Behaviorism Ethical Theory and Bioethics

Other objections to behaviorism arise from its incompatibility with concepts and beliefs that are presupposed in most ethical theories, people's common moral life, and the practice of bioethics. This suggests a choice: either to give up behaviorism or abandon much that ethics takes with utmost seriousness, such as consciousness, pleasure and pain, agency or autonomy, freedom, and human dignity, just as Skinner advocated.

CONSCIOUSNESS. Ethics asks questions about right and wrong, and about good and evil. The notions of intrinsic goodness (that which is desirable or valuable in itself or for its own sake) and intrinsic evil (that which is undesirable and to be avoided for its own sake) are of central importance to ethical theory. In teleological theories of right and wrong, right acts result in intrinsic goodness, while wrong acts fail to do so or produce intrinsic evil. Doing good and avoiding or preventing evil are momentous moral duties even in deontological theories (except for Immanuel Kant's). Doing one's duty usually, if not always, involves understanding and acting in accord with moral ideals and rules—none of which even exist, according to metaphysical behaviorism. Ethicists may disagree about answers to questions like "What acts are right or wrong?" or "What things are good or evil?" There is, however, agreement that no moral obligations and no intrinsic good or evil would exist in a world without consciousness. Moral right and wrong and intrinsic good and evil exist only in and for conscious active beings.

Almost all the philosophers who have considered the question agree that ethics would have no point in a world devoid of conscious beings. Yet Watsonian metaphysical behaviorism gives us just such a world—one in which all behavior is caused by external or environmental stimuli and no behavior is caused by inner conscious mental states and processes. Skinner's radical behaviorism may allow that some activities are spontaneous rather than environmentally caused, but these behaviors are repeated only if their consequences are positively reinforcing. (He doesn't use the terms pleasurable or enjoyable.) When Skinner admits the existence of inner mental states and processes, he denies their causal efficacy in explaining behavior and providing reasons for action, as well as their relevance to the science of psychology. They are always the effects of stimuli, never the causes of behavior; they exist only epiphenomenally, that is, as ineffective appearances. Scientific psychology can disregard them, for scientifically knowing, controlling, and predicting behavior do not require them.

Some behaviorists retain the notion of consciousness and redefine it in purely behavioral terms—as overt wakeful behavior, for example, as opposed to sleep behavior. Most ethicists, however, are convinced that ethics is concerned with wakefulness itself, as directly experienced by conscious subjects, not merely with wakeful behavior and muscle jerks as experienced by external observers.

Medical professionals are concerned primarily with wakeful consciousness itself, not solely with its public or overt expressions. They often prescribe analgesics or other pain management strategies for suffering patients. During invasive medical procedures, general anesthesia is administered, not to circumvent external pain behaviors, but to prevent conscious pain. After a lapse of consciousness, a patient's return to awareness is eagerly awaited. Lost consciousness is the tragedy of comatose patients, while death involves the irreversible loss of embodied consciousness and its necessary physiological conditions. The seriousness of these medical interests seems to be quite incompatible with a concern only for overt behavior.

PLEASURES AND PAINS. Philosophical ethicists are keenly interested in consciously experienced pleasures and pains, and medical professionals give considerable attention to conscious pains, if not also to pleasures. Most ethicists believe that pointless pains (those that are not necessary for the achievement of goals knowingly and freely accepted) are to be avoided if possible; and most recognize that happiness, conceived of as a surplus of conscious pleasures over pains for extended periods of time, is one of the great goods of life (if not the only good, as hedonists maintain). Medical professionals accept the duties of relieving pain and not inflicting unnecessary conscious pain as serious professional obligations. Patients want relief from real pains, not merely the suppression or elimination of pain behaviors. Pleasures usually means "conscious inner qualities of feeling that persons or other sentient beings normally wish to cultivate and sustain for their own sake," and pains means "conscious inner qualities of feeling that persons or other sentient beings normally wish to avoid and eliminate for their own sake" (Edwards, pp. 74, 92-96).

Although pain behaviors are indispensable for describing or communicating inner sufferings to others, most ethicists and bioethicists do not believe that overt pain behaviors, completely divorced from conscious suffering, are intrinsically bad, or that they are duty bound to relieve and not induce pain behaviors as such. Reflex responses to pain stimuli may be evoked from irreversibly comatose patients with only brain-stem, but no upper-brain, functioning, yet no one believes that these patients are thereby subjected to intrinsic evil, or that moral duties are being violated or shirked. No one, not even behaviorists, really believes that happiness consists merely of overt expressions of pleasure. Neither pain behavior nor pleasure behavior is of significance to ethics unless they indicate inner conscious pains or pleasures themselves.

Skinner maintains that only positive and negative rein-forcers, not conscious pleasures and pains, are relevant to a correct theory of good and evil. Good things are nothing but external positive reinforcers, and bad things are nothing more than external negative reinforcers. Secondarily, those stimuli, responses, or consequences that promote cultural survival may be good things, and those that threaten cultural survival may be evil things. The words good and bad may also be used to reinforce other behaviors, positively or negatively. Positive reinforcers are stimuli that strengthen the behaviors that produce them, and negative reinforcers are stimuli that reduce or terminate the behaviors that produce them. Just why some stimuli reinforce positively and others negatively is obscure for behaviorists. They cannot maintain that consciously experienced pleasures or pains are the mechanisms that induce or inhibit behaviors. According to Skinner, identifying values with reinforcers results in a purely descriptive, empirical, and scientific ethics that overcomes the "is-ought" gap that plagued traditional ethical theory.

A few philosophers accept Skinner's behaviorist ethics (Hocutt), but most are unconvinced. Most hold that G. E. Moore's "open question" ("Granted that x possesses some descriptive property, but is x good?") is not a senseless or self-answering question, not even when the x is a positive reinforcer. Skinner's position might avoid this objection, however, if construed as an answer to Moore's second question of ethics, "What things are good?" rather than to his first question, "What is the meaning of 'good'?"

Skinner's theory contains no purely empirical or descriptive method for resolving value conflicts. Suffering patients may beg stoic physicians for pain medication, who might refuse to give it because they believe that patients should be allowed, or even required, to suffer for their own good in order to strengthen their characters and powers of resolution. This value conflict is not eliminated by the behaviorist's explanation that these patients find pain-relieving behavior to be positively reinforcing, while the stoic physicians find it to be negatively reinforcing. Whether any other theory of the good can resolve value conflicts is another matter, but other theories generally do not claim to offer purely descriptive solutions to internal normative value problems. A behaviorist's recommendation to give pain medication because doing so has adaptation and survival value would be a prescriptive, not a descriptive, resolution.

Skinner often prescribes norms. He cannot resolve value disagreements about "good" and "ought" merely by describing what is positively reinforcing to individuals or to their communities of value, which are groups of individuals who find similar things to be reinforcing. The behaviorist's contention that psychology should be a strictly descriptive behavioral science does not describe the beliefs and practices of most professional psychologists and psychotherapists. It is a value prescription that, if analyzed in Skinner's own terms, means merely that he and the few psychologists who agree with him find it positively reinforcing to practice psychology behavioristically. Most psychologists and philosophers have not been so conditioned, and they cannot accept the narrow strictures that behaviorism places on psychological inquiry and practice. Skinner's program, which purports to eliminate purposes and prescriptive norms, can be advanced only purposively and as a prescriptive norm.

AGENCY, FREEDOM, AND DIGNITY. Most philosophical ethicists are rationally persuaded that moral obligation and responsibility presuppose internal, autonomous, rational agency, self-control, and choice, and that the denial of the existence or efficacy of informed conscious choice in bringing about moral action is fundamentally incompatible with morality. Ethicists may disagree about whether autonomous moral choice is compatible with rigid metaphysical determinism. Some maintain that autonomous moral choice must be creative and spontaneous, while others hold that conscious choice is sufficient for moral autonomy, even if it is strictly caused by a desire to do right (or wrong). However, ethicists seldom doubt that consciousness, agency, and self-control are essential for of morality.

Informed voluntary consent is a cardinal ethical principle in modern bioethics. This principle affirms that no diagnostic, therapeutic, or experimental medical procedures should be performed on patients unless they have consciously, knowingly, and voluntarily consented to them. The principle affirms that the rational agency or autonomy of patients—the capacity of conscious patients to make informed choices for themselves—is of paramount importance in the medical setting. When behaviorism affirms that all behaviors result from external or environmental stimuli, it denies the reality, or at least the efficacy, of inner mental processes and activities, including inner understanding and decisions.

Behaviorism affirms that people are controlled entirely by their environment, which includes other clever people trained to know how to condition them. People never control themselves or their circumstances through their conscious knowledge or efforts. Although stimulus controls can be self-administered, the "prediction and control of behavior" at which behaviorism aims is primarily meant for other people. But who controls the controllers? Where do they get, and how do they justify, the norms they impose on others by psychological manipulation?

Skinner sometimes writes as if inner conscious ideas, ideals, purposes, feelings, and choices simply do not exist (Blanshard and Skinner). At other times he makes an epiphenomenal (causally ineffective) place for inner activities like self-control, choice, agency, or autonomy. He recognizes that freedom of action is important because it allows individuals to avoid aversive or negatively reinforcing stimuli, but he can make no place for conscious moral agency.

In Skinner's view, human dignity consists of behaviors that cultivate the positive reinforcement of praise or credit from others for behaving well, or as others want them to behave. By contrast, most ethicists agree that human dignity involves conscious self-awareness, self-control, and rational persuasion. They abhor manipulative techniques that bypass these qualities, and they approve of educative and persuasive techniques that develop and appeal to them.

Escaping aversive stimuli and cultivating social credit have their proper place, but most moral philosophers would balk at Skinner's behavioral reduction of freedom and dignity to solicitous activity. Behavioral freedom means little without inner personal autonomy, and human dignity, however difficult to define, is something that persons constantly have as conscious persons; and it makes all people equals. Dignity is not just something that people possess during those rare moments when others credit them for behaving as they see fit.

Thus, behaviorism is incompatible with the ideal of informed voluntary consent as it functions in applied bioethics, as well as with many fundamental principles of ethics. In sum, it seems that one must give up either behaviorism or ethics and bioethics.

REM B. EDWARDS (1 995) REVISED BY AUTHOR

SEE ALSO: Autonomy; Behavior Modification Therapies; Coercion; Freedom and Free Will; Human Nature; Informed Consent; Mental Health Therapies; Mental Illness; Neuroethics; Patients' Rights: Mental Patients' Rights; Psychiatry, Abuses of; Psychoanalysis and Dynamic Therapies; and other Behaviorism subentries

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