Making Good Moral Decisions

Good individual decision making encompasses three elements: self-knowledge, knowledge of moral theories and traditions, and cultural perception. Self-knowledge is fundamental because feelings, motives, inclinations, and interests both enlighten and obscure moral understanding. In the end, individual selves, alone with their thoughts and private lives, must wrestle with moral problems. This sort of struggle often forces one to confront the kind of person one is, to face one's character and integrity and one's ability to transcend narrow self-interest to make good moral decisions. And once a decision is made, it must be acted upon. A decision of conscience blends moral judgment and the will to act upon that judgment (Callahan, 1991). A complementary kind of knowledge, not easy to achieve, is also needed. Even as individuals we are social creatures, reflecting the times in which we live, embodied in a particular society at a particular time. Our social embeddedness will shape the way we understand ourselves, the moral problems we encounter, and what we take to be plausible and feasible responses to them. Moral theory by itself is hardly likely to be able to give us all the ingredients needed for an informed, thoughtful moral judgment. Only if it is complemented by self-understanding and reflectiveness about the societal and cultural context of our decisions can moral theory be fleshed out sufficiently to be helpful and illuminating. Good moral judgment requires us to move back and forth among the necessary elements: the reflective self, the interpreted culture, and the contributions of moral theory. No one element is privileged; each has an indispensable part to play.

Yet something else is needed as well: a vision of the human good, both individual and collective. The biomedical, social, and environmental sciences produce apparently endless volumes of new knowledge about human nature and its social and natural setting. However, for that knowledge to be useful or meaningful, it must be seen in light of some notions of what constitutes the good of human life. What should human beings seek in their lives? What constitute good and worthy human ends? Proponents of the technological advances that emerge from the life sciences claim they can enhance human happiness and welfare. But that is likely to be possible only to the extent we have some decent idea of just what we need to bring us happiness and an enhanced welfare.

Bioethics must pay sustained attention to such issues. It cannot long and successfully attend only to questions of procedure, or legal rules and regulations, without asking as well about the ends and goals of human life and activity. Ethical principles, rules, and virtues are in part a function of different notions of what enhances human life. Implicitly or explicitly, a picture of human life provides the frame for different theories and moral strategies of bioethics. This picture should animate living a life of our own, in which we develop our own understanding of how we want to live our individual lives, given the vast array of medical and biological possibilities; living our life with other human beings, which calls up ideas of rights and obligations, bonds of interdependency, and the creation of a life in common; and living our life with the rest of nature, which has its own dynamics and ends but provides us with the nurturing and natural context of our human lives.

Is there such a thing as the human good, either individually or collectively? Is there something we can, in an environmental context, call the good of nature? There is no agreement on the answer to those questions; on the contrary, there is fundamental disagreement. Some would argue that ethics can proceed with a relatively thin notion of the human good, placing the emphasis on developing those moral perspectives that would make it most possible to live with our differences about the meaning and ends of life. Others stress the importance of the substantive issues and reflect some basic doubt about whether ethics can proceed very far, or have sufficient substance, without trying to gain some insight into, and agreement upon, those basic matters (Kass; Callahan, 1993). Those debates must continue.

The greatest power of the biomedical, social, and environmental sciences is their capacity to shape the way we as human beings understand ourselves and the world in which we live. At one level—the most apparent—they give us new choices and thus new moral dilemmas. At another level, however, they force us to confront established views of our human nature, and thus to ask what we should be seeking: What kind of people do we want to be? A choice about artificial reproduction, say surrogate motherhood, is surely a moral choice. But it is also a way into the question of how we should understand the place of procreation in our private lives and in society. To see that is to appreciate profound challenges to our understanding of sexual and familial roles and purposes. The boundaries of bioethics cannot readily be constrained. The expanding boundaries force us to take up larger and deeper problems, much as a small stone tossed into the water creates larger and larger ripples.

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Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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