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Ethics, Morality and Values in the Health Care Debate

By on September 8, 2012

I have not written of ethics and morality as a factor in health care reform. Perhaps this is a reflection of their absence in the national debate. Nevertheless assumptions concerning these expressions of American values are inherent in every statement made on the topic. No matter what we speak about, there is always a window into our own personal value system.

Values are the things we truly prize and revere. We can speak about fiscal prudence as a value we hold dear, but if we are off to Vegas periodically or spending wildly on the internet, people will soon learn this is not true.

Morals are behavioral manifestations of our values. If we lie and cheat our way to success, people deduce what our real value system is because our morals keep telling them. And if they are smart, they will resist anything we say or do.

Ethics is the studied system of what an entity views as right and wrong behaviorally. In the 1920’s and 1930’s Germany and the US performed  human sterilization experiments. Here in the US the Supreme Court issued a ruling validating them. In Germany, the nationally elected government aggressively pursued the policy on a colossal scale. It was an expression of the morals of the day. It was the ethics of a people. And it was a low watermark in human behavior

Today hospitals. medical societies, and all sorts of professional organizations have committees dealing with ethical issues in medical care. Morals are monitored. Values are often spelled out in public ‘statements.’ Issues of life and death come to them on a regular basis for ethical consideration. It is good for us as a nation that this happens. We need to talk about what we really value.

 

The trouble is we are good at papering our corporations and business entities with values, mission statements, credos and other ‘elevator’ speeches  that are not truly honored in practice. As I said our ethics and morality lie in what we do, not in what we say. Since Watergate, we have seen a new wrinkle developing in our values and morals  called ‘situational morality.’ It bends ethical and moral arguments and often is used to justify particular departures from values and morals as somehow ethical.

 

Its practitioners say certain actions were ethical or at least excusable at this time because circumstances dictated it. “Other people were doing worse things.” “I had no choice.” ” My position in society, my office allows me to be governed by different standards.” ” I was overcome by an irresistible impulse.” and worst of all, “It’s OK because it was me.” We have heard theses excuses a lot lately, and thankfully reject them, when they come from mouths other than our own. The trappings of wealth and power are no substitute for moral fiber and ethics. People need to have the courage to stand up and say so.

In this time of election when pundits tell us we have clearer choices than we have had since the Johnson-Goldwater Election of 1964, and when health care delivery looms large in that choice, it is valuable to stop and ask what values, what moral behavior and what ethics are inherent in the positions of both parties and their candidates. What do they really value? What behavior can we expect?

Elections do have consequences. They broadcast to the rest of the globe who we, as a people, are, and what we really value. They demonstrate our morals and define our system of ethics. It may not always an expression of what we are doing as much as it is a measure of what we tolerate. And why.

Since I have wondered myself in recent years about our ethical underpinnings, I think it is not a bad idea to stop and consider before we plow ahead down any political pathway, before we take on additional reform in health care or election procedures, and before we step into that booth and pull the curtain on election day.

Others are watching and judging us. Our descendants will be among them.

Tom Godfrey

About Tom Godfrey

One comment on “Ethics, Morality and Values in the Health Care Debate”

  1. KrikorD on said:

    Pondering the ethics, morals and values of health care is the focal core no one seems to see, address or want to talk about. The remainder of all that we discuss, be it finance, religion and politics, completely hinge on this very issue. We all have our convictions and beliefs of what is moral, ethical and of value. We strive to achieve an absolute definition, but are undeniably affected by situational variables. Situational morality is more the rule, we just hope to become wiser over time to achieve a state more considerate of everyone else. This is imperative as the morality we create to be true will eventually come back to haunt us down the road. History is riddled with this, we just ignore it.
    In addressing the health care issue, there are two questions to be asked: What is morally just? and What are we justly entitled to? The first question may be better asked when placed in terms of an example. A previously healthy 7 year old child is diagnosed with leukemia. We learn that the parents had willfully and knowingly chosen to forgo health insurance. Who will pay for this child’s health care? Understand money does not come from trees, thin air or wishing wells. The “Government” is all of us and the money we pay taxes into it. The hospital is not the mythical door to Stargate of wellness. So… this example begs the question: Do we have the moral fortitude, a defensible one, to deny care to this 7 year old? After all, the parents made a choice.
    In an absolute (in a vacuum) libertarian world, there should be no moral hesitation. I wonder if any “Libertarian” can go to that child and tell him/her s/he will die, because of choice. On a slightly lighter scale, recently a homeowner was denied firefighting services for his house on fire, because he did not pay his dues. Will the parents stand by their decision? Did the homeowner beg the fire chief to save his house? What do you think? What greater validation of what you believe in than to live by them. Socrates drank the hemlock knowing that if he chose to recant his teachings, they will be lost forever. His philosophies and teachings were given life by his moral fortitude and willingness to stay the course, and die for it.
    Yes, as a modern society, our morals, ethos and values would likely not allow us to turn down care for that child. This forces us to address our true moral values or conscious – who we truly are.. The ones we are able to live with. Let’s not waste time discussing documents, doctrines or ideologies we are not going see all the way through. Where does that put us? In terms of health care – a national crisis. A national crisis, because resources are not infinite. We act like they are and live in a delusional world.
    This begs the question of how we can meet our moral obligations in a sustainable manner. No not with death panels, but with managed use of resources. There are 3 variables that can be worked on: demand (people getting sick), cost (efficiency) and effectiveness (bang for the buck). A national health care system is not going to provide you with Beverly Hills plastic surgeons for a laceration to the chin. That costs $2000. It will provide you with a $200 ER visit that might leave a slight scar. This will leave $1800 for a multitude of other things we need. A national health care system will save money by keeping you healthy – finding efficient and effective ways of controlling or preventing chronic diseases vs spending boat loads treating them (that would be the current system). Let go of the ideological diatribes, focus on the practical application of reality.
    Morals are great, just the ones you can live by. The rest you can entertain yourself with in a university class or at a coffee shop. Stop panting at how things should be. If you want to change the world, invest in education. Then, the parents can be trusted to have made an educated decision when refusing health care. No one in their right mind will refuse to buy into a health care system called the affordable care act. With all its imperfections. As a society we need to demand it as a man is not an island. If s/he were, they would not be part of society.

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