Health Care Anal DOI 10.1007/s10728-006-0031-7 ORIGINAL ARTICLE
Disputes Over Moral Status: Philosophy and Science in the Future of Bioethics Lisa Bortolotti
C
Springer Science+Business Media, LLC 2006
Abstract Various debates in bioethics have been focused on whether non-persons, such as marginal humans or non-human animals, deserve respectful treatment. It has been argued that, where we cannot agree on whether these individuals have moral status, we might agree that they have symbolic value and ascribe to them moral value in virtue of their symbolic significance. In the paper I resist the suggestion that symbolic value is relevant to ethical disputes in which the respect for individuals with no intrinsic moral value is in conflict with the interests of individuals with intrinsic moral value. I then turn to moral status and discuss the suitability of personhood as a criterion. There some desiderata for a criterion for moral status: it should be applicable on the basis of our current scientific knowledge; it should have a solid ethical justification; and it should be in line with some of our moral intuitions and social practices. Although it highlights an important connection between the possession of some psychological properties and eligibility for moral status, the criterion of personhood does not meet the desiderata above. I suggest that all intentional systems should be credited with moral status in virtue of having preferences and interests that are relevant to their well-being. Keywords Moral status . Personhood . Intentional systems . Symbolic value . Animal ethics . Marginal humans
1 From moral status to symbolic value In the ethical debates on whether we have moral obligations towards non-persons, such as human embryos and non-human animals, there has been a tendency to move from ascribing moral status to ascribing moral value. The difference between these notions is very significant: if an individual is credited with moral status, then that individual deserves direct moral consideration and is taken to be part of our moral community. To acknowledge moral value
L. Bortolotti () Department of Philosophy, University of Birmingham, Edgbaston B15 2TT, United Kingdom e-mail:
[email protected] Springer
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is a way of accounting for the fact that we seem to have moral consideration for entities or individuals that are not necessarily part of our moral community. The move from moral status to moral value has attempted to bridge the gap between extreme views about moral status in the debates, but even by shifting everybody’s attention to moral value, there has been no success in finding the basis for a more widespread agreement. Bonnie Steinbock [8] argues that human embryos should be treated with respect and that not all destructive uses of human embryos are morally legitimate. This view is based on the conviction that embryos are symbols of human life and therefore should be granted respectful treatment. Bortolotti and Harris [4] have put some pressure on the plausibility of grounding the claim to respect for embryos on symbolic value. There are two paradigmatic cases of symbolic value. In the former case, entities or individuals acquire value derivatively, that is, they do not have intrinsic value but inherit some of the value of what they stand for. An example of this is the national flag. It does not have any intrinsic value but derives its value from the respect people have for what it represents, the values of a nation. In cases where the symbol has no intrinsic value, it is regarded as acceptable to prioritise the interests of individuals with intrinsic value over the respect for the symbol when these come into conflict. In the latter case, entities or individuals have intrinsic value and, in addition to that, they also have symbolic value in so far as they also stand for another valuable entity or individual. An example could be the president of a nation. As a person with interests and rights, he or she deserves the respect that we have for all persons. As a person who represents a nation and its values, the president might also be attributed additional importance and his or her life be protected to a greater extent than the life of other persons who are not powerful symbols. In these cases where the symbol has intrinsic value, it is regarded as acceptable to prioritise the interests of the individual with intrinsic and symbolic value over the interests of other individuals with intrinsic value or with mere symbolic value. It is easy to see that, in the case of the ethical debates on our moral obligations towards human embryos (which concerns termination of pregnancy, reproductive technologies and stem cell research), the appeal to symbolic value is of little help. Either we recognise from the start that human embryos have intrinsic value, and are then left to determine what specific moral obligations we have towards them, or we concede that they have only symbolic value, and then the respect we owe them will always be subordinate to our moral obligations towards those entities and individuals with intrinsic value. An example might help to clarify this point. Suppose I concede that human embryos are symbols of the life of human persons, but have no intrinsic value. If that is the case, I will not treat human embryos disrespectfully if I can avoid it. Yet, I might approve of stem cell research on human embryos, even if it results in the destruction of embryos, on the basis of my moral obligations to persons afflicted by medical conditions that have the potential to be treated with stem cells. The interests of these people will be more morally valuable to me than the respect I owe to a mere symbol. If I believe instead that embryos also have intrinsic value, and a value comparable to that of human persons, then I might come to a different conclusion and argue that they should be protected. Which side of the debate I am on depends on whether embryos are credited with intrinsic value and whether I believe I have moral obligation towards them. Considerations about symbolic value do not make a difference in the context of debates where the respect for embryos is in conflict with the interests of persons (e.g. women wanting a termination of pregnancy, women wishing to undergo IVF treatment or people whose health conditions can benefit from the outcome of stem cell research). Of course there can be other ethical debates in which symbolic value plays an important role. But such debates will have a different Springer
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structure and will not be based on a conflict between the interests of persons and respect for non-persons. This example suggests that, in debates about the treatment of non-persons, there are problems that cannot be solved by relying on symbolic value alone. One is that respectful treatment might have different implications for moral agents with different beliefs about moral status. Steinbock [8] does not believe that all practices involving the destruction of human embryos are objectionable. She is not necessarily against embryonic stem cell research or termination of pregnancy because she believes that these practices can help us safeguard the interests of individuals that have moral status. But she is opposed to any “frivolous” use of embryos. So respect in her view does not include a right to life. But Tom Regan [6], who advocates respectful treatment for some non-human animals, believes that all practices leading to the killing of mammals are morally objectionable, from the production of meat to scientific research on rats and primates, because respect in his view does include the right to life. Questions about moral status and direct moral obligations won’t go out of fashion in ethical discussions about the interests, welfare or rights of non-persons. But is there anything we can do to bridge the gap between extreme views about the treatment of non-persons and make some progress with disputes about moral status? The first step is to look at the accepted criteria of moral status. The notion of personhood, traditionally central to debates about moral status, has been intensely criticised for being too vague, too demanding, and too difficult to apply [3].
2 Back to moral status: The limits of personhood Traditionally moral status has been seen as the privilege of persons, where the term “person” refers not to human beings, but to those beings that have the capacity to reason, make autonomous decisions and consider themselves as the unique subjects of their own varied experiences. By having these capacities, persons qualify as having the power to deliberate and make choices. Autonomy implies that persons have interests and preferences and that they are vulnerable. They can be harmed when their opportunity to deliberate is denied to them or when their preferences about states of affairs that significantly affect their well-being are frustrated. Granting moral rights to persons or protecting their interests contributes to safeguarding the exercise of the capacities they have. Philosophers concerned about the well-being of non-persons have often based their own ethical argument for the respectful treatment of marginal humans or non-human animals on the basis of the fact that these non-persons share important psychological properties with persons. Regan [6] believes that anybody who fits the description of a “subject of a life” should be granted respectful treatment and in Peter Singer’s defence of the interests of non-human animals all “sentient beings” have morally relevant interests. On these views, if individuals are able to act on their beliefs and preference (and are, as Regan calls them, subjects of a life) or have sentience (and therefore have a preference for avoiding painful sensations), then they are the legitimate object of our direct moral consideration. Whether these individuals also have the capacities for rationality and self-consciousness that characterise the Lockean definition of personhood, is no longer relevant. It makes sense to adopt a psychological approach to moral status [2], that is, to accept that whether an individual has moral status depends on whether that individual possesses some psychological properties. The further question is whether personhood includes all and only those psychological properties whose possession is necessary and sufficient for moral Springer
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status. Two main problems have been identified in the choice of personhood as a criterion of moral status [3]. First, it is not an easy criterion to apply, because most of the capacities that make up personhood (intelligence, moral concern, self-consciousness, rational deliberation, emotional life etc) can be found in isolation from the others, and come in different degrees, whereas moral status is supposed to be an on/off concept. Whether an individual is credited with direct moral consideration does not admit of degrees. What might vary according to the presence of certain psychological capacities, or to the extent to which these capacities can be exercised, is the number and kind of moral rights that are granted. It does not make sense to grant liberty rights (e.g. freedom of speech) to a cat, but it does make sense to talk about the right to education for children in developing countries. Second, personhood is not an easy criterion to justify on the basis of ethical considerations, if we regard the possession of interests or preferences paramount, as non-persons can have preferences or interests without being self-conscious or rational. I shall explore this point in the next section.
3 Intentional agency: Towards a new criterion of moral status My suggestion is that we should opt for developing a criterion for moral status that captures the psychological characteristics of intentional agents. Intentional is the behaviour that can be explained or predicted on the basis of the ascription of beliefs, desires, preferences, emotions and other intentional states. The reason why this criterion seems to me to be a promising solution is that intentional agents can exercise their capacities for reason and autonomy to some extent and act with the goal of preference satisfaction, although they might fail to satisfy the criteria for rational deliberation and moral agency. The ethical justification of the use of the notion of intentional agents needs to appeal to the “powers” that moral status is aimed at safeguarding. The traditional emphasis on reason and autonomy needs to be revisited in the light of the emerging distinction between (a) the minimal exercise of these capacities represented by an agent being able to initiate actions on the basis of beliefs, desires and preferences, and (b) the full exercise of these capacities that is necessary for rational deliberation and moral agency. This distinction is very useful in accounting for the reason why we feel that direct moral consideration should be granted to infants, severely impaired human adults and, say, some other mammals, even though the full range of moral rights cannot be applied to them. Very young children and mentally impaired adults might not be regarded as morally responsible and liable for their actions as adults who have full capacity. They are likely to lack the capacity to think about themselves as unique individuals and the capacity to assess different reasons for action, which leaves them with a limited capacity for autonomous deliberation and moral agency. But as long as they are autonomous agents in the minimal sense, that is, they have preferences about states of affairs that affect their well-being, and act on the basis of those preferences to achieve their goals, they deserve direct moral consideration. They still have a “power,” although a diminished one with respect to fullyfledged persons, and that power needs to be safeguarded. Some non-human animals might be (in some respects) in a comparable state of autonomy to that of very young children and severely impaired humans, in so far as the powers they have consist in having simple beliefs and preferences about circumstances that significantly affect their well-being and allow them to act on their beliefs and preferences. The obstacle in turning intentional agency into a criterion of moral status lies in the issue of application. Some believe that only linguistic creatures, such as competent human Springer
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adults, qualify as intentional agents. For others, the notion has a wider application, ranging across many non-human animals and some automata. How can we reach agreement on the application of this criterion if the current views about the distribution of intentional agency are so disparate? The fact that intentionality is often ascribed instrumentally makes it really hard to assess the applicability of the criterion. As I said, philosophers and scientists disagree on which individuals are capable of intentional action. These differences can be partially explained by the fact that there are different notions of “belief,” “desire” or “preference” to be found in the philosophical and psychological literature and by the fact that it is not always transparent which type of behaviour would legitimise the ascription of intentional states. Is intelligent behaviour enough? I believe that this debate is not merely terminological. The current studies in comparative and developmental psychology and reputable accounts of the evolution of human cognition suggest that there are viable notions of intentional states that can be mapped onto specific behavioural patterns and that are quite minimal. By minimal I mean that they do not involve the capacity for second-order thought or sophisticated symbolic representation. How can we tell whether non-linguistic creatures, such as human embryos and non-human animals are intentional agents? Rigorous philosophical analysis and empirical studies can help to find ways to apply abstract concepts to specific behavioural patterns. For instance, Kim Sterelny [9], writing on the evolution of cognition, argues that an agent counts as having a preference if four conditions are satisfied. 1. The point of intentional action is not necessarily to obtain an immediate reward, but to change the environment in accordance with the content of the desire on which agents act. 2. Agents are sensitive to different features of their environment and in particular to the feature to be modified in accordance with their preferences. 3. Agents can learn what they want, not just how to get it, so they can acquire new preferences. 4. There can be different (competing) sources of motivation and therefore agents rank their preferences. When a detailed philosophical analysis of what the possession of preferences requires is available, it is likely that it can be matched with behavioural patterns that we can observe or study experimentally. This will lead us to some hypotheses about whether non-persons, such as a cat or a three-week old embryo, satisfy the requirements of intentional agency and have morally relevant interests to be safeguarded.
4 Conclusion In this paper I have attempted to show that appealing to issues of moral value in debates that affect the interests of non-persons might not advance the status of those debates. We have dramatically different moral intuitions about the way in which human embryos and non-human animals should be treated and often these intuitions are shaped by personal experience, religious or philosophical views and even aesthetic judgements. To say that we should care for human embryos and non-human animals because they are symbols of something intrinsically valuable will not help us reach agreement and might create confusion between genuinely moral considerations and considerations of another kind. Moreover, as I have argued, to attribute moral value to an individual is not sufficient to determine how it should be treated and what it is entitled to, when there are conflicts of interests with other individuals who have intrinsic value. Springer
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That is why it is too early to give up on moral status. We need to find some acceptable criterion of moral status that can be easily applied and can receive a solid ethical justification. The notion of personhood as a criterion of moral status has been challenged because: (1) it is difficult to apply as the definition of “person” is highly abstract; (2) it seems too demanding if we start from the assumption that having interests is what seems morally relevant; and (3) it does not vindicate some of our sensitivity to the interests of humans with severe disabilities and other non-persons. I have argued that we need a criterion that can help us make finer distinctions between individuals with different psychological properties and protect all the morally relevant interests that need safeguarding. My suggestion is that the possession of intentional states such as basic beliefs and preferences is necessary for a minimal account of autonomous agency and that a new criterion can emerge from a further exploration of these capacities. This is a tentative suggestion because more work needs to be done. Philosophers and scientists in cooperation need to identify which individuals among the vast category of non-persons can be said to possess beliefs and preferences that give rise to morally relevant interests. This is a very challenging new distribution question to answer. Pessimists will say that no amount of research in these areas will ever provide the basis for agreement on controversial bioethical issues. But I trust that the attempt will make the existing problems easier to tackle and contribute to moral progress. Acknowledgements This paper was presented at a conference entitled “Bioethics: Past, Present and Future” that took place at the University of Birmingham (UK) in June 2006. I am grateful to Jon Ives for inviting me to be a speaker at the conference and to the audience for a very stimulating discussion. In the preparation of the written version of this paper, I acknowledge the stimulus and support of the EURECA project on delimiting the research concept and the research activities, sponsored by the European Commission, DG-Research, as part of the Science and Society Research Program — 6th Framework.
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