If you owned a small insurance company that covered health policies, would you decline an applicant who was diagnosed as having Huntington’s disease, assuming that you also knew that treatment bills over a ten year period would bankrupt you? As it happens I have a friend whose father started such a company when it was illegal for an African American to own an insurance company. How would you advise him when faced by this situation? All my students had just watched Barbara Walter’s documentary, PERFECT BABY, and had seen her interview with Woody Guthrie’s son and family, none of whom have been tested for Huntington’s disease and any one of them could have the genetic disease. With few exceptions, all my students are African American, yet almost all of them would advise my friend to give the health coverage even if it meant certain bankruptcy for him. Their reasoning was that the applicant had the right to insurance regardless of consequences.
A similar situation occurred in another class. On this occasion the content of the class had been the consequences of overpopulation to organisms in general and then to humans in particular. Students were distressed by the information they learned but when asked whether there should be a limit to family size, again almost all of them thought that everyone had the right to as many children as they wanted.
My concern on these and similar occasions was not with student’s values , but that in every case their decision making by-passed what was in front of their noses. It seemed to me that, in fact, they were not acting ethically at all since their heads and their hearts were in no way connected. They expressed no compassion in their decision making and cut the connection between deed and consequences. Understanding had no part to play. My role as educator was pointless because the answers were given
. The loss of a person’s livelihood, global devastation, misery and suffering apparently did not enter in to their ethics—only the rubrics of a religion or rule book.
1(a) How to integrate science with ethics?
The problem of this unit is to find a way of presenting ethical issues in such a way that the teacher does not simply elicit responses pre-determined by home, peer group or religion, but provides a process of decision making that is intrinsically ethical, i.e. it connects values with facts, feelings with data, and deeds with consequences. The problem was directly addressed by John Dewey so his philosophy will first be examined for help in finding a concrete answer. He conceived of the problem as fundamentally the problem of the relationship of science to morality and considered the resolution of the problem the primary task of a teacher. A practical method of implementing his ideas follows the theoretical analysis.
1(b) How to teach student-centered problem solving?
The following unit was originally inspired by the need to solve the problem of how to teach genetics that was student-centered and inter-disciplinary. A practical method is given that I think achieves this and provides a suitable context in which to locate student bioethical problem solving in a scientific manner. It offers a Deweyan pedagogy in which the teacher “directs the child’s activities, giving the exercise along certain lines, and (that) can thus lead up to the goal which logically stands at the end of the paths followed.”
It breaks with traditional education that was characterized by Dewey for:
“its passivity of attitude, its mechanical massing of children, its uniformity of curriculum and method. It may be summed up by stating that the center of gravity is outside the child. It is in the teacher, the text book, anywhere and everywhere you please except in the immediate instincts and activities of the child himself.”
It was of course Dewey’s aim to bring about a revolution in teaching in which, “the child becomes the sun about which the appliances of education revolve; he is the center about which they are organized.”
The following unit has taken the above criticism to heart. Students are “given a motivation to demand the information.” It was tried out and had pleasing results.
2. Dewey’s Theory of Science.
The genius of science is not in its method but in its insistence that mind is subject to experience. Mind is not allowed to think what it pleases but must discipline itself by the hard knocks of experience, the center piece of the laboratory. By experience, Dewey means what he claims it has always meant—simply what is experienced.
“The existing experience holds us for its own sake, and we do not demand that it takes us into something beyond itself. With the child and his ball, the amateur and the hearing of a symphony, the present object engrosses. Its value is there, and is there in what is directly present.”
Over against rationalists he asserts that reason is subjective and prejudiced if it acts independently of experience and that experience in the first place is a matter of feeling (sensuous awareness). Mere reason is empty. The real is in the experience that we as reactive organisms must respond to and objectivity comes from the consequences of acting in response to that environment. Hence the name for the philosophical movement of which he was a prime architect—pragmatism. The central tenet is often thought to be that of learning by doing but this is only a partial and misleading characterization. The artist is Dewey’s hero, such as Emerson, because the artist begins with the immediacy of experience and then finds a path in and through that immediacy. The role of reason is the practical one of finding a path through an uncharted territory. Scientific knowledge is thus not about universal truths for all time but truths in the sense of sign posts that help us get around with minimal disaster.
Over against empiricists or idealists of the Kantian sort, Dewey rejects any kind of transcendentalism that implies a mental
decision making mechanism that is the deciding arbiter between truth and illusion. Dewey can agree to having a set of rules for “constructive synthesis in a differential sense” but not to a static endowment lurking in the brain that provides a “law for the determination of every experienced object”.
The problem that empiricists inherit is the simplistic notion of experience given by John Locke. It is assumed that experience consists of small frames of experience that are pieced together like frames in a film. For Dewey the mind is an active exploratory experiencing entity that follows its feeling awareness of the environment in which it is set. Reason only abstracts partially out of this continuum and must remain all too human and is fundamentally time bound and developmental. That we can make generalities and express them as laws does not alter the condition upon which these laws are based. It would be rather like splitting written music from the instrument that makes the sounds. As transcendental as music may be, it does not detract from its time bound materiality. Dewey’s passion for philosophy was directed in many respects from a desire to overcome the split ways of thinking that characterizes modern thought, and science in particular.
The starting point for thought then is experience and for science this means the experiment. It is not one experiment but one continuous multiplicity of experiments that are part of an on-going journey of thought. To understand his philosophy one has to appreciate that what is first grasped is not an idea but a feeling for qualities that are present. Secondly, Dewey cannot be understood if one forgets that the mind does not seek abstract truth but solutions to a problem, in particular how to realize the object of its desires—the fulfillment of its feelings. The invention of a telephone was an ongoing interplay of envisioning, feeling, testing out a practical solution, thinking and `seeing’ facts in a new light that then led to more tentative ideas, actions, feelings, ideas, actions and so forth. Knowledge is thus an interplay of feeling (the aesthetic), action (conation) and thinking (reason). Science (knowledge) is thus an organic process in which feelings lead the way.
What Dewey has in mind as he developed his philosophy was a reflection upon the role of mind in human evolution that he himself called a genetic way of thinking. Mind developed because of its power to help our species negotiate the environment. When the brain was set free from simply following behavior patterns given by coded instructions in DNA, it could start acquiring knowledge (science) that could be passed on to following generations through culture. The role of philosophy is to facilitate that process, i.e. to assist in solving problems and only in this respect could it justify itself (pragmatism!). Hence Dewey’s preoccupation with science and science education but the science he has in mind is not split from the arts or morality. It is not to be found in some esoteric method, but “a way for getting at the significance of our everyday experience of the world in which we live” and education is “a continuous process of the reconstruction of (that) experience”.
To illustrate what he means we may use an example from genetics and quote the inventor of the modern plum, Burbank.
“I wanted to get a plum that would ship......a plum that would be beautiful and delicious, a plum that would be large, a plum for canning, a plum with a small pit or none at all, and so on. My designs were pretty carefully worked out. For instance, as regards the shipping plum. The plum developed to be picked from the tree and eaten right there, or within a few hours in the house was quite a different thing from the plum that could be picked, packed, shipped, delivered may be thousands of miles away, unpacked, sold,carried home, and finally eaten fresh ...... And this couldn’t be acquired by accident or chance—it had to be studied and the specifications pretty carefully written.”
The experience of the plum was in the first place a matter of the senses—greater and larger than the cognitive reflections. Actively reflecting within the experience, the mind started wondering about possibilities. A number of questions were posed by that experience. A future objective was posited that would ultimately provide a conclusion to a rational study. Thought was future oriented, visionary and a social enterprise. Truth and values were relative to the inquiry from the outset to the consummation of the experiment. Truth did not concern eternal forms but about something new that in turn provided the starting point for acquisition of future knowledge.
“There is only one sure way of deciding whether a plum can travel a thousand miles, be stored on a grocery shelf, brought home and remain not merely edible but tasteful: send some of the new varieties on just such a journey. The problematic situation arose within a context and the success or failure in resolving it will be judged by a return to that context ....... Success in inquiry is inextricably connected to interactions between humans and their environments.”
3. Dewey’s Theory of Science and Morality
Once we understand John Dewey’s theory of Science, it is not such a big jump in the imagination to realize that there is no necessary gulf dividing science and morality. If science was independent of feelings then clearly we would have an inherent break that was unbridgable. If science was independent of action, then morality that concerns actions would have no connection. If morality was necessarily irrational and had no interest in cause and effect then there would be an impassable gap. If morality could not create universal generalizations out of particular experiences or science did not have an ability to make judgments on particularities or arrive at some universals we might decide
that Dewey was being fanciful. If science could not be visionary or future oriented there might be an impasse but as the example of Luther Burbank’s plum illustrates, the future is implicit in experiment. It required vision for the mind to set up its experiential procedures. If either morality or science were not inherently developmental in history and culture there might be a case to reject the impossibility of a logical analogy between the two. Clearly, however, the very same human qualities are required in making scientific judgments as are required in moral judgments. Indeed, both begin with experience and a feeling response to a specific and actual situation demanding action and rational judgment.
Dewey was concerned not to reduce morality to science but rather to show that logically they are parallel activities of the conscious mind. Morality follows on the results of scientific inquiry and its method of problem solving parallels that of the sciences. After all, in Dewey’s philosophy, feeling awareness is the real, guiding the mind and confirmed by consequences from action.
Is not a morality based in love not one that begins with a feeling awareness guided by the mind and testing itself by consequences of its actions?
Arguments against Dewey assume a transcendental bases for ethics that is independent of experience. They assume a conscience that acts according to judgments “in terms of itself “ independent of time and place. An example of this is intuitionism. Here there is a belief in immediate intuited judgments, not conclusions, having no logical relations and “not amenable to intellectual supervision” In such a belief system, morality is about future ends and values. Science is simply about causes and reflections on the past and what has happened. Values are unconditioned and science is conditioned. Morality is subjective and science objective. What we find though is a split way of thinking characteristic of past philosophies and idealisms that perpetuate its dualisms into the present. In Dewey’s philosophy of science such a split is quite unnecessary.
What then is the difference between science and morality? Morality passes a judgment upon an experience. It poses questions about what we should do with the information that we have gained through science. Martin Luther King and his associates stategized politically in exactly Dewey’s manner. In the morning they would meet to morally reflect upon what had happened the day before and then would decide upon some action for that day. They then would act upon that decision and from that experience make further judgments from which to determine how they would act on the following day. Dewey writes that only the living can make moral judgments and that these must be in terms of time and space—of antecedents and consequences. The rational component must take into account psychology and sociology.
Moral terms like freedom, responsibility, ideals, duty have no meaning except in the actual context. The need to abstract in both science and morality is to assist in making further judgments. However the fact that we can abstract does not alter the fact that all judgments are necessarily contextual whether scientific or moral.
Given that there is compelling argument, according to this author, for a parallel logic between and science and morality, can we find a parallel method of solving ethical problems that can be taught, rather as the scientific method is taught?
In reality the two processes of thought and judgment go hand in hand but because of how we think of science and morality as polar opposite activities, we tend to circumscribe out procedures of thought, feeling , activity and judgment that are coterminous with both science and morality. In other words, for Dewey, we need more awareness and clarity about what we do, rather than do something new. Before developing strategies for thinking through some classic ethical problems in genetics along Deweyan lines, it is necessary to outline an overview of method for the unit, in particular to set up instruction so that it is student-centered.
4. A Method for Teaching Ethical Problem Solving in Genetics.
If Dewey is correct, that science and morality are parallel activities involving the same skills, the only difference being that morality involves a higher order of judging, then perhaps we could teach moral problem solving in an analogous manner to teaching scientific problem solving. Logically it would seem that this is a possibility and what follows is a proposed adaptation of the scientific method to ethics.
I. Defining the problem.
To concretize my thinking I will use the ethical problem this paper began with. Should an insurance company run the risk of bankruptcy or major loss in order to cover an applicant with the genetically terminal illness, Huntington’s disease?
We have a presenting problem but we need to look more deeply to find what really is at stake. Upon careful reflection and analysis, we find two basic needs.
1) All people need health care and the resources to pay their bills.
2) All companies cannot take risks they cannot honestly cover.
II. Generate hypothetical solutions.
One needs to envision and brainstorm possible solutions to the problem. For assistance, one needs to research how others have previously dealt with this problem and take reasonable effort to consult with journals, experts, the WWW etc. We will assume that the following are an exhaustive list of hypothetical solutions.
1) Insurance companies charge realistic premiums and the government will pay over and above what the applicant can reasonably afford.
2) When the insurance company has paid out a reasonable amount of money on health bills, the government then pays all further bills.
3) The government, state or federal, implements either a national insurance plan or a national health plan.
4) All the above—1 and 2 being steps towards 3.
5) Government or/and insurance companies have pre-set limits on liability that is conducted upon medical advice, so that life support can be withdrawn or unduly expensive treatment be denied at a certain point in the progression of Huntington’s disease, for example, when mental faculties have been lost.
III. Determine what criteria would be used to deem plans/solutions as good/bad or better/worse? (Controlling variables)
The task is now to anticipate consequences of the hypothetical solutions that have been imagined. In this case we are interested in:-
1) outcomes for the parties involved—material and non material
2) outcomes for the government, state or wider
community -material and non material.
3) outcomes for dependents, family or friends—material and non material.
4) anticipate unintended outcomes, particularly in light of research into past experiences of comparable situations.
IV. Procedure/Materials/Presentation of Data.
Choose the best hypothetical plan and fully write out how it would be implemented with list of resources and costs incurred. Plan data tables, graphs and so forth to determine how outcomes can be measured and presented. Implement the plan if it seems that the more detailed plan appears to continue to offer the best outcomes.
The only way to be sure that one has made the best decision is to carry it out. The test for ethics must be ultimately come from a judgment based upon action and consequences. That ultimate test is our conclusion that will carry with it the full weight of ambiguity, presuming that in the real world, choices rarely lead to unambiguously good outcomes.
The hypothesis must be judged in terms of the data or outcomes. How good was our hypothetical solution to the problem we began with? Given our analysis of the data and the experience in implementing our planned solution, how could we refine our problem, hypothesis, procedure, materials, data collection and so forth. Ethical judgments become the basis for further research and starting point for developing better judgments and solutions. In a way, Dewey proposed no more than what is carried out in the social sciences all the time, and in deed he thought that sociology and psychology were inseparable from the process of ethical decision making.
Perhaps the above is all to simplistic, but it would seem to me that it is reasonable to make the demand on those who think that intuitions or revealed morals are the proper basis for ethics that they justify their metaethical stances in terms of actual contexts and actual consequences. No ethical stance can claim to be called ethical if it ignores the fullest use of human feeling, action and thought applied to all too human problems.
Dewey is also surely correct in saying that a public school teacher has only done half the job of teaching genetics if only facts are presented. Students are being cheated if they are not allowed to make moral judgments about the import of the information they have learned. Scientists may not hide behind science.
To show the feasibility of using this as a teaching method for High School students, a series of representative real life type situations that demand ethical problem solving are described below and worked out in the Deweyan manner. The simplicity of the method is captured in the `Life Skills’ poster used in New Haven for its Middle schools (see adaptation devised below). High School teachers are asked to use it in their respective subjects. As it happens, the correspondence is so close that the method used here can be articulated in terms of this hand-out.