Ethics as Solutions vs Constraints
Contrasting Beneficence-first vs Purity-first approaches
On one picture: The status quo is generally acceptable, but people have conflicting interests, so the central role of morality is to constrain our behaviour to prevent mistreatment of others. Other than that, we can basically do as (little as) we please and ethics doesn’t have much more to say about the matter.
On a competing view: Humanity faces severe problems (from global poverty to climate change, pandemics, and other global catastrophic risks), and needs to co-ordinate in order to develop and implement solutions. The central role of morality is to guide our choices as we navigate difficult trade-offs. We shouldn’t deliberately exploit or mistreat others, as a cooperative approach does better in practice, but our central aim should always be to find solutions, not just to maintain clean hands.
I strongly favour the problem-solving (“beneficence-first”) conception of ethics over the constraints (or “purity-first”) one. And I hope that, once the choice is made explicit, most people will agree. The status quo is not generally acceptable. That’s not to call for “revolution” or wanton institutional destruction—there’s plenty of room for things to get worse—but we do need to work on creating solutions, not just passively sitting on our laurels. And that means that indiscriminate constraints on human agency and entrepreneurship—barriers to progress—are not our friends, and should not be valorized as ‘ethical’.
Detrimental barriers to progress can be found all over the place. Some, e.g. NIMBY resistance to housing abundance, may stem more from parochial interests than from distinctively ethical beliefs. But even there, it may at least help to stress the moral case for progress, and the importance of housing abundance for (eventually) helping those struggling with current high prices.
More interestingly, there are realms—such as bioethics—where I think the purity-based conception is arguably playing a larger role. People die from kidney failure (or spend years on dialysis, with a vastly reduced quality of life) simply because kidney markets are viewed as “taboo”. The risk that some individuals might regret selling a kidney—or the worry that it’s essentially “exploitative” to allow people to trade off their medical and financial interests—is implicitly given lexical priority over all other moral considerations, including the many lives that could be saved and improved (including all the potential kidney donors who reasonably judge that they would benefit more from the extra money than they do from maintaining an extra kidney). I doubt that anyone taking a beneficence-first approach to ethics could honestly conclude that our current policy, banning markets in kidneys, secures the optimal balance between competing moral considerations here.
And of course the problems in pandemic policy were even more extreme. We had the COVID vaccine the whole time (from Jan 2020), but our regulatory system took an entire year—which itself was faster than expected!—to allow most people to access it. Why this obstruction, resulting in hundreds of thousands of unnecessary deaths, is not more widely recognized as a constraints-violating instance of mass killing, I’m not quite sure. Blocking access to life-saving medicine sadly doesn’t seem to activate people’s purity alarms in the way that granting (voluntary) access to an untested medicine seems to. The slightest risk of blood on our hands—even as a result of an entirely voluntary transaction—seems to swamp the reality of mass graves that we can instead attribute to the virus. At any rate, it seems clear that a problem-solving, beneficence-first approach to pandemic ethics and policy would look very different from what we actually ended up with.
Vaccine challenge trials are perhaps the ultimate example of this. Critics assert that it is “unethical” to allow altruistic (let alone paid) volunteers to undergo the risk of a post-vaccine deliberate exposure to the virus in order to quickly verify the vaccine’s efficacy. Even though (i) they’ve given informed consent, (ii) vastly more people ended up suffering involuntary infections due to the failure to roll out vaccines sooner, and (iii) between the vaccine itself and the lower dose of a controlled exposure, it could well be reasonable for participants to view their participation in the trial as reducing their ex ante risk from the virus (e.g. if they thought there was a high chance of their otherwise suffering an uncontrolled infection).
It’s an ethical no-brainer that, at the start of a pandemic, “ethics” barriers beyond the minimum baseline of informed consent should be suspended for promising pandemic research. Otherwise, you’re turning ethics into an enemy of humanity. This may be one of the most important implications of adopting a problem-solving, beneficence-first conception of ethics—and a good test of moral sanity (which surely requires at least some sense of proportionality). I’m embarrassed for our species that we failed it. Hopefully we’ll do better next time around.