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What would be a genuine moral dilemma?


Dear Nicola,

Thank you for your email of 27 September, with your first essay for the Moral Philosophy program, in response to the question, 'What would be a genuine moral dilemma? Assess the impact of the recognition of the existence of moral dilemmas on a philosophical account of the nature of moral judgement.'

In your essay you offer three cases which potentially could be viewed as kinds of moral dilemma: concerning the separating of Siamese twins, the limits of the duty of parental care when children are about and about, and the justification for the death penalty.

You mention the possibility of coin flipping at one point, as one mark of a moral challenge which is not a genuine moral dilemma. In the unit on moral dilemmas, I give the example of a life raft, where you can save the passenger swimming on the left or the one on the right. The reason for going left or right are clearly the same, so the only reasonable and fair course is to let chance decide.

What makes a dilemma 'genuine', I would argue, is some kind of imbalance in the reasons for or against doing a particular action. We have no yardstick for measuring one kind of reason for action against another, because they are incommensurable.

How does this apply in the case of the Siamese twins? One twin wants to take the risk of an operation while the other doesn't. This is not like the life raft case in at least one respect, the reasons aren't parallel. One twin values freedom more, the other puts a higher value on not risking death.

The problem here is that doing nothing is itself a decision, in favour of the second twin against the first. We have to decide. In theory, flipping a coin would be the only fair thing to do. We are not dealing with a single person confronting a dilemma, but rather a dilemma caused by different people wanting different things. In other words, the 'dilemma' is one facing the surgeon. However, although what I just said about what would be 'fair' seems to be correct, there is absolutely no way, in practice, that such an operation could go ahead without the consent of both twins. It is a basic principle of medical ethics that you cannot operate without a patient's consent (the only exception being when the patient is judged too young to make this decision). This does seem unfair to the twin who wants to be 'freed', but we have to also consider the wider consequences if we were to allow an exception to the basic principle in this case.

I was horrified to hear the news story about the father reprimanded by social services. This does seem a case where a general principle, justified though it may be, has been pushed beyond the bounds of what is reasonable. Social services would argue along the lines of the previous example, that you can't allow exceptions. But surely a line has to be drawn. It must be possible to make decisions on an ad hoc basis which are consistent with common sense.

The death penalty is a question which has caused huge debate. However, not every hotly debated ethical question is a moral dilemma. There is no agreement about what to do in a particular case, not because there are unbalanced ethical considerations for or against doing a particular action, but because there is failure to agree what counts as an 'ethical consideration' in the first place. Abolitionists simply will not allow any case where the death penalty is justified, no matter how extreme, because they believe that it is wrong in principle.

To some extent, it is less important whether or not your examples count as 'genuine moral dilemmas' (a classification which one might argue is being construed rather narrowly) but rather what conclusions we should draw from the fact that there are many unresolved and unresolvable moral questions. (On my view, all moral dilemmas are unresolvable, but not all unresolvable moral questions are dilemmas.) Your view is that we are forced to take a step back and allow that at least some moral questions are simply 'a matter of opinion'. In some ways, I agree with this. People will come down heavily in favour of one view or the other, and we simply have to recognize that fact.

I think there is something else here, however. Matters of opinion can simply be matters of personal taste, which you don't argue over. I just bought myself a car on eBay (the first I've driven for 10 years). It's a Scimitar GTE and I love it. Not everyone likes Scimitars, however, and I can fully appreciate that whether or not you do is a 'matter of opinion'. However 'good' your reasons for hating Scimitars, they are still only your reasons, and make no impression on me whatsoever. Whereas, in the case of the twins, even if it is not a 'genuine' moral dilemma in the strict sense, you can't simply say, 'I vote for the one who wants to be freed' or 'I vote for the one who doesn't want to risk the operation'. You feel for both, even though if the choice were up to you alone, you would come down firmly on one side rather than the other.

All the best,