Continuing my series of alternative responses to the New York Times column, The Ethicists, looking at the consequences of one’s actions instead of imposing values on others, here is a take on today’s post,”Must I Drive My Friend to Have an Abortion?”
My closest friend just got pregnant and is in no way ready to take on motherhood at 18. She has already committed to her dream school and received a scholarship. She wants to get an abortion out of state and is asking me to drive her. She would do the same for me if the roles were reversed, but my religion prohibits acts like these. I’ve been putting it off for weeks, making up excuses as to why I couldn’t take her. Is it ethical for me to drive hours away, without her parents’ consent, for an abortion, when that is regarded as very shameful in my church? Name Withheld, New Jersey
My response: If your reason for your decision is your religion, you have to ask an expert in your religion for their opinion of what is ethical.
Someone in authority telling you what is ethical doesn’t mean you have to agree. There are a lot of religions and a lot of interpretations within each branch.
There is no absolute measure of ethics. If there were, you would have consulted it, answered your question, and not had to ask anyone else. For that matter, there wouldn’t be as many religions and you wouldn’t need an authority to interpret its rules and tell you what you should believe is right or wrong. You don’t seem to agree with your church anyway, since you sound clear on its prohibition but you haven’t acted on it. There are plenty of other religions you can join that will support either decision.
So maybe instead you could consider the consequences of your actions on others. If someone tells you you’ll burn in Hell for your actions, you could take that into consideration, though I’m not sure it tells you it’s ethical or just that you fear someone will torture you. You used the passive voice: “… that is regarded as very shameful in my church”. Do you consider it shameful? Does shameful mean unethical to you? How many people in the church do it anyway, despite what other people think?
The New York Times Response:
Kenji Yoshino: It’s very ethically permissible for the letter writer to not drive her friend, because she has religious compunctions against it. I’m actually touched by how often someone says, “If our positions were reversed, the friend would do it,” but in this case, the two individuals are not similarly situated. The letter writer has these religious compunctions that the friend does not, so I see no problem here except that she’s dithering. She’s putting the friend in a much more difficult position than she needs to be in.
Amy Bloom: The unethical thing is the delay and the excuse-making. The letter writer delays but does not in any way avoid her best friend getting an abortion — that’s unethical and unkind. She can ethically not do it and tell her friend the truth immediately, or drive her and in the process either rethink her religious stance or recognize that one of her concerns seems to be the subject of shame and adult disapproval rather than her own religious beliefs. But that’s reading into the question, so I would say that the unethical thing is dithering and delaying and making it more difficult for the friend to get a ride.
Jack Shafer: I disagree, Amy. The reason that I love this question is that no matter what the letter writer does, she is acting ethically. You don’t have an ethical responsibility to drive your very best friend in her time of need, and it’s not unethical to cast aside your religious beliefs and teachings to drive your friend.
Bloom: No, we agree, Jack. She could ethically drive her; she could ethically not drive her. What I think is unethical — by which I mean unkind and unhelpful and simply giving in to her own internal difficulties without recognizing the problem they cause for her friend — is not telling the truth. Drive her or don’t drive her, but the procrastination is unkind.
Shafer: Well, I was going to say procrastination is unethical.
Bloom: In this case, there are real costs to the procrastination, and the costs are being borne entirely by the best friend.
Yoshino: Depending on where she’s getting an abortion, this could be more than one trip. It’s also out of state, not an insignificant undertaking, and these are time-sensitive issues, so I agree that the procrastination could be unethical.
Shafer: This is one of the cases where we would love to have the question restated by another person who was referred to in the letter. “Is it unethical for her to put me on hold and not immediately respond and immediately drive me based on my need?” If we were considering that question, we would say: “Maybe you’re asking too much of your friend. Maybe you’re not mindful of her religious teachings and beliefs and what she’s been taught is the right and the good, the moral and the ethical.”
But we all agree that it’s ethical no matter whether she drives or doesn’t drive.
As a physician, I was consulted by an Army veteran who brought me a sleep study (performed by and paid for by the Department of Veterans Affairs) that showed he had sleep apnea, for which he was successfully treated (also paid for by the V.A.). He was seeking a letter from me to the V.A. to attest that his sleep apnea was “service connected,” meaning it started while he was on active duty and the Army was therefore responsible for his illness and should pay for treating it over the long term. It is usually not possible medically to know exactly when this disorder starts. All doctors are taught that the patient’s needs come first but, not convinced that the Army caused his problem, I compromised and wrote a letter to the V.A. saying that this patient “tells me his problem started while on active duty. Please consider granting him service-connected status.” Did I act unethically? W.J., Atlanta
My response: You’re asking about something in the past. You can’t change it. To call it ethical or not just puts a label on it. What difference does that make?
I think your more relevant question is, if a similar situation arose in the future, could you create an outcome you like more. Then the question is what alternatives would you have and how could you act on them.
Maybe your issue is that you’re having trouble sleeping at night or living with your actions in some other way. In that case you might want to learn more about your emotions and how to manage them. You’ll never be able to avoid making decision you find you would have done differently on more reflection. Learning skills to manage your emotions in such situations will reduce internal conflict and stress in your life. A lot more than asking other people what labels they would attach to your behavior.
Back to the first point, to view such situations with a problem-solving approach instead of labeling them, I would have worked with the guy to come up with wording both of you were comfortable with. Then you’d know both of you felt comfortable. I’d suggest something like “tells me his problem started while on active duty. All my test results are consistent with that, though I can’t tell conclusively.“
I don’t know how well that wording meets your interests, but I can tell you you’ll find strategies that work better for you by trying to solve your problems more than by trying to figure out what labels to put on them.
The New York Times Response:
Shafer: Bad, bad doctor. If it’s not possible medically to know, then where does this doctor get off leading the V.A. to believe that it started during his service?
Bloom: One of the facts that you report as a medical-care provider to another medical institution is the patient’s self-report. You wouldn’t want to say it is a fact when it is not a fact, but it is a fact that the patient states that the problem began while on active duty. It might be more ethical to add to that, “It is not possible for me to ascertain when the problem began, only that it was present at such-and-such a date when he was successfully treated for it.” But there’s not an attempt to persuade the V.A. of anything. These are also medical professionals. It’s not as if they’re going to be, “Oh, my gosh, a medical professional states that it’s impossible to know something.”
Shafer: Then why is the physician troubled? Does he not know his own profession sufficiently to know whether it’s ethical or not to present the self-reported diagnosis of a patient?
Bloom: I wonder if the thing that troubles the letter writer is the sentence, “Please consider granting him service-connected status.” In other words, he is putting himself out a little further to be supportive of the patient.
Yoshino: I read the sentence “All doctors are taught that the patient’s needs come first” to mean that he really, really, really wants to help the patient but that he also understands that there is another duty to the Army benefit system. He can’t, for example, lie or shade the truth in order to get the patient’s needs satisfied. I’m right with Amy here. The only tweak I would make is, maybe he’s more of a specialist in sleep apnea than the people on the other side at the V.A. are — you don’t know what doctor is reading the file — so he might want to add that with sleep apnea it’s very difficult to know when the problem started, so here’s information about the condition as well as the information about the patient’s statement.
Bloom: That would be an important add. You’ve done the ethical thing, and you haven’t pleaded a case for the patient, but you have also not interfered with him getting the best possible response.
Shafer: What the physician seems to be doing is trying to game the system, using weasel words and weasel sentences to help this patient get V.A. care. I think that the doctor is trying to express his doubts that the patient is leveling with him, and he’s trying to bestow upon this patient the collective compassion of the V.A. system and its medical care.
If we can’t rewrite the sentence for the physician and we’re left with the sentences that he did write, do you think he acted ethically or unethically in this letter?
Bloom: It is not the ideal letter, but I don’t think it’s unethical.
Yoshino: Yeah, I’m completely unfazed by this. I think it’s completely ethical.
I recently bought an item from an online retailer that was apparently stolen from my porch. I requested a refund, which was promptly granted. Then the item turned up, having been mistakenly delivered to a neighbor. I immediately returned my $20 or $30 to the retailer. But then I got to thinking that I should have kept that money. You see, the billionaire who owns this online retailer recently acquired my employer. This billionaire not only got the company for a bargain, he also was given far more money to cover my and my co-workers’ pensions. Instead, he decided to freeze the pensions and pocketed the money. So here I had a chance to get him back, but I didn’t. Am I a fool? Name Withheld
My response: Your story doesn’t give enough information to tell if you’re a fool. If you’re dwelling in fantasies of revenge, you could probably improve your life more effectively other ways. You’re only talking about how you’ll feel yourself, as you know. Nobody but you would ever know or care about this money.
Making yourself miserable, which fantasizing about impotent acts of revenge sound like, sounds foolish. I presume you’ll tell people how you got the guy back, which might get a few laughs, but I suspect people will also see you as petty. I don’t see how focusing on the money improves your life more than moving on and improving it in other ways.
What do you mean he was “given” money to cover the pensions? What’s with all the passive voices in people asking for others to judge people’s actions, anyway? If he acquired the company, who gave him the money? Didn’t he pay others money?
The New York Times Response:
Bloom: No, you are not a fool. The letter writer did the right thing. To ethically work against the billionaire, which is a fine thing to do with your time, you might engage in some kind of protest activity aimed at said billionaire and said billionaire’s policy.
Yoshino: I agree: Two wrongs don’t make a right. The fact that the billionaire froze their pensions might be a bad thing, but the way to protest that is to go to corporate headquarters and hold a picket sign or write a letter or engage in some other form of activism. But taking that $20 is not the right way to go.
Shafer: Don’t you really want to do this to every billionaire on the planet? Microsoft makes a $20 mistake in your favor, or Citibank makes a $50 mistake — aren’t you just dying for this day to happen?
But I have to pull back and say no, the money isn’t yours, it was never yours, you did the right thing. Just draw really ugly pictures of the billionaire and put voodoo arrows in his head and call it a day.