Ethics, Caring, and Reason

I’m currently teaching Biomedical Ethics and leading the students through discussions of crucial issues such as universal health care, abortion, and euthanasia. I’ve been following the usual philosophical practice of considering these issues from the perspective of the most prominent ethical theories. These theories make moral deliberation a matter of reasoning concerning rights and duties, consequences of actions, or principles that consider both consequences and rights. For example, consideration of whether laws should permit doctors to perform assisted suicides can take into account the rights of patients, the duties of physicians, the good and bad effects of assisted suicide, and principles such as autonomy and equality.

I still think this is the best approach to teaching medical, business, and environmental ethics, but have to acknowledge that this reason-based approach is missing something. Clever psychopaths could run through all the standard reasoning patterns, reach a conclusion about what is right and wrong to do, and still blithely pursue the wrong action that harms people and violates their rights. The problem is that the psychopaths just don’t care about people.

Feminist thinkers such as Carol Gilligan and Nel Noddings have argued that ethics should be concerned with how people can and should care about others with whom they have social relationships, not with abstract theories about rights and consequences. As David Hume and Adam Smith long ago maintained, ethics is then less a matter of pure reason than of moral sentiments such as sympathy (concern for the suffering of others) and empathy (imagining the experiences of others). However, the caring view is hard to put into practice in cases such as abortion and euthanasia where there are many people with conflicting interests to care about. Caring does seem to be an important part of acting ethically, but is limited in how much it can tell us about what the most ethical actions are.

Accordingly, let me offer the slogan: Reason without caring is empty, but caring without reason is blind. This is a variant of Immanuel Kant’s famous remark about thinking and intuition. The point of my slogan is that being ethical requires both good reasoning about rights/consequences/principles and caring about all the people affected by actions. For example, when reasoning about whether doctors should perform assisted suicides, we should also engage in sympathy and empathy for the patients, family members, and medical personnel. Perhaps these kinds of caring will help to reconcile the conflicts concerning rights, consequences, and principles that inevitably arise in ethically difficult situations. Like good thinking in general, ethical thought needs to be both cognitive and emotional.