Bioethics: Analyzing Reasoning in Moral Controversy

In bioethics, moral controversies may have high stakes. Differences of fact or opinion are of a different nature than moral disagreements. There are factual disagreements where a truth may be discovered, making one side right and one side wrong. During the COVID-19 pandemic, some such factual questions were politicized, but that alone does not turn them into moral questions. That is, the question of whether masks prevent spread of COVID-19 is a factual question regardless of who believes it. The current role of factual disagreement has to do with reporting and beliefs not with the fact itself. There also are constant new discoveries and there is a time of uncertainty in the process of discovery of facts. While there may be turbulence during the learning process, facts, when ascertainable, answer controversies easily.

Simple opinions are easy too—they are the arena where people may just agree to disagree. We do not all need to have the same taste and preferences. But some opinions concern morals, and the need to address, understand, and possibly resolve them is helpful to society.

Moral Controversy

But moral controversies arguably feel more like facts than opinions to some people, although it is difficult or impossible to prove morals true objectively. To David Enoch, phenomenology could demonstrate the lived experience of holding the belief. (A post about moral objectivity and moral relativism is coming soon.) We should not approach moral disagreement in the same way as other disagreements about opinions. Agreeing to disagree may disenfranchise one side unfairly.

For example, to me, a moral approach to climate change favors mitigation, adaptation, preparation, and sustainability. But the morals-based argument that those goals conflict with individual and corporate freedoms inherent in natural law (or negative rights), the US Constitution, or other rights-based frameworks, poses a problematic impediment. To dismiss the other side without an effort to understand its reasoning ignores the moral controversy. The subject of a moral controversy can be legislatively resolved. It can be winner-take-all or involve compromise. But moral resolution requires an effort to understand the other side’s reasoning.

I use the term “mid-level morals” to address those beliefs about right and wrong that are not fundamental to the inner workings of society. For example, at a certain non-foundational level the extent to which people expect dependability or respect authority varies significantly. (The UN has found common ground on many human rights that are fundamental like freedom from slavery and torture, or a right to liberty.) Within the US, people who view themselves as highly moral engage in things other people consider highly immoral because morals vary. Taking a seat on the subway when an elderly person is standing may violate one person’s moral code and be virtually unnoticed by another.

Sometimes, morally heated debates are unproductive in the policy process. A compromise that does not shame anyone for their views or revolve around moral self-praise but provides a solution is better than two competing sides hashing out the moral issue, both believing their side is moral fact. The Righteous Mind by Jonathan Haidt gives insight into different moral structures and competing views like how differently people define fairness.

Are We Having a Moral Disagreement?

Access to health care is a moral, practical, and financial issue. People engage in the healthcare debate with different types and degrees of interest. To many weighing in, their opinion may not reflect something deep enough to label moral, while to others the issue is so deeply moral, they view it as moral fact. Competing views by libertarians and communitarians highlight moral investment in different solutions. Many people view health care as a human right and health care for those in poverty especially as a moral commitment. But many healthcare policy disagreements may be just about nonmoral opinion, or concern facts like cost, and not rise to the level of moral controversy. Sorting out the moral from the logistical is an important step to understanding how to build consensus around policy. If it is mere opinion, it seems easy to resolve legislatively by elected officials or referendum. Toning down the moral aspect, e.g., eliminating rights talk from the healthcare debate, can be helpful to achieve a policy change. But the moral disagreement requires studying the other side’s reasoning with an eye to consensus. The moral disagreement may outlast the policy debate.

Many people in the US view freedom of religion as a moral absolute. Others saw a moral obligation to prevent spread of COVID-19 even if that required forbidding live in-person church services. Each may argue the position as if it were objective and as if it were a fact that their belief is right. Each learning the other side’s reasoning could contribute to resolving the moral conflict while courts hashed out the permissibility of restrictions, albeit in a disparate way.

As we observe political polarization in the US, we see that legislation does not answer the moral questions. It can change lives, and represent progress, but it does not always bring sides together or represent cohesion. Legislation is not always a sign of winning a moral debate.

Some Disagreements are Moral to One Party and Mere Opinion or Fact to the Other

To me, disagreements in the healthcare setting are deeply moral and personal, in the mid-level moral realm. But some doctors probably feel they are not of a moral nature. If a doctor sees a disagreement as fact or opinion, but not moral, the disconnect is gaping. Autonomy is surely a moral issue and a cornerstone of bioethics. But other mid-level values like avoiding unnecessary medication, to me, reflect non-universal moral values, or moral norms that are community-based and cultural. Those who avoid excess medication or look for non-medical approaches like diet, exercise, and lifestyle, may reflect a moral norm among an elite, a friend group, a family, or a local culture. Facts enter care decisions as well, and the doctor must know and express treatment options. Dismissive doctors may not realize the depth of the meaning to the person seeking care. The murky territory of even identifying an issue as moral makes it difficult to reason on the same wavelength.

Examine Reasoning—Avoid “Because-I-Said-So”

Factual disagreements and differences of opinions on issues not recognized as moral become intertwined with issues that are deeply moral to some people. An approach requiring an effort to understand the other side would improve the difficulty we face in moral controversies in a country with a plurality of norms.

Feature Photo by Mayer Maged on Unsplash