Guest post from: David Lamb – Wednesday, 11 March 2020
The objective of any ethical inquiry into any proposal or activity is not to determine their efficacy or popularity but to assess their moral status; is it right or wrong to employ them?
The UK Government now recognise the seriousness of the corona virus outbreak, but managing the outbreak, we are told, is a balancing act with lots of factors. Ministers want to take radical measures to combat the virus with the option of closing schools, or cancelling big events but against this are costs to the social order and employment. The government wants the public to take the virus seriously, but it doesn’t want panic or damage to the economy. So they have adopted a cost-benefit strategy. The World Health Organization (WHO) is involved in combating the disease but it is clear that they have adopted a cost benefit approach, balancing the effects of the disease (a medical matter) against perceived harms to the social order (a political matter). Thus the head of the WHO said that the social stigma attached to the disease is worse than the disease, and produced a document advising people not to attach ethnicity to the disease, thus indicating that on cost benefit grounds social cohesion is a greater benefit than controlling the disease. (BBC News, March 2nd, 2020)
Many discussions on politics appear to be based on an appeal to cost benefit considerations. For example, arguments about Brexit frequently refer to financial benefits of leaving or remaining, more jobs, more trade, opposed to costs, such as fewer jobs, less trade etc. Similarly with arguments about health care; will the benefits of health outweigh the costs of therapy? Will benefits of a radical programme for combating the corona virus be outweighed by costs to the economy and public order? Ethics committees are springing up in every profession, and most follow cost benefit approaches. Here I maintain that this is counter to ethical argument and that cost benefit considerations have a limited ethical value.
Cost benefit calculations are employed in determining public policy on wide range of issues, where predicted benefits are weighed against various costs or potential harms. When allocating resources for education, health, or defence, a cost benefit analysis is seen as a method of formulating an acceptable course of action. Optimizing or cost benefit strategies have their origins in finance and banking where sums of money are set against potential financial returns. This approach is frequently transferred to ethical arguments in health care when decisions are likely to be reached by calculating the costs and benefits of proposed response to disease.
The appeal to cost benefit calculations does not refer to a standard of moral rationality; it is based on a convenient – and frequently arbitrary – way of reaching decisions in a market. An ethical approach to a debate must embrace matters of wider concern, which include an examination of concepts concerning the nature of the ethical ties which bind us to others, what we understand by respect for autonomy, integrity, and above all, our morally correct and objectively understood resistance to treating other humans and animals as tools or instruments.
We are told that the world is facing a crisis due to the spread of the corona virus. A brief examination of the strategy of the UK government, following advice from medical scientists, indicates that an optimising cost-benefit strategy has been adopted, which involves assessing the costs and benefits of a radical quarantine programme – closing schools, public places etc. – against a programme aimed at protecting the economy, minimising panic and public unrest. This will involve difficult decisions but it is clearly not a coherent ethical debate as both options are incommensurate. Maintenance of public order does not outweigh the loss of lives of those who are predicted to be at most risk.
The strategy for resolving ethical problems by means of optimising consequences has been severely criticised by moral philosophers (Grisez, 1978, Finnis, 1983, Foot, 1985, Raz, 1986, George, 2001). The principle of maximizing good (however it is defined) can only provide a choice if the various forms of good are commensurable in such a way as to facilitate the weighing and comparison of alternatives in the manner required by the utilitarian principle. As the critics have shown, this comparison is an illusion, resting on an implicit denial of incommensurability (Raz, 1986). One cannot, without an element of arbitrariness, compare a deficit such as the loss of trust on the one hand with a benefit, such as improvements in scientific knowledge, on the other hand. One cannot compare the welfare of a species against an environmental deficit, unless one has already pre-selected idea of which has the higher value. One cannot conduct a value free comparison between competing welfare interests of cats, bats and rats. One may have to make a choice, but the options are not commensurable and it cannot rest on a value free assessment of costs and benefits.
If we face incommensurable options – for example, between combating corona virus and protecting the economy and public order – then a prior moral judgement is required and the appeal to consequences is superfluous. If one considers that public health is paramount then a cost benefit assessment is unlikely to reverse this standpoint.
Optimising strategies might appear plausible if an equal value is assigned to all components and one is presented with commensurable options. When faced with a practical choice one would then be directed to choose the greatest amount of good. This, however, reveals the incoherence of the consequentialist model. To say that one option offers greater good than another would be to say that everything of value in the latter option was available in the former, plus some more. In which case there would be no reason to choose the latter option. Immoral choices would be irrational. One might choose the latter option out of some emotional or perverse reaction, but this would not be an exercise of rational choice. In which case the consequentialist model (which purports to offer a rational means of choosing) is entirely superfluous (see George, 2001).
The incoherence of the consequentialist cost benefit model lies in denial of incommensurability and also its failure to satisfy the twin functions it postulates as a requirement of a rational moral theory. These are: 1) the provision of directions for a person making a free choice between practical alternatives; 2) the direction of this choice by identifying one possibility of providing greater good or lesser evil. But if the second condition is fulfilled then no morally significant choice is available, as one could only have sub-rational motives for choosing an alternative.
From an ethical standpoint the problem of setting limits to costs will inevitably arise. With sufficient imagination one can produce scenarios where benefits could be cited to justify even the most extreme infliction of pain, as we observe in the arguments of regimes that adopt Bentham’s (1973) advocacy of torture – always for beneficial consequences! When presented with this kind of speculation there is an overriding moral imperative to replace speculation and thought experiments with hard evidence.
Cost benefit calculations are of limited ethical value
Cost benefit calculations are therefore dependent upon rigorous scientific procedures and accurate predictions, as discrepancies in the data will inevitably negate the conclusions. Although often presented as an acceptable framework for ethical decision-making, largely because of the influence of classical utilitarian theory, cost benefit calculations at best represent only a limited area of ethical inquiry and often result in recommendations which remain ethically problematic.
It can be argued that even conducting a cost benefit assessment of the consequences of a policy which seeks to minimise the mortality rate, calculating the number of deaths set against other factors, is a step too far, revealing a callous attitude. As Roger Scruton (2000: 211-2) points out: ‘We judge callous people adversely not merely on account of the suffering that they cause, but also, and especially, for their thoughtlessness. Even if they are calculating for the long term good of all sentient creatures, we are critical of them precisely for the fact that they are calculating, in a situation where some other creature has a direct claim on their compassion.’
BBC News, 2nd March 2020, https://www.bbc.co.uk/news/world-51712437
Grisez, G. 1978, Against consequentialism’, American Journal of |Jurisprudence, 23,
Foot, P. 1985, ‘Utilitiarianism and the virtues’, Mind, 94., 196-209
Raz, J. 1986, The morality of Freedom, Oxford: Clarendon Press.
George, R.P. 2001, Making Men Moral, Oxford: Oxford University Press.
Bentham, J. 1973, Unpublished essay, Of Torture, cited in Twining W.L., and Twining, P.E., ‘Bentham on Torture’, Northern Ireland Law Quarterly, 24, 3: 305-356.
Scruton, R. (2000: 211-2, ‘The Moral Status of Animals’ in R. Hursthouse, Ethics, Humans and Other Animals, London, Routledge.
Finnis, J. 1983, Fundamentals of Ethics, Oxford: Oxford University Press.