Why Not Just Ask? Preferences, “Empirical Ethics” and the Role of Ethical Reflection
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Why Not Just Ask? Preferences, "Empirical Ethics" and the Role of Ethical Reflection
| Author(s) | Hausman, Daniel, M. |
|---|---|
| Abstract | This paper considers several ethical questions about health and health care, considering who should ask and answer these questions, and how. Theories of choice are considered within a variety of approaches: economic, ethical, and philosophical. One approach is simply to rely upon the values that prevail within each culture. These may be difficult to elicit, but the difficulties are sociological and psychometric, not ethical. The task is not to figure out how, in a particular society, the cost of health care ought to be distributed or whether for example blindness is a more serious disability than deafness. Instead the task is to figure out what is the social consensus on these questions. The idea that these difficulties can be solved if the World Health Organization will “just ask” is a tempting one and deserves a full and careful answer. Why shouldn’t those concerned with health policy simply ask those who are affected by the policy? Why aren’t the difficulties in answering evaluative questions merely technical problems about how to elicit the responses of the target group? What role should ethical reflection play, and what part should be taken by those who have devoted themselves to ethical reflection, such as religious leaders, academics, essayists, journalists, and even some politicians? When economists attempt to evaluate economic institutions, policies and outcomes, they usually ask whether they make people better off. Given their theory of welfare as the satisfaction of preference, they are asking how well institutions, policies and outcomes satisfy preferences. However most economists deny that objective comparisons can be made of how well satisfied are the preferences of different individuals. So they cannot assess policies by adding up their consequences for the welfare (that is, preference satisfaction) of different individuals. Empirical ethics is thus very much a counsel of despair. Moral questions concerning health and health policy, including the questions concerning the evaluation of health states upon which this essay has focused, are terribly difficult. Since they are so hard, it is tempting to turn from reflection on what is good and what is right to eliciting what members of some group think. But if health administrators, economists, philosophers, and theologians are all baffled, surely members of the target group who take the issues seriously must be baffled, too. Those who participate in deliberative groups muddle through somehow, but to suppose that all that is needed are mislabeled “preference measurements” would be irresponsible. Because most adults possess a very considerable competency in the morality that governs their society, their moral judgments are raw material for philosophical articulation and criticism in much the same way that the judgments of grammaticality of native speakers are raw material for theories of grammar. |
| IssueNo | |
| Pages | 1-54 |
| Article | Access to Article |
| Source | University of Wisconsin Madison |
| VolumeNo | |
| PubDate | 2000 |
| ISBN_ISSN | |
Alternatives to Mainstream Economics
- Behavioral Economics
- Ecological/ Sustainability Approach
- Feminist Approach
- Institutionalist/ Evolutionary Approach
- Interdisciplinary Approach
- Keynesian/ Post-Keynesian Approach
- Marxist/ Political Economy Approach
- Moral/ Ethical/ Values Approach
- Religious Approach
- Social/ Humanistic/ Contextual Economics
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