which we have already encountered. Another is that we must always treat other people as ends, never as means. While these formulations of the Categorical Imperative might be applied in various ways, in Kant’s hands they lead to inviolable rules, for example, against making promises that we do not intend to keep. Kant also thought that it was always wrong to tell a lie. In response to a critic who suggested that this rule has exceptions, Kant said that it would be wrong to lie even if someone had taken refuge in your house, and a person seeking to murder him came to your door and asked if you knew where he was. Modern Kantians often reject this hardline approach to rules, and claim that Kant’s Categorical Imperative did not require him to hold so strictly to the rule against lying.
How would a consequentialist – for example, a classical utilitarian – answer Dostoevsky’s challenge? If answering honestly – and if one really could be certain that this was a sure way, and the only way, of bringing lasting happiness to all the people of the world – utilitarians would have to say yes, they would accept the task of being the architect of the happiness of the world at the cost of the child’s unexpiated tears. For they would point out that the suffering of that child, wholly undeserved as it is, will be repeated a million fold over the next century, for other children, just as innocent, who are victims of starvation, disease, and brutality. So if this one child must be sacrificed to stop all this suffering then, terrible as it is, the child must be sacrificed.
Fantasy apart, there can be no architect of the happiness of the world. The world is too big and complex a place for that. But we may attempt to bring about less suffering and more happiness, or satisfaction of preferences, for people or sentient beings in specific places and circumstances. Alternatively, we might follow a set of principles or rules – which could be of varying degrees of rigidity or flexibility. Where would such rules come from? Kant tried to deduce them from his Categorical Imperative, which in turn he had reached by insisting that the moral law must be based on formal reason alone, which for him meant the idea of a universal law, without any content from our wants or desires. But the problem with trying to deduce morality from reason alone has always been that it becomes an empty formalism that cannot tell us what to do. To make it practical, it needs to have some additional content, and Kant’s own attempts to deduce rules of conduct from his Categorical Imperative are unconvincing.
Others, following Aristotle, have tried to draw on human nature as a source of moral rules. What is good, they say, is what is natural to human beings. They then contend that it is natural and right for us to seek certain goods, such as knowledge, friendship, health, love, and procreation, and unnatural and wrong for us to act contrary to these goods. This “natural law” ethic is open to criticism on several points. The word “natural” can be used both descriptively and evaluatively, and the two senses are often mixed together so that value judgments may be smuggled in under the guise of a description. The picture of human nature presented by proponents of natural law ethics usually selects only those characteristics of our nature that the proponent considers desirable. The fact that our species, especially its male members, frequently go to war, and are also prone to commit individual acts of violence against others, is no doubt just as much part of our nature as our desire for knowledge, but no natural law theorist therefore views these activities as good. More generally, natural law theory has its origins in an Aristotelian idea of the cosmos, in which everything has a goal or “end,” which can be deduced from its nature. The “end” of a knife is to cut; the assumption is that human beings also have an “end,” and we will flourish when we live in accordance with the end for which we are suited. But this is a pre‐Darwinian view of nature. Since Darwin, we know that we do not exist for any purpose, but are the result of natural selection operating on random mutations over millions of years. Hence there is no reason to believe that living according to nature will produce a harmonious society, let alone the best possible state of affairs for human beings.
Another way in which it has been claimed that we can come to know what moral principles or rules we should follow is through our intuition. In practice this usually means that we adopt conventionally accepted moral principles or rules, perhaps with some adjustments in order to avoid inconsistency or arbitrariness. On this view, a moral theory should, like a scientific theory, try to match the data; and the data that a moral theory must match is provided by our moral intuitions. As in science, if a plausible theory matches most, but not all, of the data, then the anomalous data might be rejected on the grounds that it is more likely that there was an error in the procedures for gathering that particular set of data than that the theory as a whole is mistaken. But ultimately the test of a theory is its ability to explain the data. The problem with applying this model of scientific justification to ethics is that the “data” of our moral intuitions is unreliable, not just at one or two specific points, but as a whole. Here the facts that cultural relativists draw upon are relevant (even if they do not establish that cultural relativism is the correct response to it). Since we know that our intuitions are strongly influenced by such things as culture and religion, they are ill‐suited to serve as the fixed points against which an ethical theory must be tested. Even where there is cross‐cultural agreement, there may be some aspects of our intuitions on which all cultures unjustifiably favor our own interests over those of others. For example, simply because we are all human beings, we may have a systematic bias that leads us to give an unjustifiably low moral status to nonhuman animals. Or, because, in virtually all known human societies, men have taken a greater leadership role than women, the moral intuitions of all societies may not adequately reflect the interests of females.
Some philosophers think that it is a mistake to base ethics on principles or rules. Instead they focus on what it is to be a good person – or, in the case of the problems with which this book is concerned, perhaps on what it is to be a good nurse or doctor or researcher. They seek to describe the virtues that a good person, or a good member of the relevant profession, should possess. Moral education then consists of teaching these virtues and discussing how a virtuous person would act in specific situations. The question is, however, whether we can have a notion of what a virtuous person would do in a specific situation without making a prior decision about what it is right to do. After all, in any particular moral dilemma, different virtues may be applicable, and even a particular virtue will not always give unequivocal guidance. For instance, if a terminally ill patient repeatedly asks a nurse or doctor for assistance in dying, what response best exemplifies the virtues of a healthcare professional? There seems no answer to this question, short of an inquiry into whether it is right or wrong to help a patient in such circumstances to die. But in that case we seem bound, in the end, to come back to discussing such issues as whether it is right to follow moral rules or principles, or to do what will have the best consequences.
In the late twentieth century, some feminists offered new criticisms of conventional thought about ethics. They argued that the approaches to ethics taken by the influential philosophers of the past – all of whom have been male – give too much emphasis to abstract principles and the role of reason, and give too little attention to personal relationships and the part played by emotion. One outcome of these criticisms has been the development of an “ethic of care,” which is not so much a single ethical theory as a cluster of ways of looking at ethics which put an attitude of caring for others at the center, and seek to avoid reliance on abstract ethical principles. The ethic of care has seemed especially applicable to the work of those involved in direct patient care. Not all feminists, however, support this development. Some worry that presenting an ethic of care in opposition to a “male” ethic based on reasoning reflects and reinforces stereotypes of women as more emotional and less rational than men. They also fear that it could lead to women continuing to carry a disproportionate share of the burden of caring for others.
In this discussion of ethics we have not mentioned anything about religion. This may seem odd, in view of the close connection that has often been made between religion and ethics, but it reflects our belief that, despite this historical connection, ethics and religion are fundamentally independent. Logically, ethics is prior to religion. If religious believers wish to say that a deity is good, or praise her or his creation or deeds, they must have a notion of goodness that is independent of their conception of the deity and what she or he does. Otherwise they will be saying that the deity is
