Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World - Adrian Furnham 2021

Morality and Ethics

What is moral is what you feel good after, and what is immoral is what you feel bad after. (Ernest Hemingway, Death in the Afternoon, 1950)

It horrifies me that ethics is only an optional extra at Harvard Business School. (Harvey Jones, The New Elite, 1987)

Moral psychology is concerned with explaining individual differences in moral conduct. This question is important for three reasons. First, morality, defined as the behaviours and beliefs that individuals consider to be right or wrong helps social living by censuring self-indulgence and promoting social justice. Second, moral conduct is positively related to happiness, career success and leadership. In short, good people do better for lots of reasons. Third, moral deficits disrupt personal and work relations, lead to counter-productive work behaviours (e.g., bullying, theft and absenteeism) that cost the economy billions every year.

There is no doubt that some people are more moral than others in that they follow moral codes more closely. We know that psychopaths are without a conscience and are therefore able to abuse and hurt people without any guilt. They are cold and callous.

Academics study ethics in medicine, philosophy and theology. Medics are particularly interested in the ethics behind resource allocation. Traditionally, the two philosophical principles of utilitarianism and egalitarianism have been used to underpin discussions concerning the ethics behind resource allocation methods.

Utilitarianism is a consequentialist theory because it focuses on the outcomes of actions rather than the actions themselves. In accordance with utilitarianism, the best, or most ideal, action is one that brings about maximum happiness, and the worst action is one that causes maximum unhappiness, where happiness is defined as ’pleasure and the absence of pain’ while unhappiness is defined as ’pain, and the privation of pleasure’. In the context of resource allocation, utilitarianism would endorse allocation to the person whose health and wellbeing would bring about most happiness in society, thus giving rise to individual judgements of social worth.

The second philosophical perspective is egalitarianism, which is a deontological principle. Deontology, in contrast to consequentialism, is focused on the act rather than the outcome and the morality of the act is determined by a known and accepted set of rules (Broad, 1930). As such, egalitarianism puts forth the rule that all individuals are equal in terms of social worth. However, with scarce resources, some sort of selection usually has to be made.

Medical people often have to make difficult ethical choices when they have to choose who to treat because there are too many people wanting treatments that are limited. As a consequence ethicists have come up with different systems, strategies or principles. A recent study suggests there are essentially eight principles that may be used to allocate scarce medical interventions. These are listed below:

Lottery: the random allocation of interventions, through drawing recipients blindly.

First-come, first-served: allocating interventions based on the order of request, or requirement.

Sickest first: prioritizing those with the worst future prospects if left untreated.

Youngest first: prioritizing those who have had the least life years, and thus have the potential to live longer if cured.

Save the most lives: aiming to save the most individual lives possible, through offering all people treatment.

Prognosis or life-years: aiming to save the most life-years, thus prioritizing those with positive prognoses, and excluding those with poor prognoses.

Instrumental value: prioritizing those with specific skills and usefulness — e.g. those producing a vaccine, or those who have agreed to improve their health following treatment and thus requiring fewer resources (stop smoking, lose weight, etc.)

Reciprocity: prioritizing those who have been useful in the past — e.g. past organ donors.

ETHICS COMMITTEES

Many kinds of public institutions have found it necessary to appoint ethics committees. Ethics committees are there usually to facilitate decisions as to whether a course of action — such as conducting a research project — fulfils certain criteria. The theory is that a group of (wise) individuals can perform a disinterested evaluation of a proposed course of action that minimizes harm to any and maximizes benefits to many.

Furnham (2015) recommended that to make ethics committees function, the following seem useful requirements. First, have a chair who knows about ethics. Second, decide on a system or code that is to be implemented. Third, choose and vet committee members carefully and do not have too many. Fourth, have a lawyer on board. Fifth, ensure this process and dynamic is functional, not dysfunctional. Sixth, ensure the committee knows precisely its function and duties. Seventh, have an appeals procedure. Eighth, ensure people have a set period on the committee and do not automatically renew. Ninth, give the committee feedback on their earlier decisions. Tenth, consider changing the name from ethics committee to something else like ’Litigation’, ’Harm Avoidance’ or ’Research Progress’ Committee.

REFERENCES

Furnham, A., McClelland, A., & Drummond-Baxter, E. (2010). The allocation of a scarce correctional resource: Deciding who is eligible for an electronic monitoring program. Journal of Applied Social Psychology, 40, 1605—1617.

Furnham, A., Petrides, K. V., & Callahan, I. (2011). Prioritizing patients for surgery : Factors affecting allocation of medical resources for kidney transplantation, IVF, and rhinoplasty. Journal of Applied Social Psychology, 41, 588—608.