Doing The Best One Knows

This morning I finally got around to listening to a recording of a Radio 4 program about Lawrence Kohlberg’s stages of moral development. The Heinz dilemma is a frequently used example in many ethics and morality classes. One well-known version of the dilemma, used in Lawrence Kohlberg’s stages of moral development, is stated as follows:

A woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. The drug was expensive to make, but the druggist was charging ten times what the drug cost him to produce. He paid $200 for the radium and charged $2,000 for a small dose of the drug. The sick woman’s husband, Heinz, went to everyone he knew to borrow the money, but he could only get together about $1,000 which is half of what it cost. He told the druggist that his wife was dying and asked him to sell it cheaper or let him pay later. But the druggist said: “No, I discovered the drug and I’m going to make money from it.” So Heinz got desperate and broke into the man’s store to steal the drug for his wife.
Should Heinz have broken into the laboratory to steal the drug for his wife? Why or why not?

There is much I might say however the hour is late and perhaps it’s best to just sit with the above. In fact that’s just what we do with moral dilemmas isn’t it? And then there is responding…best one knows how.

Hat-tip to my fellow monastic for the recording and to his late mother, who spent time studying with Lawrence Kohlberg.

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10 thoughts on “Doing The Best One Knows”

  1. Thanks Rev Mugo,
    apart from the moral dilemma, for me at least, this raises many questions surrounding the actions of many of the multi-national drug companies (often referred to as Big Pharma)that health professionals are immersed in each day.
    Quadruply so if you are not living in the first world.

    PS. I wear the Bodhi leaf badge you sent me every day on my lanyard at work. People always ask me what medical course I had to do to get it.
    I just tell them it has to do with basic life support.

    Cheers,
    Ian.

  2. Ian. How wonderful to hear you wear the Bodhi leaf badge to work. And your response to questioners too! I’m reminded that I need to get more of those badges made… (wonder what I’m talking about? search on Bodhi Leaf, that should find the reference).

    I’m making a mental note to post on a whole host of sites around mental health. One such site guides people through the process of coming off prescription drugs, SAFELY. Medicines can help so much, and….. there is a lot of AND, The ‘and’ is for each of us to come to terms with. Very much to do with this posting I’d say. That’s doing the best one knows in the face of huge pressure, subtle and not so subtle pressure.

    Anyway glad to know you are helping the world the way you do that.

  3. As always you take interesting turns on your blog. I find that for me the second thought seems to be the one that has more weight for me. My first thought was, of course; break into the store! Get the medicine, it’s needed! My second thought was that almost all acts that we perform have hidden and/or non-obvious consequences. In this case, lets say that I break into the store and as I’m in there I set off an alarm, the police come after I’ve left and arrest an inebriated drunk in the alley. They put him into their police car and as they’re driving to the station they become aware that he is having some acute physical reaction, they then speed up to get him to a hospital and crash into another car, injuring two other people, etc, etc;

    How often when we set out to do something good, something we feel NEEDS doing, does it turn into something going in the other direction?
    It is so difficult to refrain from doing the RIGHT thing of the moment. So difficult to let life UNFOLD.

    I’m not saying that to be passive in all situations is the right thing either, but that, for me, it’s good to let the first thought or conclusion slide by, then see if there isn’t something else to consider.
    Of course that’s on a good day!

  4. “There is much I might say however the hour is late and perhaps it’s best to just sit with the above. In fact that’s just what we do with moral dilemmas isn’t it? And then there is responding…best one knows how.”

    Thanks for this Rev Mugo – perfect timing as I have a difficult dilemma I’m working on right now. Not sure as it would be described as a “moral” one, but challenging and difficult – yes! I’ve been attacking it every which way, searching for an answer which only seemed to get further away, then yesterday I decided to back of and just sit with it – feels like a weight is off my shoulders even though no decision made.

    As for your story – with slight hesitation I decided the man should not break in to steal the drug. Whilst sympathising with his terrible dilemma, breaking the precept not to take anything that is not given is not worth it – the consequences are unknown, but good cannot come of it. Who knows, the next day the pharmacist may, without knowing why, suddenly decide to confront his greed and take pity on the dying woman. If the husband has broken in and stolen it, he is taking away the pharmacist’s opportunity to relent and perform a good action as well as performing an unskilful action of his own.

  5. First impression: I feel I can’t possibly judge Heinz: I don’t know his love and devotion for his wife; I don’t’ feel his desperation and the life they shared together. How could I? It seems there is no “why or why not” for me in this matter.

  6. Moral dilemmas like this frequently put the ponderer in an artificial position, often a dualstic one. It seems to me, the situation here poses a false dilemma – to steal or not to steal, when in reality – or even in the artificial situation presented – many more options and considerations are open to a person.

    Will the druggist accept finance – payment in instalments – perhaps even with interest? If not, why not?

    The wife suffers from a ‘special kind of cancer’ – how rare is it? Is it financially prudent for the druggist to refuse such financing when offered, if the treatment might not be needed that frequently?

    Is there a way the husband could have explained the consequences of the druggist’s decision on the wife and husband, the family, extended family and friends that would have reached the cold heart of the druggist?

    If he remained unmoved by such pleas, how about the consequences on the druggist, himself? This seems like a small town and everyone seems supportive of the husband and wife – how will the druggist deal with seeing these people every day looking at him as the person who could have, but refused, to save this woman’s life?

    Why can’t the husband appeal more widely for money? A local or national newspaper might be able to help the appeal – once it goes so public, how willing is the druggist to stick to his refusal? Faced with the prospect alone, how willing is he to remain unmoved?

    Can the husband explain to the druggist that it’s in his best interests, in terms of his ‘reputation’ or profile to accept $1000? If this is the first treatment case, would that not make good publicity – good business sense – perhaps with an agreement not to disclose that the treatment was purchased for half the price (the druggist could be a ‘mystery benefactor’ who anonymously raises the other $1000).

    Perhaps the formula is stolen instead of the drug: passed around the world; unlicensed versions made and sold to benefit all.

    Does the druggist even have a patent to prevent this? If not – copy (not steal!) the formula and make the drug elsewhere. If he has a patent, is it a world-wide patent? If not, import on the grey market (maybe from Canada!)

    Paying cash or stealing the drug is a false dilemma that would seem only reasonable after other alternatives have been tried – alternatives that would explore and test the situation and might reveal yet other alternatives.

    Finally, to attack the premise of the dilemma itself: who are any of us to say what someone “should” or shouldn’t do? Can we really speak for anyone but ourselves?

    The husband did what he did. There will be consequences to his actions. If he was stupid enough not to cover his tracks he may be caught. Will a jury of his peers convict? If he goes to jail, it may be for a trivial amount of time. That may effect his job prospects, but an explanation might counter those consequences or even prove beneficial.

    He may go free, but still suffer consequences – the enraged druggist may attack him, even kill him. Or not.

    His wife will be alive, but once she has recovered she may leave him, perhaps for his best friend. The husband, distraught, may kill himself – or her! Or start a new life with a more trustworthy companion. New children born that would not have been born but for that new relationship may one day cure all cancers. Or destroy the world!

    Or something entirely more ordinary altogether.

    As the saying from that famous Taoist story goes “Who’s to say what’s good or bad?”

  7. Hm, easy to theorise when faced with a theoretical dilemma. A risky activity, I’d say. Hubristic, almost.

    Making decisions when you are in extremis and the theory has become blood and guts reality is different. Things deeper than considered logic comes into the mix then. It’s hard to simulate that. The only certainty is that you will do your very best at that moment – for better or worse but that’s consequences for ya!

    I’ve known a man do ugly things for money, usually because he’s hungry….I’ve known the same person starve himself for days so that his dog can eat. I’m ashamed at my easy judgements about what he actually should have done in either circumstance.

    Hope all is good with you…over the past week or two the spring has sprung gorgeously here in Gloucestershire, I imagine Throssel and surrounds must also be quite a picture.

    Kind regards,

    Hobson.

  8. As far as I can understand it the story and question posed was not so much to get answers but more to examine the development of moral judgement in any one individual. There were six ‘levels’ of development postulated. I believe these can be found within one of the links in the posting. Thanks for sharing your thought process re the question. In the end, as you suggest, in any given situation one can only act best one can.

  9. Yep, nothing like backing off and just sitting with it. So often the right thing slides in the side with nary a trumpet blast.

    Good to see you are still aboard.

  10. I read this obituary today for this lady. I believe it is relevant to this discussion – does one accept that things have to stay as they are, or challenge the view or belief. You have the choice to choose the battles you wish to fight – even if they seem insurmountable. In this case she challenged and won. She passed away last month, quietly. In gassho.

    http://news.bbc.co.uk/1/hi/magazine/7974298.stm

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