The “Moral Objection” Argument to Healthcare

This post has been inspired by the recent spate of holier-than-thou-ness of medical workers who deny their services to clients that fail to live up to their personal religious expectations. In particular, I’ve just come across this article, which has my hackles good and raised. This trend has been has been underway for some time now (certainly more than a year, though I’m not sure when it actually started), and I have regularly voiced my opposition to it, but I’d like to lay my thoughts out here in what will surely fail to be a concise manner.

* * *

I simply do not understand why so many people are this willing to accept it when religious healthcare organizations* deny reproductive health services to people for moral reasons. This is patently hypocritical. If a Catholic ER patient died on the operating table from exsanguination because a Jehovah’s Witness surgeon refused to perform or allow a blood transfusion, society would not stand for it. We would rightly view it as a serious moral transgression, and we might very plausibly charge this doctor with homicide. How much worse would it be if the order never to transfuse came instead from a hospital administrator? It is not hyperbole to suggest that the broader consequences of denying someone access to medical care over religious objections are no less severe than the hypothetical case I’ve provided. As such, it is deeply offensive when doctors and pharmacists use their own personal faith to justify denying care to their patients. This is no less true even if those patients happen to share the healthcare non-provider’s religion; it is not up to anyone else to determine what your personal religious beliefs are, even if that person is your very own priest. (Even though official Catholic doctrine forbids birth control, for example, the vast majority of Catholics support its use or use it themselves.) No one has the moral authority to unilaterally dictate how you live your life as long as you conduct yourself within the boundaries of the laws of a civil society. So why is it okay for birth control and other reproductive services (and now AIDS medicine) to be denied when the attempt to deny other forms of life-saving care would be sharply condemned? Are we to accept the premise that religious devotion permits the denial of quality-of-life care but not life-saving care? Given the ultimate fate a person with untreated AIDS is sure to face, this answer is entirely insufficient.

The primary moral imperative, to consider the wellbeing of others instead of merely yourself, dictates that you are not permitted to inflict your own prohibitions on an unwilling populace without adequate justification. In this case, no such justification can possibly exist; no amount of rationalization is sufficient to merit the imposition of one’s religion on another. If we are to live in a society where you can dictate my behavior, then it must also be a society where I can also dictate yours, and the end result of this is nothing short of perpetual misery. The denial of care to someone in need may very well mean the ruination of that person’s life—quite possibly even their death—and by supporting this denial, one must also accept responsibility for all of the negative consequences that follow. Ask yourself if this world, where a hostile group has physical control over your body, would be the kind of world you’d wish to live in. I would humbly suggest that anyone who finds this idea tenable check themselves into a mental institution with all due haste.

Christianity is said to be based on the idea of forgiveness. A believer’s sins may be forgiven through faith in Christ, even if the specific avenues of this forgiveness vary from sect to sect. If you are forced to administer healthcare that you feel is immoral, you may beg the forgiveness of your god afterwards, and all will be right again (“pray like this, and all is mended…”). Those whose lives are directly impacted by the unrighteous imposition of others’ doctrinal mandates often have no such recourse. I speak in terms of Christianity not because it is only this religion that punishes others for their nonbelief—it unquestionably is not, and clearly not every Christian (nor even a majority) would condone this practice. No, I reference Christianity merely because the Western world is predominantly Christian, so it is typically a Christian faith that is cited in defense of this discrimination.

Before I close, I must make a confession. In my second paragraph, I told a lie. Yes, I have borne false witness, and now I seek forgiveness. You see, I do understand why this meme of alleged moral objection has propagated. It persists because those who are victimized by this development are the socially disadvantaged. For the wealthy, it may very well be a trivial inconvenience to seek alternatives elsewhere, even out-of-state (or country) if necessary. For the other half, however, there is no escape. Those who lack social capital are unable to effect change when they cannot sway the majority to their aid. It is far too easy to express support for the rights of the disadvantaged without actually taking steps to support them. I think—I hope!—the majority of believers would never dream of personally denying these services to those in need if they were in the non-providers’ shoes, but by not speaking out against this practice, they lend implicit support to it. This emboldens the deniers, giving them free rein to claim, “Aha! But I am supported by my religious brethren! See, look how none condemn me for my actions! Look how my fellow believers support my bravery!” This tacit support must be withdrawn, and these people must be made to understand, in no uncertain terms, that if they are not willing to fulfill the demands of their profession, they must seek work elsewhere. If you see this kind of injustice, speak out about it! Do not remain silent while the rights of the few are disregarded by a shortsighted majority.

*These organizations appear to be predominantly but certainly not exclusively Catholic. To be honest, the very notion of a religious medical institution shouldn’t even be comprehensible. Religion is based on faith while healthcare is based on empirical evidence. These two ideas are not compatible.

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57 responses to “The “Moral Objection” Argument to Healthcare

  1. My criticism still applies, namely that you need another moral standard in order to distinguish between competing created moral standards and that this standard cannot be created too or we are back where we started. Notice that I said this distinguishing standard must be moral – in the sense that it must distinguish between all moral and immoral actions.

    Frankly, this makes no sense. Please explain your reasoning.

    Observation: Living organisms have functions they will perform if uninhibited.
    Consequence: These functions correspond with “good,” at least as it relates to those organisms.

    How do I need a moral standard to evalulate this?

    So, the rule does not distinguish between things only if they affect God. It makes judgments about everything about which God has an opinion.

    It would be more accurate to say that it makes judgments about that which God has expressed an opinion, since the only measure we allegedly have of God’s desires is the Bible, which is a finite text. You will find nothing in the Bible on the subject of intellectual property law, for example, so I suppose we would have to assume that copyright violation cannot be immoral.

    . To use an example I heard, the police can knowingly punish an innocent man in order give the impression of being efficient and dissuade potential criminals. They can also successfully keep this a secret, but even if it leads to less crime (and harm in general) in the end than would have been otherwise, it would still be immoral.

    We agree here–punishing an innocent person is immoral even if it leads to a reduction in crime. If an innocent person is punished but good things happen after, it’s immoral even if it’s useful. This is because it adds undue suffering–there are less harmful alternatives, such as the police lying about having punished someone without actually having done so.

    You can’t discard other standards in favor of this one for that reason – it says that we can and should commit such clearly wrong actions if they bring more harm than good.

    If you were to approach this discussion without your preconceptions, it would be easier to communicate. You could, for example, phrase your concern in the form of a question, so that we could discuss that concern, rather than merely stating your preconception as if it were fact. Here’s an example of what I have in mind:

    “Wouldn’t this standard mean that clearly wrong actions should be committed if they bring more good than harm?”
    No. For starters, if they’re “clearly wrong,” I don’t see why we’d even need to discuss them. To say that something is good because it brings more good than harm, we have to actually establish that it does so.
    “Wouldn’t it be good for a police officer to punish an innocent person if it led to less crime?”
    This consequence would not follow from that scenario. The consequence of an innocent person being punished is unwarranted harm. Nothing about this inherently causes a reduction in crime. It is possible that the advertisement of a punishment might reduce crime (research suggests this is unlikely in the long run), but even if so, this can be accomplished without harming an innocent person (like through deception, if nothing else). Ultimately, the punishing of an innocent person means that the guilty party has gone free, and this strongly suggests an increase in future crime, not a decrease.

    If you still feel that the standard I’m applying would demand the punishing of an innocent party “to reduce crime,” I would request that you explicitly lay out the causal chain that would lead to this consequence. If you do this, I believe I can demonstrate why your reasoning does not apply. If I am mistaken and your reasoning is solid, then we can at least advance the discussion.

    I’m sure you’re still busy, so feel free to take your time.

  2. “Observation: Living organisms have functions they will perform if uninhibited.
    Consequence: These functions correspond with “good,” at least as it relates to those organisms.”

    To prevent equivocation, it is important to clarify the meaning of good in the last sentence. By saying good there, you could just mean that it is beneficial to the organism. That is a tautology and as such, obviously true. It is not something we create. It is would be a true fact even if we declared that it is not. However, you can also mean that it is an ideal that everyone ought to strive to. There, you have proposed a standard for evaluating actions. The problem arises when you say that this standard is something that we create. In that case, someone could propose a different standard ‘my well-being is what everyone should strive towards’, for instance. You need a way to say truthfully that your standard is right and the other wrong. That’s where you need a standard – a yardstick b which to measure both claims and see which is truly moral.

    I’m not asking questions, because I’m making an argument. Your standard amounts to the claim that for any action x, x is the right choice if the net good (well-being minus harm) it produces is better than that of competing actions. My criticism is not specifically the claim that the police would be right in punishing a man if it results in less crime. It is more general. It is that claim that your standard can also be stated as follows:
    If the murder of a homeless orphan leads to more harm than good than competing alternatives, it is right. (This would be clearly true if the orphan is, unbeknowst to the community, a serial rapist and murderer with no relatives and the result of the murder is less rapes and deaths, increased police surveillance and increased care for the homeless in that community). I don’t know how I can make it any clearer. Your standard amounts to the claim that murder, punishing the innocent, etc. are right in cases where they produce more harm than good than competing alternatives. But murder and knowingly punishing the innocent are wrong. Part of your response in the previous comment was to argue that punishing a guilty man would not lead to more harm than good (than other alternatives). But that’s beside the point. You don’t attack a if-statement by denying the antecedent. That just makes the statement true. The criticism is that if a murder were to lead to more harm than good, it would be right under this standard. If you still don’t get it, we’ll just have to move on.

    By the way, the Bible never mentions intellectual property, but it has a lot to say about stealing, respect for other people’s possessions and love for others. It follows from its statements about the character of those things that stealing someone else’s work is wrong.

  3. By the way, the Bible never mentions intellectual property, but it has a lot to say about stealing, respect for other people’s possessions and love for others. It follows from its statements about the character of those things that stealing someone else’s work is wrong.

    Intellectual property theft is not “stealing” because it does not deprive the original owner of their possession at all. Now we’re back to interpreting the vague admonition “love others,” which puts us in the same position I mentioned before–you might reason that you would not cause harm to someone you love, and you are supposed to love everyone, so you should not harm anyone. Occam’s razor still suggests that we excise the unnecessary step.

    ~

    Throughout your entire response, you seem to be getting it backwards by saying something is good if it causes more harm. I’ll assume this is the result of an editing error. For clarification, it should be the other way around: something is bad if it causes more harm.

    . By saying good there, you could just mean that it is beneficial to the organism. That is a tautology and as such, obviously true.

    Defining a word is not a tautology.

    you could just mean that it is beneficial to the organism … However, you can also mean that it is an ideal that everyone ought to strive to.

    If you want to include the “ought,” it would look something like this:

    Observation: Living organisms have functions they will perform if uninhibited.
    Consequence: These functions correspond with “good,” at least as it relates to those organisms.
    Conclusion: A reasoning organism should strive to function because failing to do so is damaging to or fatal for that organism.

    I’m not asking questions, because I’m making an argument.

    Exactly. You obviously don’t understand what you’re arguing against, so what’s the point? It should be clear by now that the idea you have in mind does not match the idea I have in mind. Your repeated challenges are not against what I am suggesting but of the straw man that lives inside your head. This may be a failure to communicate on my part, or it may be an unwillingness to see beyond erroneous preconceptions on yours, but for whatever reason, if you’re not interested in understanding my position before making an argument against it, I don’t see any reason to continue.

    You don’t attack a if-statement by denying the antecedent. That just makes the statement true. The criticism is that if a murder were to lead to more harm than good, it would be right under this standard. If you still don’t get it, we’ll just have to move on.

    The problem is that you are making a dishonest argument. If X causes net harm, it’s bad. If X causes net good, it’s good. To say “if murdering an innocent person causes a net good, then it is morally good under this standard” follows the preceding pattern (and is thus structurally valid), but it’s a red herring. How can murdering an innocent person cause a net good that cannot be achieved without murdering that person? You have not answered this question.

    The closest you have come to answering it is this:

    If the murder of a [a serial rapist and murderer] leads to more harm than good than competing alternatives, it is wrong. [ED–see initial note]

    But this misses the mark because a serial rapist and murderer is not an innocent person.

    Furthermore, a person murdering this SRAM without knowing anything about his crimes still creates a harm. SRAM’s killer was trying to kill in cold blood–a murder with no justification. (Intending to kill someone for no reason is bad because it reflects a desire to cause net harm.) Furthermore, such a person is an active threat to society in their willingness (desire?) to kill innocent people–this is also harmful.

    The criticism is that if a murder were to lead to more harm than good, it would be right under this standard. If you still don’t get it, we’ll just have to move on.

    Let’s accept this criticism for the sake of argument. If hypothetically murdering an innocent person truly does lead to a net gain, it might be good thing. That’s a pretty big if, and thus far, you have not been able to provide an example where murdering an innocent person produces a net gain. Furthermore, you will also have to demonstrate that the highest possible good can come only from killing the innocent person for this if-then statement to be true. If you can do this, I will accept your words as the criticism they were intended to be. If not, your criticism is irrelevant (and strikingly similar to the charge, “If God commanded you to murder scores of innocent people, would it be morally good?”).

  4. “Observation: Living organisms have functions they will perform if uninhibited.
    Consequence: These functions correspond with “good,” at least as it relates to those organisms.
    Conclusion: A reasoning organism should strive to function because failing to do so is damaging to or fatal for that organism.”

    Now, the question is that for the consequence, you have made a claim, but unless we are going to accept these things without reason, you must say why it is so. Why should we define good as ‘the functioning of an organism’ as opposed to ‘my functioning’ like some people do or ‘the functioning of plants’. Saying that the functioning of an organism is beneficial to the organism is what I was calling tautological. At the very least it is obviously true. The question is why we should call this ‘good’ as opposed to other things. in other words, your definition of the word ‘good’ is quite unclear. Do you just mean that this is beneficial to the organism? Why call it ‘good’? That is what I say you need a standard for – to differentiate between the good and the bad. You can’t pull labels out of thin air.

    For the conclusion,
    1. I don’t think the ought you have defined there is a moral one. It is equivalent to the claim “i ought to believe that stars exist if I have good evidence for it”. That is true, of course, but my lack of belief would make me irrational, not immoral. In the same way, an organism should strive to function if they know what’s good for them, but refusing to do so makes them irrational, not immoral.

    2. Secondly, that claim does not support your harm/well-being standard. It supports egoism i.e. the belief that the right course of action is the one that maximizes one’s own self-interest (not the self-interest of everyone). For instance, giving your life for a stranger under that standard would be immoral because it does you more harm than good.

    _____________________

    My example was not intended to be one about the murder of an innocent person. It was supposed to be about murder. Of course the murderer and rapist is not innocent, but his murder does produce more good than bad. Is it then good? We have both done something wrong at some point, so even we are not technically innocent.

    “To say “if murdering an innocent person causes a net good, then it is morally good under this standard” follows the preceding pattern (and is thus structurally valid), but it’s a red herring. How can murdering an innocent person cause a net good that cannot be achieved without murdering that person? You have not answered this question.”

    It is not a red herring. I am not trying to change the topic of this conversation. Are you saying that for something to be good it has to produce a net good that cannot be produced through other means? Lots of good things produce net goods that can be produced through other means but they are still good.

    I have to be somewhere so this is rushed but I hope I’ve given you a but more clarity.

  5. If you mean that things are right and wrong whether we think so or not, I agree. If you’re wondering whether I think that belief is warranted given certain background beliefs, that depends on what those beliefs are.

  6. Why should we define good as ‘the functioning of an organism’ as opposed to ‘my functioning’ like some people do or ‘the functioning of plants’.

    For the same reason that we don’t define morality as “the things Steve thinks are good or bad”–the meanings of these words do not correspond to a single person’s opinions.

    The definition of good is found by reusing the verbiage of the observation. For an organism, at the very least, goodness is functioning more or less in one’s biologically predetermined capacity. We extrapolate from there to morality by observing the kinds of social conditions that promote and preclude a socity in which organisms (people) can function within the parameters of non-destructive variation.

    You claimed that the only way to have non-relativistic morality was with an uncreated foundation. I offered this interpretation as a foundation for secular morality. You’d be right to say that this is not a comprehensive treatise on morality, but it isn’t meant to be.

    Of course the murderer and rapist is not innocent, but his murder does produce more good than bad. Is it then good?

    You can conclude that it is beneficial to society at large to have that person off the streets, but that does not change the fact that the murderer is willing to murder. I think you are refusing to see that a society in which people are allowed to murder each other is ultimately harmful to all in that society. (Police exist and can arrest the rapist-murderer without telling people it’s okay to kill each other.)

    To return again to your question of “murdering an innocent person is moral when it creates a net good,” I find this question meaningless. Hopefully an analogy will communicate my sentiment: Is it morally okay for a man to remain a bachelor until his sixth year of marriage?

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