MORAL REASONING

At the end of the session students must be able to:

 Explain what is moral reasoning;
 Form one’s own moral decisions.
Overview:
This is a logical analysis of the process that leads to moral judgment, providing some guide on
how to make decisions on moral dilemmas

Introduction
In the original Ethics syllabus from CHED this section comes before Kohlberg’s theory. In this
book it is put after in the hope that understanding how people actually do moral reasoning would
students reflect on their accustomed way of doing it. By the time one enters college and enrolls
in an ethics class that person has already done countless moral reasoning processes and made
countless decisions in the past. Regardless how tentative the student’s procedure might be,
he/she has gotten used to it. After reflecting, students may have some ideas on what areas need
improvement. This part can help in that regard as it provides a guide, a set of tips.
There is no assumption though that the seven-step process given here will be an improvement for
everyone. Some young people could be mature beyond their years and have developed their own
effective ways of making moral decisions. The process given here is a suggested model, not a
prescribed method.
Reasoning is a process of deriving a conclusion from one or more premises. Moral reasoning is
the process of deriving conclusions about what is good and what is the right way to act. In
Kohlberg’s theory every stage has its characteristic moral reasoning pattern, or at least a major
premise. Given the same situation different individuals derive different conclusions, make
different moral judgments, relative to the premises they use. In short, it results to relativism.
Moral relativism defeats the very purpose of ethics. It invalidates all ethical principles, leaving
no basis for justification. Consequently it may permit any behavior, which in practice can result
to conflicts.
Moral judgment may refer to the mental act of determining the right act to do in a given
situation. Situations often come in the form of issues or dilemmas. There is no hard and fast
rule on resolving moral dilemmas. As earlier mentioned, different people have different ways of
approaching them. Ethics has yet to see one moral reasoning process that everyone finds
acceptable and that proves effective in every situation. But some heuristics may be made as a
guide. The moral reasoning model given below, adapted from Dr. William W. May,i may be
followed if and when it applies.
1. Gather the facts
Find as much relevant information—who, what, when, where, why, how—about the situation.
Some ethical dilemmas may be resolved simply by clarifying facts. Even with complex cases
which cannot be resolved that way, gathering of relevant facts is necessary in resolving them.
Without facts there would be nothing worth analyzing and reflecting upon. Sometimes available
information might not be enough. Intelligent decision may require not only what is already
known but also awareness of what should have been known. For example, discrimination
against homosexuals is often caused by ignorance on the causes of homosexuality. The more
facts serving as bases of a conclusion the more likely that the conclusion would lead to an
intelligent decision.
2. Determine the ethical issues
An ethical issue is about competing interests. For example, a person being robbed is torn
between giving away his valuables and taking the risk of fighting the robber; either protect his
property (and fight crime) or protect his life. The more people—and therefore more interests—
involved the more complicated an issue would likely be. Issues must be presented in _____
versus _____ format to highlight the conflicting interests. For example, the Heinz dilemma can
be presented as “the right to life of Heinz’s wife versus the druggist’s right to property (from
which he intended to gain much profit).”
3. Identify the principles that have bearing on the case
Every ethical dilemma involves some principles or norms. The more principles are involved,
especially when they cannot all be met, the more complex a dilemma is. Norms are not equal;
some may take precedence over others relative to the situation.
For example, a person suddenly collapses in a public area. When the ambulance crew arrives the
person is unconscious; no one around knows him, no one can make decisions on his behalf. In
such case the principle of beneficence (do good) may take precedence over autonomy. With the
patient unable to give expressed consent, the ambulance crew would perform procedures on the
presumption of implied consent, just to save the person’s life.
4. List the alternatives
A dilemma presents two courses of action to take, but they do not necessarily represent the only
or even the best options. One has to be creative in finding other possibilities, other choices.
Hopefully, with more alternatives comes better chances of coming up with making an intelligent
decision. For example, is it necessary to choose between two competing interests? Or would it
be possible for the two competing sides to compromise to arrive at a win-win solution?
5. Compare the alternatives with the principles
Alternatives are not equal. Some deserve serious consideration. Others are just impractical and
thus can be dismissed with little deliberation. One guide to tell is to compare them with the
principles. If the dilemma is simple enough that only one principle is involved and of the many
alternatives only one meets the principle then at this point a moral decision can be made.
6. Assess the consequences
Aside from principles, consequences may also have to be considered in moral reasoning. (For
some ethicists, it is the most important consideration. But that will be discussed in later
chapters.) While emphasis on consequence has its own problems, it tends to be practical.
However (and to pre-empt future discussion on consequentialism with a caveat), considering the
consequences of alternatives may be an unreliable guide on what to do. One cannot precisely
know the consequences of an action beforehand, especially the long-term ones. One has to act
first and only after that would the consequences happen, when what has been done cannot be
undone. There are just too many possibilities and uncertainties.
For example, when a patient’s chances of survival is uncertain the family may be torn between
unplugging the respirator (allowing the patient to die) and prolonging a loved one’s life. The
consequences, ranging from emotional stress to financial burden, are too varied that they defy
comparison.
7. Make a decision
Ideally after step 6 one would be able to clear confusions and removed doubts. But in the real
world some uncertainties might remain. Moral decision making is done to solve some practical
time-sensitive problem, the consequences of which can seriously affect people’s lives. It cannot
go on forever. At some point a decision has to be made, an action has to be done.
Even an inability to decide, a failure to act, would still count as an act of omission. Whether one
acts or not, there would be consequences.
I choose the dilemma below because it highlights the reality that oftentimes decisions have to be
made in spite of incomplete information and uncertainties.

The Emergency Medical Services office receives a vehicular accident report; an ambulance is
dispatched and arrives at the scene minutes later. And after a quick survey of the scene the
Emergency Medical Technician notes the following:
Three people are lying on the road; a damaged motorcycle nearby.
One adult female, wearing a helmet without a visor; abrasions with capillary bleeding in
different parts of the body; groaning but otherwise unresponsive.
A child, more or less ten years old, no helmet; unconscious; broken arm with protruding
bone, profuse bleeding; normal breathing, slow heartbeat.
One adult male, no helmet; unconscious; swollen right side of face, cracked skull, bleeding;
clear fluid coming out of the ears; shallow breathing, slow heartbeat.
Only one victim may be attended to and carried in the ambulance to the hospital at a time.
Who should the EMT prioritize?
Given the sample dilemma above, let us practice the seven steps.
1. Facts: The EMT has the skill, and the professional obligation, to help. But the situation
involves more patients than the EMT can handle simultaneously. He must prioritize. A
rapid assessment (which is standard procedure considering that emergencies are time-
sensitive) does not provide detailed information. It only provides a rough estimate of the
situation.
All three people appear to need immediate help, but the gravity of injury of each varies.
There is no way to ascertain since all are unresponsive or unconscious.
2. Issue: Prioritizing one implies delaying treatment of everyone else. Whom to treat first?
3. Principles: Health care ethical principles are clear—a) beneficence; b) non-maleficence; c)
veracity; d) autonomy; and e) justice.
a) It is implied that the EMT is willing to help all, but cannot, and so has to choose one.
b) It is also implied that the EMT has no intention to harm anyone, but choosing one can
adversely affect the other two.
c) Veracity does not apply as the EMT has little information and has no reason to withhold
it from anyone.
d) Autonomy does not apply since all three victims are physically and mentally unable to
make decisions for themselves.
e) While ideally benefits should be distributed equally, there is not enough for everyone.
Only one EMT is available at the time.
Furthermore, the principle of triage prescribes that those who have more chances of survival
are to be prioritized over those who have less chances.
4. Alternatives: The EMT has to choose one out of three.
a) Adult female seems to have high chance of survival because of less serious injury,
positive breathing and circulation.
b) Child seems to have high chance of survival, although needs immediate care to keep from
bleeding to death.
c) Adult male seems to have the least chance of survival, even if given immediate care.
5. Alternatives and principles: Since the primary aim of health care is to maintain or restore
health and save life then prioritize the one who could benefit the most. And whenever
possible maximize the number of beneficiaries. In this case, the adult male may still die of
his injuries even if treated. The adult female has no apparent life-threatening injury and thus
whose treatment may be delayed. The child could survive but only if treated immediately.
6. Consequences:
a) If the adult female is treated first then the child and adult male would almost surely die (1
survivor out of 3);
b) If the adult male is treated, then the adult female may still survive but the child would
almost surely die. Yet given the gravity of his injury the adult male could still die (1
survivor out of 3);
 c) The child is likely to survive if treated first. The adult female could still survive. The
adult male would most surely die (2 survivors out of 3).
d) Decide: Prioritize the child—pack, load and go.
The dilemma was chosen for many reasons. First, it highlights that at times the information
available is incomplete; one has to decide based on a rough estimate of the situation, and fast.
Second, the number of alternatives may complicate decision-making, especially when many
people’s lives or welfare are at stake. Third, while there many alternatives, the consequences of
each are uncertain. Fourth, regardless how much we want to do what we think is good for others
we may not be able to help everyone; someone or some people may just have to be left behind.
Fifth and perhaps the most positive, a dilemma is not always between good or bad; sometimes it
is about good or better.
Moral reasoning is a skill. One can learn and develop it through practice. Also, it is a mental
skill. It is not purely intellectual; much of it involves one’s emotional stability and strong will.
With the right mindset, one can use it in actual situations.
Developing moral reasoning is a continuous process. One should aim to develop a pattern of
thoughts and actions; the neural connections made are ready to be activated when a situation
arises.
The seven-step model has its own limitations, though. It represents a heuristic process that tries
to encapsulate a long, complicated process in a short series of tasks. It is not maximally reliable,
though at times it can work. Also, the appreciation of facts in the process can be subjective;
thus, it is vulnerable to personal bias and other psychological weaknesses. However, the model
offers a way of looking at dilemmas from both consequentialist and principle-based moral
reasoning.
That leads us to character.

Exercise:
Apply the seven-step to the dilemma below:

Mr. Y goes out to celebrate his recent 18 th birthday with his friends. After dinner they
proceed to one of his friend’s condominium unit. One friend brings out some marijuana and
encourages him to smoke. He is surprised; he had not known that his friends use illegal drugs
until then. He never used illegal drugs before and is not inclined to try. Even though they
assure him that, unlike methamphetamine hydrochloride (shabu), marijuana has no lasting
adverse effect he is not convinced. All his friends present are smoking marijuana; he does
not want to be a killjoy.
If you were Mr. Y what would you do and why?
i
Rae, Scott B. and Paul M. Cox. Bioethics: A Christian Approach in a Pluralistic Age. (Michigan: Wm. B. Eerdmans
Publishing, 1999), 298-300