ETHICS: Ethically resolved

Deborah Bowman ponders her ethical resolutions for 2015. Ethics column from the Winter 2015 issue of MDDUS Summons

AS I WRITE, the first few windows on the advent calendar are open and I am hovering somewhere between guilt and anticipation as I prepare for Christmas. I love the rituals and traditions. One of the most established winter traditions is that a few days after Christmas, I’ll engage ambivalently with the idea of resolutions for the New Year. Will the seductive fantasy of disciplined improvement trump realistic cynicism? Perhaps the solution is to eschew the usual resolution suspects. Instead, I have come to wonder, what might my ethical resolutions be and, more importantly, will I be able to keep them beyond Twelfth Night?

1. I resolve to listen, really listen, to those with whom I disagree Ethics is inherently contested. That is part of its joy. The diversity of perspectives and opinions makes it a rich field of inquiry. However, listening to those with whom we disagree, really listening to their ideas and arguments, is more difficult than we like to admit. As we hear their words, or even certain trigger words, we are busy constructing our counterargument or dismissing their claims as poorly conceived, badly presented, misguided or downright foolish. We’ve rehearsed this conversation – sometimes in discussion or in writing, sometimes just in our heads. We infer, assume and leap ahead. Then there’s the background noise of confusion, frustration and even disbelief: the emotional effect of disagreement is fascinating and inhibiting. Is anyone really listening? Just listening? Not secondguessing, assuming, interrupting and interpreting. I don’t do it often enough. I need to do it more.

2. I resolve to return to classic texts. Every year I read hundreds of books and papers about ethics (broadly defined). That tally may even be in four figures. Yet, I too rarely return to the classic texts; those that I read when I first encountered philosophy and ethics. My engagement with those titles now tends to be based on what I teach and the limitations of the same. This is the year that I will blow the dust of my copies of Aurelius’ Meditations, Spinoza’s The Ethics (Parts I-V since you ask), Hume’s An Enquiry Concerning Human Understanding, Rawls’ A Theory of Justice and Foot’s Virtues and Vices. I’ll be in my study if you want me.

3. I resolve to seek out the experiences and perspectives of those who are too rarely heard in ethics discussions. In the last five years, I have spent more time working with, and learning from, those who don’t work in healthcare settings or universities. I have been part of a philosophy for schools programme. I have spoken at festivals and at events organised by Carers UK, the University of the Third Age and Medicine Unboxed. I have been doing research on the phenomenon of death cafes. These meetings and conversations have been transformative, reminding me that the “ethics of the everyday” are too rarely considered in the mainstream of ethics debate and discourse. Discussions of moral questions and ethical problems are too often shaped and led by those with professional status and expertise. Ethics, as a field of inquiry, must become more inclusive and imaginative in its approach. It must attend to those whose experiences and voices are not being heard. There is much to do and much to learn.

4. I resolve to spend time on the areas of ethics I don’t enjoy. I love my subject and my job. I don’t know what it is to dread going to work. At the risk of sounding horribly like an academic Pollyanna, I consider myself privileged to be paid to do something that I enjoy so much. Yet, there are areas of medical ethics that don’t excite me. In fact (whisper it), there are one or two subjects that leave me cold. I am fortunate to have a colleague who is, by happy coincidence, interested in the areas of ethics that make me sigh. The downside though is that it has become too easy for me to resist thinking about questions that may not appeal to me, but are nonetheless important and deserve attention. So, 2015 will be the year that I read properly the journal papers I’d usually skim, go to the conferences that I’m inclined to skip and learn to love questions of research ethics and resource allocation.

So, there you have it: a public statement of intent. That the list is not longer is not just a consequence of word limits and editorial direction. I have enough self-knowledge to realise that managing expectations matters. However, this short list is not, I hope, without significance. It reflects a sincere commitment to change and to small but meaningful improvement. Might you join me? What would your ethical resolutions be? I wish you all a peaceful, healthy and happy new year.

Deborah Bowman is Professor of Bioethics, Clinical Ethics and Medical Law at St George’s, University of London