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Diagnosing true virtue? Remote scenarios, warranted virtue attributions, and virtuous medical practice

Abstract

Immanuel Kant argues in the Foundations that remote scenarios are diagnostic of genuine virtue. When agents commonly thought to have a particular virtue fail to exhibit that virtue in an extreme situation, he argues, they do not truly have the virtue at all, and our propensities to fail in such ways indicate that true virtue might never have existed. Kant’s suggestion that failure to show, say, courage in extraordinary circumstances necessarily silences one’s claim to have genuine courage seems to rely on an implausibly demanding standard for warranted virtue attributions. In contrast to this approach, some philosophers—such as Robert Adams and John Doris—have argued for probabilistic accounts of warranted virtue attributions. But despite the initial plausibility of such accounts, I argue that a sole reliance on probabilistic approaches is inadequate, as they are insufficiently sensitive to considerations of credit and fault, which emerge when agents have developed various insurance strategies and protective capacities against their responding poorly to particular eventualities. I also argue that medical graduates should develop the sorts of virtuous dispositions necessary to protect patient welfare against various countervailing influences (even where such influences might be encountered only rarely), and that repeated failures to uphold the proper goals of medicine in emergency scenarios might indeed be diagnostic of whether an individual practitioner does have the relevant medical virtue. In closing, I consider the dispositions involved in friendship. I seek to develop a principled way of determining when remote scenarios can be illuminating of genuine friendship and genuine virtue.

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Notes

  1. See, for example, Hursthouse [1, pp. 28–31].

  2. For example, the use of obstacle courses and ‘boot camps’ in military organisations are often said to aim at ‘separating the sheep from the goats’.

  3. See, for example, Doris [2].

  4. See also Vranas [4, pp. 27–8]. Vranas asks, ‘why is deplorable (or admirable) behavior in “extraordinary” situations not supposed to count? … The idea that only everyday-life behavior is relevant to character evaluations seems misguided’ [4, p. 29]. He subsequently concludes that ‘most people are indeterminate…. Character evaluations are epistemically unwarranted: we almost never have adequate evidence to evaluate with confidence particular people as good, bad, or intermediate’.

  5. See also [5, pp. 119–20]: ‘there are real moral virtues that are not extremely rare and that play a part in a wide variety of human lives…. There are qualities with respect to which it is empirically allowable to suppose that people are commonly consistent over time, and which are promising candidates for recognition as virtues or potential parts of virtues’.

  6. See also the discussion in Doris [2, pp. 160–4] of Conrad’s Lord Jim. Despite having shown courage in a variety of difficult situations, First Mate Jim is haunted by what he sees as his cowardice in abandoning the apparently sinking Patna before the passengers, and he takes this as overriding any claims he may previously have had to genuine courage. Doris argues, ‘The misproportion is that Jim reached a conclusion about himself more global than a single behavior warrants; despite the Patna debacle, there was much about Jim “worth having”’ [2, pp. 163–4]. Elsewhere in the book, Doris says he is willing to accept that there can be character-traits, but only highly specific and localised traits, such as ‘witnessing-paper-dropping-after-finding-a-dime-in-payphone-altruism’ or ‘office-party-sociability’ [2, p. 66]. But one can reject Kant’s skepticism about genuine real-world virtue without resorting to belief only in such highly specific, localized character traits.

  7. See, for example, Bolsin et al. [7] and a recent UK report [8].

  8. See also Hafferty and O’Donnell [10].

  9. Intensive care nurse Toni Hoffman discovered this in her efforts to expose the dangerous practices of surgeon Jayant Patel at Bundaberg Base Hospital in Queensland, Australia, in 2005: see Thomas [12].

  10. Of course, this is not to say that doctors ought to develop a sort of misplaced bravado, such as rashly disregarding grave personal risks in an emerging serious epidemic by attempting to treat newly infected patients without taking sufficient precautions for their own safety (as reportedly occurred in the early stages of the SARS epidemic in 2003). In Nicomachean Ethics Book II, chapter 7, Aristotle explains how courage is to be understood as a mean between the twin vices of cowardice and rashness [13], and so beyond a certain point, taking such risks might overflow beyond courage into rashness. For further discussion of these points, see Oakley [14].

  11. Here, one might think that it is no wonder that Kant rejected virtue as a basis for right action, given his (epistemic) doubts about the purity of agents’ character traits.

  12. This is a variant of one of Nagel’s [15] cases in his discussion of what he calls ‘resultant moral luck’.

  13. The idea that the availability of a disposition in reserve as a sort of ‘back-up’ can count towards one’s credit and virtue in the actual case is familiar from examples of motives being held in reserve (as indeed, some Kantians themselves seem to accept, in the case of the duty motive).

  14. Note that ‘more blameworthy’ is ambiguous between ‘more deserving of blame’, and ‘deserving of blame for more’ (the same ambiguity also occurs with ‘more creditworthy’). Here, I am using ‘more blameworthy’ in the sense of ‘more deserving of blame’ (and, likewise, with ‘more creditworthy’). I leave aside issues about whether blameworthiness is best analysed in terms of desert.

  15. Diana Backwell as quoted in [18].

  16. Of course, it is important to acknowledge here that sometimes possible worlds that might seem to us to be remote from the actual world might be nearer than we assume—e.g., we might find it inconceivable that a happily married couple could ever become bitter enemies, yet if their mutual love is broken by some highly unlikely incident (e.g., unexpected news of an ex-partner that one’s spouse had withheld from one, despite previous reassurances of honesty), then the love may quickly turn to bitter hatred. So, this makes my hating X a nearby possible world, after all (i.e., it’s precisely because I love X that my hating X is a nearby possible world). As Nat King Cole sings, ‘Sometimes I love you, sometimes I hate you. But when I hate you, it's because I love you’.

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Acknowledgments

Earlier versions of this paper were presented at the Australian Catholic University conference on Reasons and Virtues, Melbourne, 2015, at the Australasian Association of Philosophy Annual Conference, Macquarie University, Sydney, 2015, and at a seminar at Kyoto University Centre for Applied Philosophy and Ethics. I wish to thank audiences on each of these occasions for their very helpful comments. Special thanks to Steve Matthews, for his valuable feedback as a commentator on the paper at the ACU conference. I am also grateful to the following people for their comments on previous versions of the paper: Robert Audi, Russell Blackford, Steve Clarke, Ben Cullen, Garrett Cullity, Karen Jones, Satoshi Kodama, Cathy Legg, Luke Russell, Nic Southwood, John Thrasher, Bernadette Tobin, and Peter Shiu-Hwa Tsu. Thanks also to Daniel Kim for his helpful editorial suggestions, which improved this paper.

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Oakley, J. Diagnosing true virtue? Remote scenarios, warranted virtue attributions, and virtuous medical practice. Theor Med Bioeth 37, 85–96 (2016). https://doi.org/10.1007/s11017-016-9352-1

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Keywords

  • Virtue ethics
  • Virtue attribution
  • Medical virtues
  • Milgram experiments
  • Kant
  • Situationism
  • Moral luck
  • Friendship