hurt or with people in the future).”
I wanted to end with reciprocity because the first two tenets are very individual-focused. But living ethically is about how we interact with other people. I believe that reciprocity is the undercurrent that must inform autonomy and accountability in order for them to be ethical. I cannot focus only on my own autonomy; I must work to make sure that everyone has the ability to make autonomous choices. I cannot focus only on my own accountability; I must work to hold other people (especially the people who have some form of authority over others) accountable as well. We live in a very individualistic society, so it would be easy to just create an ethical code that looks out for me, myself, and I. But reciprocity tells me that the choices I make do not matter only to me; they matter to everyone around me. And maybe this is the facet that is easiest to dumb down to just being nice. Because it’s a lot of responsibility to realize that all of my actions have consequences. If I focus on just myself, I’d say that I have the right to waste my time on the weekends watching hours and hours of Buffy the Vampire Slayer. But what acts of justice am I neglecting to do if I do that? I’m not saying it’s not important to rest. We cannot focus on other people if we are burnt out ourselves. That’s part of reciprocity too! Reciprocity is not just treat others as you want to be treated (with autonomy and accountability); it is also treating yourself how you want others to be treated: with kindness and compassion.
Obviously, I am only a young person who has just started thinking about ethics, so it is likely that my views on this will change. But I think it’s a good starting point. What do you think of my three ethical tenets? How would you define your own?