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Responsibility
The Role of the Clinician I
The Role of the Clinician II
Soft Paternalism I
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Responsibility
Michael A. Gillette, Ph.D.

This document and the ideas presented herein are the intellectual property of Bioethical Services of Virginia, Inc. and may be used and reproduced only with proper citation.

In the previous two issues of Centerline we have been discussing the troubling moral problems that surround a situation in which a staff person is asked to provide services in a way that he or she feels is inappropriate. Specifically, we have been considering the circumstance of a client who is slated for transfer into a community living arrangement, while the person responsible for making those arrangements feels that the client would be best served by remaining in the Training Center environment.

Two months ago I suggested that this problem might boil down to a debate concerning the relative evils involved in doing what one has been ordered to do, or suffering the consequences of refusing to do as you are told. Last month I examined a line of reasoning that argues that since the transfer will take place whether or not you are the one to do it, it isn't morally wrong for you to initiate the transfer yourself. The first approach to this problem involved a careful weighing of costs and benefits, the second approach attempted to skirt the moral issue altogether. Last month I argued that the second approach failed, and I would now like to try one additional method of dealing with this difficulty.

Imagine that a political terrorist has kidnapped an innocent group of people and now holds them hostage. This terrorist threatens to kill all of his hostages unless you assassinate the President of the United States. Take it as a given for this argument that as reprehensible as this criminal is, he is also very trustworthy. It is clear to you that if you do as he asks, he will uphold his end of the agreement and let his hostages go free. Apparently, you are faced with a difficult decision. If you assassinate the President, you will save the lives of the hostages. If you do not assassinate the President, you will make a choice that will result in the death of those hostages.

One approach to this problem is to weigh off the relative value of saving the President versus saving the hostages, and make the choice that brings about the greatest long-term good for everyone involved. This approach would be just like the one outlined two months ago. This is not likely to be the first response that most people make.

The first response that most people would have to this sort of hypothetical situation is that both the assassination of the President and the murder of the hostages is morally wrong. Furthermore, if you assassinate the President, you will be doing something wrong. If you do not assassinate the President, the terrorist will do something wrong. Since, as I argued last month, you have a special responsibility for what you do, it is of first importance that you act in a way that is morally responsible. Therefore, you must not assassinate the President, even when innocent lives are at stake.

While the answer to this conundrum might seem obvious, on second glance it is more complicated. Imagine now that I own a company that produces toxic waste as a by-product of production, and I hire someone to carry away that waste. I do this knowing that the selected person is likely to dump the toxins into a nearby river and thereby pollute the water supply. Even though I didn't do the immoral act of dumping the pollutants, I knew that someone else would. Although this case now seems much like the terrorist case, most would agree that I am responsible for choices that result in other people doing wrong. This case shows that I can be morally responsible for the activities that someone else engages in as a result of my actions. Why then aren't I responsible for the activities of the terrorist which are equally the result of my decisions?

One important difference between the terrorist case and the toxic dumping case is that in the terrorist case there is another person, the terrorist, who is responsible for initiating the immoral circumstance. The terrorist is the source of the problem in that situation. If it weren't for the existence of the terrorist, then I would not even be considering the assassination of the President. Therefore, when I refuse to kill the President, the blood of the hostages will not be on my hands if the terrorist chooses to kill them.

In the case of the toxic dumping, I am initiating the problematic activity. If I know what is likely to happen by hiring a certain dumping company, and I pass my toxic waste over to that company, then I am the one who initiates the activity. I would not be responsible, however, if I had every reason to believe that the company with which I was working would care for the hazardous material properly.

Now, back to the Training Center. If I am ordered to place someone into the community against my better judgment, am I acting more like the person who refuses to assassinate the President, or like the person who irresponsibly dumps toxic waste? In both scenarios something bad happens, but I am only responsible for that outcome in one of the two cases.

If the Training Center case is like the Terrorist case then I may be in the clear. I would argue, however, that one major difference between the Training Center case and the Terrorist case is that in the former I do the action that is considered wrong, while in the latter, someone else does the wrong. Perhaps it is necessary to consider whether there is a moral difference between doing something bad, and letting something bad happen.

 

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