A blog from the Centre for Research Ethics & Bioethics (CRB)

Tag: virtue ethics

Encourage children to take responsibility for others?

It happens that academics write visionary texts that highlight great human challenges. I blogged about such a philosophically visionary article a few years ago; an article in which Kathinka Evers discussed the interaction between society and the brain. In the article, she developed the idea that we have a “proactive” responsibility to adapt our societies to what we know about the brain’s strengths and weaknesses. Above all, she emphasized that the knowledge we have today about the changeability of the brain gives us a proactive responsibility for our own human nature, as this nature is shaped and reshaped in interaction with the societies we build.

Today I want to recommend a visionary philosophical article by Jessica Nihlén Fahlquist, an article that I think has points of contact with Kathinka Evers’ paper. Here, too, the article highlights our responsibility for major human challenges, such as climate and, above all, public health. Here, too, human changeability is emphasized, not least during childhood. Here, too, it is argued that we have a responsibility to be proactive (although the term is not used). But where Kathinka Evers starts from neuroscience, Jessica Nihlén Fahlquist starts from virtue ethics and from social sciences that see children as social actors.

Jessica Nihlén Fahlquist points out that we live in more complex societies and face greater global challenges than ever before in human history. But humans are also complex and can under favorable circumstances develop great capacities for taking responsibility. Virtue ethics has this focus on the human being and on personal character traits that can be cultivated and developed to varying degrees. Virtue ethics is sometimes criticized for not being sufficiently action-guiding. But it is hard to imagine that we can deal with major human challenges through action-guiding rules and regulations alone. Rules are never as complex as human beings. Action-guiding rules assume that the challenges are already under some sort of control and thus are not as uncertain anymore. Faced with complex challenges with great uncertainties, we may have to learn to trust the human being. Do we dare to trust ourselves when we often created the problems?

Jessica Nihlén Fahlquist reasons in a way that brings to mind Kathinka Evers’ idea of a proactive responsibility for our societies and our human nature. Nihlén Fahlquist suggests, if I understand her correctly, that we already have a responsibility to create environments that support the development of human character traits that in the future can help us meet the challenges. We already have a responsibility to support greater abilities to take responsibility in the future, one could say.

Nihlén Fahlquist focuses on public health challenges and her reasoning is based on the pandemic and the issue of vaccination of children. Parents have a right and a duty to protect their children from risks. But reasonably, parents can also be considered obliged not to be overprotective, but also to consider the child’s development of agency and values. The virus that spread during the pandemic did not cause severe symptoms in children. Vaccination therefore does not significantly protect the child’s own health, but would be done with others in mind. Studies show that children may be capable of reasoning in terms of such responsibility for others. Children who participate in medical research can, for example, answer that they participate partly to help others. Do we dare to encourage capable children to take responsibility for public health by letting them reason about their own vaccination? Is it even the case that we should support children to cultivate such responsibility as a virtue?

Nihlén Fahlquist does not claim that children themselves have this responsibility to get vaccinated out of solidarity with others. But if some children prove to be able to reason in such a morally complex way about their own vaccination, one could say that these children’s sense of responsibility is something unexpected and admirable, something that we cannot demand from a child. By encouraging and supporting the unexpected and admirable in children, it can eventually become an expected responsibility in adults, suggests Jessica Nihlén Fahlquist. Virtue ethics makes it meaningful to think in terms of such possibilities, where humans can change and their virtues can grow. Do we dare to believe in such possibilities in ourselves? If you do not expect the unexpected you will not discover it, said a visionary Greek philosopher named Heraclitus.

Jessica Nihlén Fahlquist’s article is multifaceted and innovative. In this post, I have only emphasized one of her lines of thought, which I hope has made you curious about an urgent academic text: Taking risks to protect others – pediatric vaccination and moral responsibility.

In summary, Jessica Nihlén Fahlquist argues that vaccination should be regarded as an opportunity for children to develop their sense of responsibility and that parents, schools, healthcare professionals and public health authorities should include children in debates about ethical public health issues.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Jessica Nihlén Fahlquist, Taking Risks to Protect Others – Pediatric Vaccination and Moral Responsibility, Public Health Ethics, 2023;, phad005, https://doi.org/10.1093/phe/phad005

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Approaching future issues

Does public health need virtue ethics?

So-called virtue ethics may seem too inward-looking to be of any practical use in a complex world. It focuses on good character traits of a morally virtuous person, such as courage, sincerity, compassion, humility and responsibility. It emphasizes how we should be rather than how we should act. How can we find effective guidance in such “heroic” ethics when we seek the morally correct action in ethically difficult situations, or the correct regulation of various parts of the public sector? How can such ancient ethics provide binding reasons for what is morally correct? Humbly referring to one’s superior character traits is hardly the form of a binding argument, is it?

It is tempting to make fun of the apparently ineffective virtue ethics. But it has, in my view, two traits of greatest importance. The first is that it trusts the human being: in actual situations we can see what must be done, and what must be carefully considered. The second is that virtue ethics thus also supports our freedom. A virtuous person does not need to cling to standards of good behavior to avoid bad behavior, but will spontaneously behave well: with responsibility, humility, compassion, etc. So a counter-question could be: What good will it be for someone to gain a whole world of moral correctness, yet forfeit themselves and their own freedom? – This was a personal introduction to today’s post.

In an article in Public Health Ethics, Jessica Nihlén Fahlquist discusses public health as a domain of work where moral virtues may need to be developed and supported in the professionals. Unlike medical care, public health focuses on good and equal health in entire risk groups and populations. Due to this more universal perspective of collective health, there can be a risk that the interests, rights and values ​​of individuals are sometimes overlooked. The work therefore needs to balance the general public health objectives against the values ​​of individuals. This may require a well-developed sensitivity, which can be understood in terms of virtue ethics.

Furthermore, public health is often characterized by a greater distance between professionals and the public than in medical care, where the one-on-one meeting with the patient supports a caring attitude in the clinician towards the individual. Imagination and empathy may therefore be needed in public health to assess the needs of individuals and the effects of the work on individuals. Finally, there is power asymmetry between public health professionals and the people affected by the public health work. This requires responsibility on the part of those who use the resources and knowledge that public health authorities possess. This can also be understood in terms of virtue ethics.

Jessica Nihlén Fahlquist emphasizes three virtues that she argues are needed in public health: responsibility, compassion and humility. She concretises the virtues through three ideals to personally strive for in public health. The ideals are described in short italicized paragraphs, which provide three understandable profiles of how a responsible, compassionate and humble person should be in their work with public health – three clear role models.

The ethical problems are made concrete through two examples, breastfeeding and vaccination, which illustrate challenges and opportunities for virtue ethics in public health work. Read the article here: Public Health and the Virtues of Responsibility, Compassion and Humility.

Jessica Nihlén Fahlquist does not rule out the importance of other moral philosophical perspectives in public health. But the three virtue ethical ideals (and probably also other similar ideals) should complement the prevailing perspectives, she argues. Everything has its place, but finding the right place may require good character traits!

If you would also like to read a more recent and shorter discussion by Jessica Nihlén Fahlquist on these important issues, you will find a reference below.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Jessica Nihlén Fahlquist, Public Health and the Virtues of Responsibility, Compassion and Humility, Public Health Ethics, Volume 12, Issue 3, November 2019, Pages 213–224, https://doi.org/10.1093/phe/phz007

Jessica Nihlén Fahlquist, Individual Virtues and Structures of Virtue in Public Health, Public Health Ethics, Volume 15, Issue 1, April 2022, Pages 11–15, https://doi.org/10.1093/phe/phac004

This post in Swedish

We like challenging questions

Our individual responsibility for antibiotic resistance

Antibiotic resistance is a global threat to public health, as the chances of treating infections decrease when antibiotics lose their effect on bacterial growth. But who is responsible for antibiotic resistance and what is the responsibility?

We may believe that the problem is too big and complex for us as individuals. Antibiotic resistance is a problem for governments and international organizations, we think. Nevertheless, it is not least our individual use of antibiotics that drives the development. For example, we may take antibiotics when it is not really necessary, or perhaps we do not follow the doctor’s prescription but discontinue the antibiotic treatment prematurely and throw leftover pills in the dustbin. Then we go on a journey and spread bacteria that are resistant to the antibiotic that we did not use properly. Or we ignore getting vaccinated because we think that there are antibiotics if we get sick. Well, maybe not for long!

If we have an individual moral responsibility to act with awareness of environmental problems, then it is not unreasonable to think that we also have a responsibility to act with awareness of the antibiotic problem. Mirko Ancillotti (who recently defended his dissertation at CRB) examines this possibility in an article in Bioethics. Do we have an individual moral responsibility for antibiotic resistance and how should the responsibility be understood?

Mirko Ancillotti immediately points out that not all people have the same opportunities to improve their antibiotic behaviour. Apart from the fact that many people lack information about antibiotic resistance, not everyone finds it as easy to change their antibiotic use. Some have less access than others to correctly prescribed treatments, for example, if they live far from a hospital but can easily buy antibiotics without a prescription. In addition, not everyone has the same financial means to stay at home if they are ill.

Another thing that makes it difficult to talk about individual responsibility for antibiotic resistance, is that you can hardly determine how much the pills you threw in the dustbin actually contributed to the problem. We know that people die due to antibiotic resistant bacteria, but it is difficult to determine the consequences of your particular antibiotic behaviour.

For these reasons, Mirko Ancillotti proposes a virtue ethical concept of responsibility. He suggests that we as individuals cultivate personal qualities and habits, which support responsible antibiotic use as a virtue. If I understand him, this means cultivating certain norms about antibiotics use, which we try to meet, such as following the doctor’s prescription, not using antibiotics unless necessary, not persuading the doctor to prescribe antibiotics, and making sure that we are vaccinated. However, since the conditions for acting with this normative sensitivity vary with human circumstances, there is in many cases a need to improve the conditions and institutional support for responsible antibiotic use.

A comparison: We have learned that we should preferably not travel by air, that it is irresponsible and perhaps even shameful to fly if it is not necessary. To be able to meet this new norm, new societal conditions are needed in the form of better international train connections and simpler ticketing systems. In the same way, new normative sensitivities regarding antibiotics can be developed, simultaneously with improving the opportunities for meeting the norms, Mirko Ancillotti suggests.

If you want to read more about Mirko Ancillotti’s virtue ethical concept of an individual responsibility for antibiotic resistance, read the article in Bioethics: Individual moral responsibility for antibiotic resistance.

Pär Segerdahl

Written by…

Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.

Ancillotti, M., Nihlén Fahlquist, J., & Eriksson, S. (2021). Individual moral responsibility for antibiotic resistance. Bioethics, 1– 7. https://doi.org/10.1111/bioe.12958

This post in Swedish

We like real-life ethics