Moral Dilemmas and

Levels of Moral Dilemmas

Morality

 Morality-is the effort to guide one’s conduct by reason-

that is, to do what there are the best reasons for doing-
while giving equal right to the interest of each individual
who will be affected by what one does.
Moral Dilemma

 Moral Dilemma is a conflict in which you have to

choose between two or more actions and have moral
reasons for choosing each action.
 Moral dilemmas are situations where two or more moral
values or duties make demands on the decision-maker,
who can only honour one of them, and thus will violate
at least one important moral concern, no matter what he
or she decides to do.
Cases #1 Baby Theresa

Theresa Ann Campo Pearson, an anencephalic infant known

to the public as “baby Theresa” was born in Florida in 1992.
Anencephaly is among the worst congenital disorders-
important parts of the brain (cerebrum and cerebellum) and
the top of the skull are missing. There is however, a brain-
stem and so autonomic functions such as breathing and
heartbeat is possible. Anencephalic infants or “babies
without brain” are still born and those born alive usually
die within few days.
 Dilemma

Parents knowing that their child could not live long and
that even if she could survive, she will never have a
conscious life. They volunteered her organs for transplant.
They thought that her kidneys, liver, heart, lungs and eyes
should go to other children who could benefit from them.
Florida law does not allow the removal of organs until the
donor is dead. By the time baby Theresa died, it was too
late for the other children-her organs could no longer be
transplanted because they had deteriorated too much.
Discussion

 The benefits argument

 The argument that we should not use people as
means to other people’s ends
 The argument from the wrongness of killing
 The benefits argument: If we can benefit someone. Without
harming anyone else, we ought to do so. Transplanting the organs
would benefit the other children without harming baby Theresa.
Therefore we ought to transplant the organs.”
The parents argue that being alive was doing her no good. Being
alive is a benefit only if it enables you to carry on activities and have
thoughts, feelings and relations with other people-in other words, if it
enables you to have a life. In the absence of such things, mere
biological existence is worthless.
The argument that we should not use people as
means: “It is wrong to use people as means to other
people’s ends.”
“Using people” typically involves violating their
autonomy-their ability to decide for themselves how
they live their own lives, according to their own
desires ad values. A person’s autonomy may be
violated through manipulation, trickery and deceit.
Autonomy is also violated when people are forced to
do things against their will.
Taking Theresa’s organs would not involve deceit,
trickery or coercion. However, taking her organs
would be doing it without her permission. If we were
doing it against her wishes that might be reason for
objecting-it would be a violation of her autonomy.
But baby Theresa is not an autonomous being; she
has no wishes and is unable to make decisions for
herself.
 When people are unable to make any decisions for
themselves, and others must do it for them, there are two
reasonable guidelines: First, we may ask “what would be in
their own best interest? In the case of babyTheresa, her
interest will not be affected…She is going to die soon no
matter what. The second guideline appeals to the peron’s
own preferences, we may ask “if she could tell us what she
wants, what would she say? This sort of thought is often
helpful when we are dealing with people who are known to
have preferences but are unable to express them (example,
a comatose patient who have signed a Living Will). But
sadly, in the case of baby Theresa, she has no preferences
about anything, and never will have. The upshot is that we
are left to do what we think is best.
 The argument from the wrongness of
killing: “It is wrong to kill one person to
save another.” The prohibition on killing is
certainly among the most important moral
rules. The question then is whether taking
baby Theresa’s organs should be regarded
as an exemption to the rule. She is going to
die soon anyway, no matter what is done,
while taking her organs would at least do
some good for the other babies.
 Levels of Moral Dilemmas
1.Individual-
Michael had several friends including Roger and Daniel. Roger has
recently met and started dating a wonderful lady named Phyllis. He
is convinced this is a long term relationship. Unknown to Roger,
Michael observed them at a restaurant several days ago and
realized Phyllis is the wife of his other friend Daniel.
Michael is deciding whether to tell Roger that Phyllis is married
when he receives a call from Daniel. Daniel suspects his wife is
having an affair and since they and Michael share many friends
and contacts, he asks if Michael has heard anything regarding an
affair.

To whom does Michael owe greater friendship to in this situation?

No matter who he tells, he is going to end up hurting one, if not
both friends. Does he remain silent and hope his knowledge is
never discovered?
2.Organizational
The mood at Baileyville High School is tense with anticipation. For
the first time in many, many years, the varsity basketball team
has made it to the state semifinals. The community is excited too,
and everyone is making plans to attend the big event next
Saturday night.Jeff, the varsity coach, has been waiting for years
to field such a team. Speed, teamwork, balance: they've got it
all. Only one more week to practice, he tells his team, and not a
rule can be broken. Everyone must be at practice each night at
the regularly scheduled time: No Exceptions.Brad and Mike are
two of the team's starters. From their perspective, they're
indispensable to the team, the guys who will bring victory to
Baileyville. They decide-why, no one will ever know-to show up
an hour late to the next day's practice.

Jeff is furious. They have deliberately disobeyed his orders. The

rule says they should be suspended for one full week. If he
follows the rule, Brad and Mike will not play in the semifinals. But
the whole team is depending on them. What should he do?
3. Systemic/Structural
Alan works in the claims department of a major hospital. Paperwork
on a recent admission shows that a traumatic mugging caused the
patient to require an adjustment in the medication she is prescribed
to control anxiety and mood swings. Alan is struck by the patient's
unusual last name and upon checking her employment information
realizes she is one of his daughter's grade school teachers.
Alan's daughter seems very happy in her school and he cannot
violate patient confidentiality by informing the school of a teacher's
mental illness but he is not comfortable with a potentially unstable
person in a position of influence and supervision over his eight year
old daughter. Can Alan reconcile these issues in an ethical manner?
 Assignment
Case #2 Jodie and Mary
 The infants Mary and Jodie were conjoined twins joined at the
lower abdomen. Their spines were fused and they had one heart
and one set of lung between them. Jodie, the stronger was
providing blood for her sister. The doctors said that, without
intervention, they would die within six months. The only hope was
an operation to separate them. This would save Jodie but Mary
would die immediately.
 The parents who were devout Catholics, refused permission for
the operation on the grounds that it would hasten Mary’s death.
They believe that nature should take its course. “If it is God’s will
that both our children should not survive then so be it” the
parents said. The hospital believing it was obliged to do what it
could to save at least one of the infants, asked the court for
permission to separate them despite the parent’s wishes. The
court granted permission, and on November 6, 2000, the
operation was performed. As expected, Jodie lives and Mary died.
 Dilemma: Would it be right or wrong in these circumstances, to
separate the twins? The decision should be left to the parents and
object to the court’s decision.
 The arguments that we should save as many as we can
 The argument from the sanctity of Human Life