pp. 174-176 in Bioethics for the People by the People, Darryl R. J. Macer, Ph.D., Eubios Ethics Institute 1994.

Copyright 1994, Darryl R. J. Macer. All commercial rights reserved. This publication may be reproduced for limited educational or academic use, however please enquire with Eubios Ethics Institute.

Bioethics surveys and the quantification of ethics


Frank J. Leavitt, Ph.D.
Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel

Those of us who have been or will be involved in this and similar surveys might enhance our contribution to the bioethics movement if we pause to reflect self-critically on the goals and underlying assumptions of our activity.

A statistical survey, analysed by computer methods, lends an aura of scientific respectability to the discipline of ethics. Indeed, at least from the time of the proto-Euclidean logical axiomatic methodology of Aristotle's Posterior Analytics, an enquiry has been judged to the "scientific" just to the degree to which it resembles mathematics. Again, in the seventeenth century, Descartes was willing to regard something as certain only to the degree to which it could be studied clearly and distinctly by his analytic geometry. And in our own day a study is often seen as "scientific" only to the extent to which it is quantified.

It is, therefore, tempting to try to study ethics through methods similar to those in use in the mathematical and physical sciences. What better way to make ethics scientific than to study it statistically? But it is not clear that the subject matters of ethics lend themselves to quantitative studies. Bioethics has two components, the scientific and the moral. The scientific component comes from the life and health sciences. But the moral component comes from the thoughts and feelings of human beings, from dreams, visions, spiritual astonishment, wonder, love and pity, daemons and angels, prophetic insight, poetic inspiration, the touch of a loved one near a brook in spring, the spiritual traditions of the nations and the commands of God's Scripture. While mathematical statistical methods may by appropriate to the admittedly sublime profundities of quantum physics, for example, it is not clear that such methods apply to the macroscopic sensuous world which we humans inhabit or to the divine world from which we learn our most basic moral principles.

But in this brief note I shall only try to list a few reasons why scientific method may be inappropriate for ethics.
1) A survey only studies the opinions of the persons surveyed, certainly not those of "a people" as a whole.
2) Those persons actually surveyed only record their immediate reactions to questions. Had they reflected deeply they might have given other answers.
3) The "multiple choice" form of question, indeed any form accessible to statistical analysis, necessarily forces the respondent to choose among a predetermined range of concepts in terms of which the respondent might not have thought before he saw the survey. The respondent's thoughts are forced into an arbitrary mold. The survey does not, therefore, study what the respondent thought but rather what the survey taught him to say he thought.
4) Informal or "semi-structured" interviews and "free" answers may more accurately report a subject's considered reflection. But such interviews cannot be analysed statistically unless informal answers are arbitrarily interpreted in terms of a finite set of categories which the subjects themselves did not choose.
5) Statistical surveys provide too easy a basis for generalizations. If 81% of a sample in some neighbourhoods in the country of Xyhootik check a box expressing disapproval of genetically engineered chewing gum, we can easily use this as grounds for going around and saying: "The Xhootikians don't like genetically engineered recreational masticables". But the generalization goes far beyond the evidence.
6) But even if such inaccuracies and hasty generalizations are avoided and a perfect survey constructed, what purpose can it serve? Political parties and product marketers have used public opinion surveys as a mean of predicting and guiding the behaviours of large populations for the sake of political advertising of various types have definable effects on responses to surveys, or on voting, purchasing or other measurable forms of behaviour, one might begin to entertain the thought that a population may perhaps be tuned and steered like a machine for the sake of political power, financial profit or social or ethical goals. While some of these goals arise form our lowliest greediest instincts, others, like the goals of true bioethics, are highly laudable. There exists a dream that wars, poverty, unethical behaviour and environmental disasters can be prevented and a global "good society" built if mankind could just be driven by the methods of the social scientists. {See John Maddox, "Social science and the new world order", Nature 366 (1993) 403.) But thinking and impassioned humans. Dreams of workable global ecological policy and of a really democratic Eastern Europe have not yet given any grounds for belief that they can be realized. So we as yet have nothing on which to base the belief that the methods of the social sciences will help make the world more bioethical.
7) Finally, even if the methods of the social sciences really do turn out to be able to run global bioethical opinion like a machine, it is not clear how much his approach respects what is really behind the idea of moral autonomy. Although "autonomy" is often a badly misused dogmatic in bioethics, it conveys a certain truth. Opinions are of moral worth only when they arise from serious informed reflexion and spring from the active use of the mind. Moral autonomy depends upon epistemic autonomy. It is not clear how much we respect the capacity of humans for autonomy when we treat their opinions quantitatively.

These remarks are not intended to belittle the hard work of those people, myself included, who participated in this international survey. But it seemed to me that a dissenting opinion might help encourage the kind of intellectual self-criticism which may lead us to try to look at things more deeply. As should be clear from these remarks I have methodological difficulties with generalizations from statistical samples, so I hesitate to draw conclusions from the Israeli sample. I do think, however, that much can be learned from the Jewish tradition on which much if not all Israeli thinking is based. For this I refer the reader to my accompanying paper on Neshama, as well as to another recent paper (in Intractable Neurological Disorders, Human Genome Research and Society, 1994).


References

Some of the points made in this note may be explored more fully in the following sources. Problems with using scientific method to study human beings are explored in:
Collingwood RG, The idea of history (London, Oxford University Press, 1946)
Dray W., Laws and explanation in history (Oxford, Clarendon, 1957).
Benn IS and Mortimer GW (eds.), Rationality and the social sciences (London, Henley, Boston, R and KP, 1976).

I have briefly discussed the importance of individual persuasion to morals, and the matter of epistemic autonomy, in the following essays, where references to the Lockian and Spinozistic philosophical traditions may also be found:
Leavitt F.J., Inalienable rights. Philosophy 67: 115-118 (1992).
Leavitt F.J., Weeks, Spinoza's God and epistemic autonomy. Sophia: philosophy of religion 31: 111-118 (1992).


Response - Quantification of Ethics


Darryl Macer,
Institute of Biological Sciences, University of Tsukuba, Ibaraki 305, JAPAN

The International Bioethics Survey will come under criticism for this attempt to look at bioethical decision-making and reasoning using opinion surveys. It is therefore important to have the criticisms inside this book. Some of the criticisms were also discussed at the Tsukuba Bioethics Roundtable and Fukui International Bioethics Seminar, held in November, 1993. I have outlined the hopes and reasoning behind the survey in the first part of the book on universal bioethics, and in the section overview. A response to the list of seven critiques made above, would be:
1) Yes, opinion surveys look at opinions, and not the person as a whole. However, the actions of individuals, and also society, can be predicted by surveys - with a real margin of error that can only be determined after surveys are conducted.
2) The written survey allows more thinking on issues, than an interview does. However, there is a debate in social science on whether this is good - but I agree, that for bioethics it is the thought out responses that are crucial to bioethics.
3) Yes, multiple choice answers can be leading, hence the use of many open choices.
4) Open responses, free questions, were used but a finite set of categories was used. I would propose that it is possible to summarise the arguments that almost all people express, their reasoning, by a finite number of ideas. The finite ideas are probably generated by education, and religion, with some genetic influence (i.e. some sense of bioethical respect for the environment and other life may be part of out genetic nature, and some part of our genetic and environmental "nurture" and spirit). Whether this can be done can be judged by the readers from the analysis tables, and example comments. There always exists the "other" category for the unusual ideas, which is why the open comments are reproduced in this book. The incompleteness of assigning comments on life and nature to categories is why all the comments are reproduced here, however, looking through them will show that there are major themes, ideas and major items (e.g. trees, ecology, God) that are often mentioned.
5) It may be too easy to generalise, it is important to look at all the data, and test the data from surveys with the data we obtain from literature, customs, and observation.
6) Yes, surveys may be misused, as I have said in the introduction - this is a real fear that I have. Yet, I hope the "truth" can be used to form policy that respects the persons and personal choices that are expressed, as some countries in the world do not allow this expression of informed choice, this is my hope and dream.
7) No, I would reject this and say autonomy is respected, if the hopes of point "6" are implemented it could result in greater autonomy for persons in some countries.

In conclusion, this survey is just a beginning and from addressing some of the issues exposed it is hoped further research in bioethics based on the perspective of "from the people for the people" may be implemented all around the world. It is also hoped that constructive criticism will build on this to develop international bioethics, and be used to test whether we really have universal ethics, as I think we do.


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