Deconstructing a Dilemma

A physician friend oversees the lethal-injection program in another state. I say this is unethical. He says just the opposite. Before him, he says, executions were often prolonged and painful. Now they are fast and painless. Because the state will continue the program with or without him, he feels that his work is humanitarian in nature. Who’s right? NAME WITHHELD, NEW YORK

To answer this question, I need to operate from the premise that capital punishment is fundamentally unethical. I’m not doing so to forward any kind of political position; in this case, my personal views on capital punishment are irrelevant. The nature of your question, however, requires that I work from that vantage point. There obviously wouldn’t be any conflict if the doctor in question saw the death penalty as something positive. If your friend believes that capital punishment is ethical, his professional contribution to the practice would not contradict anything, except your own opposing opinion.

But your query suggests something murkier.

Let’s assume that this doctor believes capital punishment to be ethically wrong — but he knows it will still happen regardless of his involvement. He realizes that people will be put to death one way or another, and that without his personal oversight the procedure might be conducted inhumanely. So the real question is this: Is it acceptable to participate in something unethical if the act itself is inevitable?

At least in this instance, I would say no.

We are all citizens of the same world — and it’s a world that is (quite often) wicked. Unethical acts happen constantly, and most of them are outside the control of any one person. Some of them are so embedded in other activities that they are almost impossible to avoid; others are debatable or difficult to detect. But sometimes an unethical act is isolated, tangible and clear. And when this is the case, the most ethical response is to avoid participation. If there isn’t a collective or legal obligation to participate, every person retains the right to opt out of activities that he sees as morally wrong. If this doctor believes that capital punishment is unethical, he should not use its inevitably as a pragmatic rationalization for his personal involvement. By overseeing the event, he is latently justifying the existence of the process.

But here’s where things gets complicated: Our doctor’s argument for overseeing a form of punishment he (theoretically) abhors would probably fall somewhere along these lines: “If everyone who disagreed with lethal injection removed themselves from its application, the only people policing it would be those who think lethal injection is awesome — and people like that might not care about the welfare of those sentenced to experience it.” This argument is not terrible. But it doesn’t holdup to scrutiny. What it ultimately suggests is that society must somehow ensure that the various details of an unethical process are nonetheless conducted as ethically as possible. Here again, the process is latently justified: Attempts to govern and humanize the procedure distract from the fact that society is consciously taking someone’s life.

I’m not going to pretend that this is an easy question. It’s not — in fact, each rereading of my response makes me tempted to alter my position. But my central belief is that trying to police society at large is a less reasonable aspiration than policing the day-to-day ethics of one’s own life. The only thing we can truly control is how we live. As such, I think a doctor who disagrees with the death penalty should not involve himself with the practice of executions, even if his motive is humanitarian. It is a losing game. 

         This column by The Ethicist from the New York Times addresses the ethics of capital punishment by lethal injection. The asker has a physician friend participating in the lethal-injection program, and he writes that he believes it is unethical. Now, I think that one of the first thing the Ethicist should have done is define what ethics are, especially in comparison to morals. I will do that for him: both relate to what is "right" and what is "wrong". However, morals will refer to an individual's own opinion and principles about what is right or wrong. On the other hand, ethics is in regards to a set of rules established by an external source in relation to the individual (for example, a religion). Based on that standpoint, the issue of the asker seems to revolve more around morals rather than ethics. I liked that the Ethicist actually acknolwedged that: if the physician's morals allow him to feel like what he is doing is ethical, then there is no issue with the situation, except for the asker, whose morals dictate that the situation is wrong. 

          Having that in mind, would I have been the Ethicist I would have stopped there. The main reason for that is that there is a lack of information on the physician's position, which the Ethicist does not necessarily acknowledge. Instead he takes on a different path where he will (not exactly rightfully) make an assumption : the physician believes lethal-injection is unethical. I think it is a problem to assume that so quickly and with so little information because whether he believes lethal-injection is ethical or not is quite ambiguous. Without that it is hard to produce a satisfying answer to the issue. Additionally, it seems that he goes on a tangent by talking about the doctor rather than answering the question. The New Yorker wants to know who is right, but the Ethicist begins to talk about how a doctor who believes something is unethical should not participate in it. 

        The question touches on a particularly controversial topic: capital punishment. There have been several issues with lethal-injection in particular, namely the fact that the anesthetic drug  would last too short of a time resulting in the person waking up, unable to express pain because of the paralyzing drug that was administered right after the anesthetic. This is just one of the problems brought about by this issue. I think that the Ethicist largely left that out in answering the question, because those issues alone make the capital-punishment much more complex and controversial than the simplified answer he seems to give. If the capital punishment by lethal-injection program is going to go on, is it ethical for that physician to let it be painful for the people who are going to die anyway? It does seem right that, if someone is going to die, it is better to make it not painful (regardless of whether you think capital punishment is unethical). Another flaw I notice is that the Ethicist takes a side: capital punishment is fundamentally unethical. Although he makes a point of acknowledging two different scenarios (the physician believes capital punishment is ethical versus he believes it is not), he fails to take on two different perspectives of the issue. Instead of looking at it from two different points of view, he takes it from one point of view and analyzes two different situations. I think it would have been more productive to look at it from two different points of view: if one believes that t It seems that either way, he would somewhat go along with the asker, whose question can be looked at from various vantage points rather than a single one. Additionally, the idea that people perceive the world through different frames is somewhat disregarded. Not only do we lack information on the physician's position as mentioned before, but we also lack information about either individual's backgrounds. For all we know, one of them could be extremely religious while the other is not. Besides, they were likely brought up differently and that could have affected their personal standpoint on the matter. These differences gives them a different frame and take on their environment, resulting in different morals.
        Throughout his answer, the Ethicist also makes various assumptions, and highly extrapolates -in my opinion - the topic. I was especially bothered by this sentence: "But sometimes an unethical act is isolated, tangible and clear. And when this is the case, the most ethical response is to avoid participation.". Preceding that sentence is the Ethicist acknowledging unethical acts happen all the time are often embedded with other external things, thing outside of any individual's control. Yet, I disagree with what follows. It is rare that any ethical or unethical act is isolated, tangible AND clear, because not only do they depend on frames and perception, but also because ethics and morals are highly interconnected. Based on the idea that ethics come from the outside while moral come from the inside, it makes sense that they would encounter each other. Capital punishment is unethical, right but so what? What if your personal morals tell you that it is unethical to risk someone dying in pain when you guaranteed that it would not be painful? If you can help change that, why would you not? To what extent can something unethical have ethical components?
       Ultimately, I agree with the Ethicist conclusion, that if the person strongly believes that something is unethical then they do not have to participate in the carrying out of the process. However I do not think that participating in the process makes it that he is justifying its existence, as the Ethicist has suggested. The doctor could have many other motives and opinions, that I feel the Ethicist fails to acknowledge.