Elusive Ethics

Published: August 11, 2015
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The writer is a Howard Hughes Medical Institute professor of Biomedical Engineering, International Health and Medicine at Boston University. 
He tweets @mhzaman

The writer is a Howard Hughes Medical Institute professor of Biomedical Engineering, International Health and Medicine at Boston University. He tweets @mhzaman

Not all questions have easy answers. Some that we face today in our society, despite their ugliness and moral pungency, do not pose a dilemma on what is right. Violence, exploitation and extortion are the easier ones. It is not difficult to find in ourselves a deep anger with a strong desire to stop the ugliness in all its forms. Why we find ourselves paralysed to do anything substantial is a completely different story. But there are many more issues that we face in our professional lives that do not have clear answers, or require deeper introspection on our part. Here again, our lack of training or ability to deal with complexity gets in the way of doing the right thing, or in most cases, doing anything at all.

Let me illustrate this with an example that my students and I deal with regularly. As I have argued on numerous occasions, there is a need for local innovation to solve our long-standing medical challenges. Let us assume that someone finally decides to take up on the idea and a group of bright students comes up with a device to test a particular deadly disease among children in a rural area. Let us assume that the device, when tested, performs exceptionally. But the student team soon finds out that the rural area has no facility or capacity to cure the sick children. The local hospital is overwhelmed, out of medicines and the private hospital is too far and expensive beyond the means of the family.

Knowing this, should the students test the device? Should they even make the device? Is informed consent sufficient? By testing the technology — that is potentially a game changer — on children who will not get the subsequent cure (that is available elsewhere), are they doing the right thing? Would this lead to more misery for the family? What is the right thing to do?

While this situation may seem hypothetical, it is in fact a well-known problem in medical ethics. There are several schools of thought that have tried to understand and unravel these and many other similar challenges. There are many similar well-studied problems, most notably the ‘bystander effect’, where the presence of others discourages one, with good reason, from acting in an emergency situation, or the ‘tragedy of the commons’, where individual rational actions do not lead to the overall best interest of the group. These challenges are all very real, and occur in many flavours in our professional lives, yet we often find ourselves incapable of not only addressing them, but even understanding their very basis. In my conversations with bright young men and women of the country, who are enthralled with the idea of stem cells or nanotechnology or synthetic biology, I am always disappointed that there is never any understanding or appreciation of the ethical implications of these technologies. Here, the real culprits are not those who never learn them, but those of us in the faculty and administration, who never bother to teach.

While there is a general lack of appreciation of social complexity and the role of ethics in education, nowhere is the lack of focus on ethics and ethical decision-making more acute than in engineering and sciences. By refusing to understand the real-world complexity, by giving a variety of lame arguments that range from focus on depth to covering ethics in the required courses mandated by the government, we are, by design, creating technologists who are incapable of addressing complex social issues through the very technology they proudly create. The issues of ethics cannot be separated from those of real world applications of technological innovation. It is both sad and ironic that a society that values technical education above all else, graduates people who are poorly suited to understand or address the ills of society.

Education, particularly higher education, is meant to improve our lives by making us better human beings. While a lofty target, it is not unachievable. However, by refusing to equip our students with the ethical tools to navigate their decisions, we are making this goal all the more elusive.

Published in The Express Tribune, August 11th,  2015.

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