Monday, March 15, 2010

Assessing the "Ick" Factor

If you have the time, I highly recommend this interesting piece: Ick! versus Ethics Part 1: the Infantilization of Ashley. It's short and very interesting. The point of the composition is to assess whether or not there is an actual ethical basis upon which to reject the Ashley "treatment", or whether the "ick factor" "leads the public to confuse personal revulsion with ethical judgement."

By applying certain "golden rules" of ethical judgment, it is said that it is possible to come to a conclusion...and they do...that even if the treatment appears barbaric it is not, technically, unethical.

I have to say that being a Religious Studies major puts me very close to being a philosophy student, which means I enjoy the sort of word play that comes with the territory of discussions of this sort. In the end, it's all about word play in the game of ethical analysis...

Now here's another perspective. Chapter 9 of "Ethics of Practices with Minors" is conveniently reproduced online. It addresses the Ashley story directly. It presents a very balanced view of the situation and comes up with this on page 190:

Whichever position one takes,Ashley’s case, like many of those in this book, demonstrates several hard facts for which ethical decision making offers little comfort: even sound decisions may be troubling or unpalatable, child-serving systems are flawed, resources are finite, and parents are imperfect.

"Ick vs. ethics" had a similar view, but came to a hard conclusion. This textbook, which is by all accounts one used to educate Social Workers, addresses several key areas of "imperfection" that make ethical decision making difficult: imperfection of solutions, systems, resources, and parents. The arguments are excellent, clear and forthright. I find that there is a theme running through each category which I think can be best summarized with this sentence:

When service delivery falls short of aspirations, the professionals,consumers, and citizens involved must provide the critical feedback and advocacy necessary to encourage change.This is not a short or easy process, but failing to do so signals capitulation to the status quo and to a lifetime spent facing the same dilemmas the flawed system is now creating. (p.191)

Ethical analyses cannot follow hard and fast rules in a world full of "imperfections". Neither should we accept the status quo on a situation that fundamentally arises from these imperfections. Sometimes, things have to change...current ethical structures may be too narrow to correctly define or embrace certain realities.

When it comes to the Ashley "treatment" "Ick vs. Ethic's" conclusion is too simplistic. In the end, I prefer their own observation about the whole thing:

We know the benefits that her treatment supposedly confers on Ashley, but where is the harm? If there is harm, it must be harm to us, and our respect for humanity. If we treat the human body with so little reverence that we are willing to mutilate and distort it for convenience, will this coarsen our culture and diminish our respect for all human life? If so, is that a fair price for us to pay to save Ashley from her bedsores? Do we want to live in a society that is not repulsed by the Ashley Treatment? What other attitudes would such a society embrace?