Core Theme-Ethics

Ethics
How do we identify relevant facts when considering an
ethical dilemma?

Dilemma:
a situation in which a difficult choice has to be made between two or more alternatives,
especially ones that are equally undesirable

Ethical dilemma is a choice between two options, both of which will bring a negative
result based on society and personal guidelines.

In other words, An ethical dilemma (ethical paradox or moral dilemma) is a problem in

In ethical dilemmas, we can develop a solid TOK analysis of the principles by:

• exploring which facts or knowledge about the situation are relevant to the decision
• considering where this knowledge comes from
• asking why we have chosen some facts over others in making a decision.

Another way of saying this is to consider which features you would place on the map
that helps you make sense of the ethical dilemma.

CASE STUDY

Mapping an ethical dilemma In the year 2000, a couple from Malta (an island in the
Mediterranean Sea) travelled to Manchester in the United Kingdom. The wife was
pregnant with conjoined twins and, knowing that it would be a very difficult birth and

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that the babies would need intensive care, the UK had invited the couple to St Mary’s
Hospital in order to look after the mother and babies. The babies were born in August,
but one of the twins, Mary, was very sick and her heart and lungs stopped working
immediately after birth. Being conjoined, this meant that the other baby, Jodie,
provided blood and oxygen for both of them. Unfortunately, this placed a huge burden
on Jodie’s heart and lungs and the doctors did not expect Jodie to survive for long as
she was doing so much work for both twins.

The doctors wanted to separate the twins, believing that Jodie had a very good
chance of survival, though they knew that because Mary’s heart and lungs were not
functioning, she would not survive any attempt at separation. The babies’ parents
understood the medical facts and the likely outcomes, but did not consent to the
operation, arguing that they could not willingly consent to an operation that would kill
one of their children.

The hospital, believing that it had a duty to protect life where it could, went to the
courts to ask permission to separate the babies. The first court (Crown Court) allowed
the separation against the parents’ wishes, but the parents appealed to the High
Court to stop the operation. The High Court also allowed the operation, but for
different reasons. The operation was successfully conducted, Mary died, and the
family returned to Malta with Jodie, who grew up healthily and happily (BBC News).

There are all sorts of ways to explore this example, which is full of ethical and
legal dilemmas as well as deep human tragedy and triumph. One way is to
analyse and evaluate the reasons the judges gave for their decisions to separate
the twins and the different approaches they used. These different approaches can be

thought of as different ‘maps’: the reality of the situation was about babies, biology
and law, but the ethical dilemma was hard to describe. The first Crown Court judge,
Lord Johnson, described the situation using the language of ‘life support
machines’, arguing that Mary ‘lives only because of her physical attachment to Jodie.

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The blood and the oxygen that maintain her life come from Jodie. In the words of one
of the doctors, Jodie is her life support machine’ (A (Children)). Think back to what we
said about maps earlier. Lord Johnson takes the reality and translates it into a
different set of circumstances which provide a method of thinking through the
dilemma.

The map Lord Johnson used to think through the situation emphasized Mary
and her well-being. He asked the traditional questions one asks when faced with
someone who is on life support and who is not expected to survive. In those cases,
the tools available (the elements of the ‘life support map’) are things like quality of life
and questions such as, ‘is it right to end a life of unending suffering with no hope
of long-term survival?’ Characterizing the situation in this way and using this sort of
reasoning led to a relatively straight forward answer – it was in Mary’s best interests to
allow Mary to die and end her suffering.

The High Court decision, while advocating for the same result, used an entirely
different map to navigate the complexities of the issue. In their decision, one of the
judges, Justice Ward suggested that Mary ‘sucks the lifeblood of Jodie and her
parasitic living will soon be the cause of Jodie ceasing to live’ (A (Children)).

While the first map emphasized Mary’s

characterizes the issue as a medical health issue, suggesting that Jodie’s life is being
threatened by something that will quickly kill her and it draws on the duty of the
doctors to protect that life.

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The maps therefore drew on quite different principles, and each distorted the reality of
the situation, but in so doing, made it possible to navigate the very sad and
challenging decisions that had to be made. In each case, the application of the
maps gave the doctors a clear choice (‘when to remove a patient from life support’
and ‘what needs to be done in order to protect a patient from a dangerous
parasite’) and a clear set of principles to make an ethical decision.

The parents felt that their faith in God and their beliefs about God meant that the
situation was somehow part of God’s plan. As parents, they felt that a course of
action which resulted in the death of one of their children was never an option.
These are certainly reasonable things to consider in making this decision, even if you
wouldn’t choose them yourself. However, the doctors involved used a different map to

see their way through the dilemma, emphasizing instead the chance of a
successful medical intervention in keeping one of the
children alive. The judges also then identified relevant
facts and used them to develop analogies, saying that
the situation was sufficiently similar to when a patient is
on a life support machine, or when a patient is suffering
from the effects of a parasite. These models could then be used to
guide their decisions on what would be the ‘right’ thing to do.

ACTIVITY
Consider the two positions offered by the Justices in the case study about
the conjoined twins.

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1 What are the various strengths of the two maps being applied to the situation?

2 Is one way of understanding the dilemma better than the other? How are you
measuring this?

3 What other maps might have been applied to the case? Try to develop a different
way of unpacking the various elements of the dilemma.

4 What is different about your map of the situation from others?

5 What are the different priorities in the various approaches?

6 Are there better and worse approaches to dilemmas like this? How can we
decide which is better or worse?

ACTIVITY
Consider an ethical dilemma.
Some examples of ethical dilemma examples include:
● Taking credit for others' work.
● Offering a client a worse product for your own profit.

1 Choose a stance to take on the dilemma and decide which facts pertaining to the
case you would choose in order to develop an argument for your position.

2 Now choose a different position on the case. Are there different facts you would
choose to explore in relation to the dilemma?

3 How can you overcome the challenges of deciding which factors are most relevant?

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Different people may disagree fundamentally on what the right facts to consider are in
an ethical dilemma, and this will undoubtedly be the result of a whole range of factors.
An individual’s religion will have an influence, as will their background knowledge and

which community of knowers they are part of. The parents of the
conjoined twins, being religious, imposed that element
onto the situation; the doctors at St Mary’s Hospital had a particular skill set, so
naturally thought of the dilemma in terms of what their medical abilities could do in the
situation to make things better. The judges chose different maps again: given that their
task was to decide, they needed to look to models that were helpful for decision making
and applied maps which have been helpful in the past. Whether to withdraw someone
from life support or to protect someone from a threat are situations for which answers,
and methods to find answers, have already been developed. Finding similarities with the
case of the conjoined twins and applying these models provided clear methods to find
answers in this case too.

KNOWLEDGE QUESTION
If moral claims conflict, does it follow that all views are equally acceptable?
(A moral claim evaluates the rightness or wrongness of an action)

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The reasons why you’ve been encouraged to consider who your puppet masters are or
which communities of knowers you belong to is another way of exploring what tools you
can use to explore challenging ethical dilemmas such as those described above.