Friday, January 12, 2024

First Do No Harm: ethics of morality, amorality, and immorality

 

     "First Do No Harm" (FDNH) is an adage that applies to the medical profession as well as variants of which as used by a high-tech company as their stated guideline. While this seems quite straight-forward, it rarely is. However, it is an ethics question that should be "top of mind" with every analysis of action, decision, or behavior.

     In the case of medicine, most treatments have possible, even likely, side-effects. It is always a judgement call as to whether the medicine, or treatment, is likely to do more good than harm. Both the effects of the treatment and the potential side-effects are on various sliding scales. Effects range from Very unlikely to help to almost guaranteed to help. Potential side-effects move along the sliding scale from unnoticeable to greatly affecting the quality of life. The side-effects have an additional sliding scale which ranges from extremely unlikely to occur to almost guaranteed to happen.

     Even if these sliding scales can be adequately defined, it is impossible to put any situation on a specific point on all of the scales. Effects, side-effects, and likelihoods are going to vary from person to person. Additionally, the importance of those effects, side-effects and likelihoods are going to vary also. Because this is true, FDNH evaluation often should be relegated back to the patient, rather than remaining solely with the doctor. For cases where (in the weighted opinion of the doctor) the positive effects are likely to be small and the potential negative side-effects have a large chance to be significant and quite harmful it makes no sense for the patient to not have the last word.

     Moral behavior for an individual or business must include the aspects of doing the best that one can -- with the least negative and the most positive. Actions should also be equivalent for all people, groups, and circumstances. For instance, if a salary freeze is in effect for a company then it should apply to all -- from the CEO or President to maintenance staff. I remember one year, in a large research company, when a salary freeze was put into effect -- but executive staff was given a 25% increase. Immoral and highly destructive to company morale and productivity.

     Evaluation of morality of actions and behavior always fall into a subjective arena. There will always be trade-offs and a variety of formulas of actions that affect different people in various ways. Sometimes, companies will allow the employees to choose between possibilities. One company presented the options of compensating for a lowered income stream by laying off a large number of people or taking a pay cut for all employees. When given explicit choices, I am proud to relay that the decision which is supportive of the most people is most often taken.

     What about immoral, or "bad",  behavior and actions? Usually immoral behaviors end up counter-productive and do not survive -- as long as such behavior is visible and subjected to external response and criticism. It does not make business sense to do "bad" things deliberately if the result is negative to the bottom line. In addition, doing "bad" things deliberately reduces corporate competitiveness. It is one of the major reasons why corporations are typically supportive of inclusive policies. Inclusive policies increase the customer base, increase the intellectual and physical pool of employees, and (not quite universally) adds to the corporate image. Non-inclusive, or discriminatory, policies do the opposite.

     One multinational megacorporation formalizes the trade-offs between positive effects and negative effects. When they set up their spread sheets for production and marketing, there are spots, in the rows and columns, for potential deaths and how much such deaths (or significant health effects) will cost in terms of legal costs, settlements, and PR hits that might affect the bottom line.  The company does not particularly WANT bad effects but they are very tolerant of living with such if profits are maintained -- they follow the definition of an amoral corporation. They are often at the target end of boycotts but the percentage market hit of those participating in the boycotts are also weighed into the spread sheet. Alas, not surprisingly, the spreadsheets often indicate that they can make more profit by allowing avoidable side-effects. And the boycotts have only moral value and do not significantly affect profits.

     Moral -- trying to do the most good and the least harm. Amoral -- trying to personally benefit the most while taking into account the repercussions of negative behavior; the negative behavior can be evaluated as excessive by outside forces. Immoral -- doing the most harm in spite of negative consequences.

     While these aspects of ethics can certainly be viewed in other manners, these are one set of usable criteria.



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