Right, wrong, and the morals of ethics

PAUL WOLPE lives and breathes ethics. He speaks with one of his ex-students and one of our editors, KASHISH KALWANI, about how we rely on ethical decision in everyday life—at work, in our families, and also for ourselves. Also, how ethics, values and morals are connected, and how it is very rarely about right and wrong.

KK: To break the ice, tell us three fun facts about yourself.

PW: Fact number one: My father was a rabbi, two of my three brothers are rabbis, and one of my two daughters is a rabbi. I am surrounded by spiritual people. Fact number two: I put myself through graduate school as a massage therapist. Fact number three: I have a hang gliding license.

KK: Wow, that’s cool.

How would you define ethics in the simplest way?

PW: My definition of ethics is not in textbooks or the dictionary: Ethics is how we determine, express, and assess our values in the world. Morality is how we establish, maintain, and conduct our relationships as expressions of those values.

KK:  I remember you sharing that on the first day of class. It’s not about what is right and wrong, but a conflict of two rights. That really struck a chord with me.

PW: I think we’re taught about ethics incorrectly. We’re taught it’s about determining right and wrong, and sometimes it is. With children, you need to set the fundamentals: It’s wrong to steal, it’s wrong to be violent, it’s wrong to lie in certain cases. But once you’ve got those fundamentals down, the rest of your life is spent figuring out a different question: I have a set of values I want to express in the world, so what do I do when they come into conflict? That’s what ethical dilemmas are. They’re rarely about right and wrong. We phrase it as, “What’s the right thing to do here?”, but what we really mean is, “What’s the best right thing to do here?” because there’s not just one right thing, there are many right things to do.

Ethics is how we determine, express, and 
assess our values in the world. 
Morality is how we establish, maintain, and 
conduct our relationships as expressions of those values.

I teach ethics to doctors, and give them cases about conflicts of values. The patient wants to do one thing, while another thing is in their best interest; a patient’s autonomy is a good value, a doctor’s responsibility to take care of their patients is a good value, and they can’t both be honored. How do you get to the best right thing to do?

There are certainly wrong things you can do, like killing the patient so you don’t have to worry about it. But there are usually a range of right things you can do. Being mature is about trying to figure out what the best right answers are.

KK:  That’s a great example. What inspired you to pursue a career in bioethics, and what has been the most rewarding aspect of it?

PW: I’ve got an overdeveloped sense of justice. Trying to figure out when people are expressing their highest best qualities is something I’ve always done. It’s part of my personality. I was always interested in science, medicine, and technology. Putting those things together, there was this wonderful field called bioethics.

Now it is a really well-known field, but back then it was pretty obscure. What’s so wonderful about bioethics? Once you develop an expertise, you can apply it to anything. Any business has ethical challenges; any group has ethical challenges, internally and in relationship with the world. If ethics is how we express our values in the world, then every interaction we have has ethical elements to it. 

Deciding how a business is going to treat its customers and employees, how safe its products will be, how safe its workplace will be, how it’s going to advertise and where, how it’s going to manufacture its goods in another country with cheaper labor, where the laws don’t protect workers well; each of these is an ethical decision. Businesses are making ethical decisions all the time. Professionals are making ethical decisions all the time. Individual business owners are too. In our relationships—with friends, with partners, with parents, when we walk into a store and talk to a clerk—there is always an ethical element.

You asked what is the most rewarding part. In my career, I was bioethics advisor to the National Aeronautics and Space Administration (NASA). I was bioethics advisor to Planned Parenthood Federation of America, I was on committees in Canada to give out millions of dollars of state funds to worthy projects. I have sat with the Dalai Lama in Dharamsala. I’ve met famous singers and directors. I never expected where ethics was going to take me. I thought I was getting into an academic profession and never thought my career would allow me to do many of the things I’ve done.

KK:  A lot of our readers are young adults. How can we think ethically in everyday life situations? Given that there are wars going on and climate change happening, what is the importance of ethics in the life of a young adult?

PW: Ethics is challenging. It’s not simple and it’s not easy. Many times, the ethical thing is painful and means you don’t get some other desirable outcome. For businesses to do the ethical thing might mean losing money. For me to do the ethical thing might mean turning down an opportunity, or turning down income, or losing a friend. We joke and say ethics is not for sissies.

It’s easy to make casual ethical decisions. It’s when we’re faced with a situation where doing the best right thing means giving up something else significant that we often fail. We all do it, but it’s particularly problematic when big businesses do it, governments do it, people with power do it. Part of what defines a leader for me is taking the responsibility to do the best right thing for an organization, a country, or a group. It’s a hard standard to keep, and we see it failing over and over again.

In our relationships- with friends, with partners, 
with parents, when we walk into a store and talk to a clerk—
there is always an ethical element.

KK:  How do we make an ethical choice in daily life, then?

PW: We teach a methodology to businesses on how to make ethical choices. It’s a little different than how we make ethical choices in our individual lives. Very often, we know what the ethical choice is, but the struggle is, “Do I really have the courage to do what I think is right?” There are situations where the right ethical choice is controversial or problematic, where none of the choices seem completely right. That’s an ethical dilemma. Very often they require compromise. That’s when we tend to talk them over with friends and loved ones.

After studying ethics for a long time, the expertise we develop is to take apart an ethical situation into its pieces and clarify. For example, I do rounds three or four or five times a year with the OB-GYN residents, they send me their ethical dilemmas, then we talk about them. They have trouble teasing out what is a social issue, a clinical issue, a legal issue, an ethical issue; they’re wrapped up together. I help them take it apart, because the ethical piece is the conflict in values. And that’s different from the clinical, social, and legal pieces. Until you have clarity about that, it’s hard to see what to do. Sometimes it helps to start by clarifying values: “What do I think is the value I should be honoring? Is it patient autonomy, or the best interests of the patient?”

In the United States in the 21st century, it’s patient autonomy. That’s what the country’s decided is the value we’re going to honor. It’s not true in every country. In some countries, a physician will override a patient if they think what the patient is doing is not in their best interests. In the US it used to be that way too, but we made a decision to prioritize the value of individual choice. It’s not about us being right, and another country being wrong. We have a best right choice, while another country based on its traditions, its history, its values, its religious background, its political beliefs, etc., says, “We think the best right choice is to do what’s in the best interest of that patient in view of the people who really understand medicine. And, eventually, we believe the patient will thank us, even though right now they may not.” And that’s a defensible, ethical position.

We try as parents to give our children an ethical compass, because most of the time when we make decisions we don’t sit and analyze them and take them apart. We intuitively do what we think is best. Developing a good intuitive ethical center; part of the job of parents with their children is to teach them how to do that.

KK: I have so many follow up questions. One question is: Do you feel guilty for some decisions? You mentioned that you talk with nurses and you teach doctors. What if your own bias affects their understanding?

Another question is about parents teaching their kids an ethical compass: Will the bias of parents with their traumas be passed on to their kids, influencing their decisions?

PW: We all have biases. In the ethics community, we believe that, for difficult and complex decisions, we need to talk about them in groups. During Covid, I was President of the Association of Bioethics Program Directors, which encompasses every organization that runs a bioethics program in the US. There were so many tough decisions we had to make.

At the beginning, we thought they might run out of ventilators at certain hospitals. We were writing policies for hospitals on who would get ventilators if there was a shortage. I started an every-two-week phone call of all the bioethics presidents and leaders of centers. We discussed all these things, and ended up publishing papers on those questions.

While I was at NASA, space flight was evolving from being centralized in a government agency, to happening in private space agencies all over the world. We brought together a group of ethicists and people in the private and commercial fields, because there are a lot of ethical questions about putting bodies up into space and doing experiments on those bodies. Bodies in space are a scarce resource.

So we bring together people with a wide range of experience,
coming from many different fields, cultures, religions, and backgrounds,
then debate these questions and try to come up with the best policies we can. 
Then we publish a paper somewhere so that other people can read them.

When commercial companies start putting bodies in space, pharmaceutical companies, medical instrumentation companies, and commercial device companies will want to send up instruments and experiment on those bodies. NASA has a well-developed process for that, but the commercial companies do not.

So we bring together people with a wide range of experience, coming from many different fields, cultures, religions, and backgrounds, then debate these questions and try to come up with the best policies we can. Then we publish a paper somewhere so that other people can read them.

When it comes to individual ethics, or teaching children, it’s not just parents; kids learn ethics from their peers, schools, and religious institutions. The best thing we can do is to understand that we all have biases. When children learn different values and ideas outside the family, entertain them in a serious non-defensive and nonjudgmental way. Don’t immediately have a kneejerk reaction and say, “Oh my God, this is wrong!” Entertaining and discussing ideas have helped children develop a critical sense and a critical judgment about ethical values. It’s a tough job being a parent.

KK:  Is there anything more you’d like to share with our readers?

PW: One of the most difficult things around our values is protecting them. We feel like anyone who challenges our values is threatening us at a deep level. Listening to another person’s articulation of their values is often threatening. Many of the fights in the world are really about a blind unwillingness to entertain the values of the other side. We defend our values by branding them as right, and the values of others as wrong, evil, or misguided. So we’re back to the beginning! This violates the whole idea that ethics is about conflicts of values, and people prioritize values differently.

Deep listening to the other person is a skill we can develop. If I wanted to leave a message it would be that we need more deep listening in the world right now.

KK:  I feel that listening is such a powerful tool, clearing lots of misunderstanding and miscommunication.  

What is next for you?

PW: I’m stepping down as director of my center in June and building a new center for conflict resolution, mediation, and peacebuilding at Emory. I’ll be traveling on sabbatical next year to Oslo, Geneva, The Hague, and other places, talking to people in different conflict resolution centers, and trying to build some innovative models.

KK: That’s great. Thank you for taking the time for this.