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Accepting Moral Luck and Taking Responsibility in Public Health Crises

Published online by Cambridge University Press:  05 December 2022

Daniel Tigard
Daniel Tigard*
Affiliation:
Department of Philosophy, University of San Diego, San Diego, California, USA
*
Email: daniel.tigard@tum.de
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Abstract

We see cases of moral luck arising in recent times, as we face the uncertainties of provisional rules for navigating the coronavirus pandemic. How should we respond to rule-breakers, and how should they view themselves, when they cause harm inadvertently? Although some argue that guilt is unnecessary for any harm that may result from luck, this paper takes moral luck seriously and encourages consideration of the benefits to be achieved by expressions of self-blame amidst troubling circumstances, from pure accidents to how we live during pandemics. It argues that rule-breakers in public health crises show us the importance of taking responsibility for our actions.

Keywords

moral luckmoral responsibilityblamerule-breakingpandemicspublic health
Type
Research Article
Information
Cambridge Quarterly of Healthcare Ethics , Volume 32 , Issue 1 , January 2023 , pp. 34 - 40
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Notes

1. This set of cases was introduced by Crisp R. What the problem of moral luck can teach us about lockdown rule-breakers. New Statesman 2020; available at https://www.newstatesman.com/international/2020/08/what-problem-moral-luck-can-teach-us-about-lockdown-rule-breakers (last accessed 29 June 2021). I will discuss the details further below.

2. My depiction of moral luck here is reflected in Nelkin DK. Moral luck. In: Zalta EN, ed. Stanford Encyclopedia of Philosophy (Summer 2019 Edition); available at https://plato.stanford.edu/archives/sum2019/entries/moral-luck/ (last accessed 29 June 2021). As the present article deals only with a brief application of moral luck, I highly recommend Nelkin’s work for a more thorough treatment of the issue.

3. Nagel, T. Moral luck. In: Mortal Questions. New York: Cambridge University Press; 1979 Google Scholar; Williams, B. Moral luck. In: Moral Luck. Cambridge: Cambridge University Press; 1981 CrossRefGoogle Scholar.

4. See Wolf, S. The moral of moral luck. Philosophic Exchange 2001;31:5–19 Google Scholar. The account defended here provides contemporary illustrations of this view. Yet, subtle differences can be drawn, for example, by noting that for Wolf the ‘nameless virtue’ consists in going beyond what one is responsible for, quite ‘objectively’. Whereas, for myself and others, responsibility just is a matter of holding oneself or others responsible. For an account of the latter, see Shoemaker, D. Response-dependent responsibility; or a funny thing happened on the way to blame. Philosophical Review 2017;126:481–527 CrossRefGoogle Scholar.

5. Here I have in mind the idea of solidarity as actions that reflect ‘a collective commitment to carry costs (financial, social, emotional, or otherwise) to assist others’. See Prainsack, B, Buyx, A. Solidarity in contemporary bioethics–Towards a new approach. Bioethics 2012;26:343–50CrossRefGoogle ScholarPubMed.

6. See note 1, Crisp 2020.

7. See D’Arms, J, Jacobson, D. Sentiment and value. Ethics 2000;110:722–48CrossRefGoogle Scholar.

8. See note 1, Crisp 2020.

9. See note 3, Williams 1981.

10. Further, as I argue below, if there are similarities to be drawn, it is mainly in the sense that for both the lorry driver and lockdown rule-breakers, there are good, forward-looking reasons to express negative emotional responses.

11. Interestingly, because rule-followers might also inadvertently infect others, the account defended here can be said to apply to them too. That is, for rule-breakers and -followers, there may be good reason to expect some degree of blame even for purely inadvertent harms. For comments on this point, I thank an anonymous reviewer.

12. See note 1, Crisp 2020.

13. See note 3, Williams 1981.

14. For insightful discussion on the lorry driver’s response, see Jacobson, D. Regret, agency, and error. In: Shoemaker, D, ed. Oxford Studies in Agency and Responsibility. Vol. 1. Oxford: Oxford University Press; 2013 Google Scholar.

15. Relatedly, Shoemaker argues that an agent would be ‘quite callous’ to perk up after ‘playing a key role in a tragic causal chain.’ Shoemaker, D. Responsibility from the Margins. New York: Oxford University Press; 2015:86 CrossRefGoogle Scholar.

16. For helpful discussion on this point, see Nagel, T. War and massacre. Philosophy and Public Affairs 1972;1:123–44Google Scholar.

17. See Mason, E. Between strict liability and blameworthy quality of will: Taking responsibility. In: Shoemaker, D, ed. Oxford Studies in Agency and Responsibility. Vol. 6. Oxford: Oxford University Press; 2019 Google Scholar; Also, Tigard, DW. Taking the blame: Appropriate responses to medical error. Journal of Medical Ethics 2019;45:101–5CrossRefGoogle ScholarPubMed.

18. The following scenario is a variation on Mason’s example of Perdita inadvertently losing her friend’s necklace. See note 17, Mason 2019.

19. In cases of harms resulting from the use of digital medical data, it may be particularly unclear who is responsible and how to remedy the situation. Accordingly, we see the need for newfound ‘harm mitigation bodies’. See McMahon, A, Buyx, A, Prainsack, B. Big data governance needs more collective responsibility: The role of harm mitigation in the governance of data use in medicine and beyond. Medical Law Review 2020;28:155–82Google Scholar.

20. Naturally, this position is open to criticism by those concerned for the psychological wellbeing of individual agents who take responsibility, emphasizing instead the team-oriented nature of healthcare, specifically. See Duthie, EA, Fischer, IC, Frankel, RM. Blame and its consequences for healthcare professionals: Response to Tigard. Journal of Medical Ethics 2020;46:339–41CrossRefGoogle ScholarPubMed. For resistance to the dichotomy between a so-called ‘culture of blame’ and a ‘culture of safety’, see note 17, Tigard 2019; also, Tigard, DW. Taking one for the team: A reiteration on the role of self-blame after medical error. Journal of Medical Ethics 2020;46:342–4CrossRefGoogle Scholar.

21. As Bernard Williams notes, ‘lawyers and doctors have elaborate codes of professional ethics… [because] clients need to be protected, and be seen to be protected, in what are particularly sensitive areas of their interests.’ Williams, B. Politics and moral character. In: Moral Luck. Cambridge: Cambridge University Press; 1981:54–70 CrossRefGoogle Scholar.

22. Again, see note 5, Prainsack, Buyx 2012; Also, Prainsack, B. The “we” in the “me” solidarity and health care in the era of personalized medicine. Science, Technology, & Human Values 2018;43:21–44 Google Scholar.

23. See note 17, Mason 2019.

24. Along with public health crises, consider here the relevance of environmental concerns or the recent social justice movements. For some, it will be not only difficult but perhaps impossible to remain content, to not take some degree of responsibility and be moved to improve the future.

25. For pressing me on this point, I thank an anonymous reviewer.