Doing Good and Doing Well

Abstract

Here is a surefire way to get in an argument with many analytically trained moral philosophers, some of whom are bioethicists: claim that there is an inherent relationship between being a good person and a good ethicist. Good ethical thinking, the defensive response goes, is a matter of well-tuned analytical skills, logical consistency, and rationally defensible premises. Some people have those skills and others don't. Moral character has nothing to do with it. That's wrong. It takes a person of character to argue honestly with himself, to concede effective counterarguments to cherished positions, and not to give up until he has reached the bottom of things. It also requires that one be independent, beholden to nothing but the truth. Ethics is full of the possibility for self-deceit, for ideological captivity, and--of late--for succumbing to the lure of money. It takes more than clear thinking to deal with those traps. begin with that philosophical dispute because it is at the heart of the conflict of interest problem for those of us working in bioethics. What are the best conditions for giving advice? Unless there is outright bribery, no one can prove that taking for providing ethical advice necessarily leads to wrong or distorted moral judgments, and make no such claim. Nor do think it patently wrong to take for one's professional work, even that work happens to be ethics. But the taking of opens the door to wrongful influences, even that is rare. It is better to keep that door closed than to wrestle with those influences once it is opened. Those of us in bioethics have a special obligation not only to avoid acting corruptly, which no one would defend, but also to avoid being part of a culture of that can force bad choices on us. Where a culture of exists, those who live in it think that, they are doing worthy work, there is not simply a right to a living wage, but more than that: a right to make whatever the market will bear. Just like any other honest merchant. That's fine, suppose, one is in business. Are we selling ethics? The former Senator Daniel Patrick Moynihan, perhaps a bit jaded, spoke some years ago of those who came to Washington to do good but ended by doing well. The 1980s ushered in a new era in American life, or at least saw the stakes raised for what otherwise had been low-key practices. It was an era that saw the final dissolution of the line dividing amateur and professional athletics, football coaches earning more than college presidents, academic biologists turning into biotechnological entrepreneurs, universities beginning to see dollar signs dancing in their heads at the prospect of commercial agreements with pharmaceutical companies, and physician subspecialists earning up to $1 million a year for doing all their good things. Bioethics was not then, and still has not become, part of that culture, but there are a few disturbing signs. Here and there, evidence can be found of a demand for salaries based on that most routine of all entitlement arguments: I'm worth it, and that's what everyone else is getting. once floated a trial balloon among some bioethical colleagues, suggesting that those of us who wrote and spoke on the need for health care equity and rationing should not accept large lecture honoraria. The response was chilly, running the gamut from I need the money through if we don't take it, others will, to what's wrong with taking anyway? That balloon popped in a hurry. And it is increasingly the case that bioethicists are taking for confidential work for pharmaceutical and biotechnological companies, a source of new income in the 1990s. distinguish here between acting corruptly oneself and aiding and abetting a potentially corrupt culture. Though the vices are different, they are almost equally bad. Those of us in bioethics should have one motive only: to help others, or society more broadly, make good moral judgments. …