Ethics in Public Life

Good Practitioners in a Rising Asia

K. Winston

• Publisher: Palgrave Macmillan
• Year: 2015
• Print ISBN: 9781349504565, 9781137492043
• eBook ISBN: 9781137492050
• Topic: Politics & International Relations
• Subtopic: Ethics & Moral Philosophy
• Index: Politics & International Relations

The topic of moral competence is generally neglected in the study of public management and policy, yet it is critical to any hope we might have for strengthening the quality of governance and professional practice. What does moral competence consist in? How is it developed and sustained? These questions are addressed in this book through close examination of selected practitioners in Asian countries making life-defining decisions in their work. The protagonists include a doctor in Singapore, a political activist in India, a mid-level bureaucrat in central Asia, a religious missionary in China, and a journalist in Cambodia—each struggling with ethical challenges that shed light on what it takes to act effectively and well in public life. Together they bear witness to the ideal of public service, exercising their personal gifts for the well-being of others and demonstrating that, even in difficult circumstances, the reflective practitioner can be a force for good.

1

A Gift of Life: Developing a Framework for Ethics

Let’s begin with a story shared by one of my students, based on his personal experience. “Henry” graduated from the Harvard Kennedy School several years ago, and I have been wrestling with his quandary ever since.¹

In brief, the story is this. One day, in his first year of medical practice in Singapore, Henry was the only doctor in the antenatal ward when a nurse asked for his assistance with a woman who had come to the hospital for an abortion. The pregnancy was unplanned, and she and her husband felt they were not ready for a third child. One of Henry’s colleagues had administered the prostaglandins that cause the uterus to contract and expel the fetus. In most instances, the fetus dies in the process of being expelled. This woman, however, was apparently a borderline case; the pregnancy was relatively advanced and probably very near the 24-week limit as provided by law. Henry did not know why this case had been accepted, but whatever the reason the baby had been expelled and was still alive. According to the nurse, the baby had been breathing and moving for more than fifteen minutes. Henry wondered what he should do.

Put so starkly, the answer seems obvious. But if we simply jump to a conclusion, we will fail to understand why a question arose and thus fail to understand how this fleeting incident had such a powerful impact on Henry and stayed with him for the rest of his life. The question for us is not whether Henry did the right thing but whether it was for the right reason. Only careful analysis will uncover the layers of obligation—personal values from family, education, and religion; professional values in career choice; social values based on shared moral understandings—whose intersection at this moment created an excruciating conflict for Henry.

Henry’s Moral Environment

It is often useful to begin the analysis of a story by attempting to understand the moral environment of the protagonist. This helps not only in seeing the conflict from the practitioner’s point of view but in identifying the intellectual and institutional resources available for grappling with the ethical issue posed for resolution. In Henry’s case, as in a number of the cases that follow in this book, the moral environment is constituted in part by cultural traditions and social norms that will be somewhat unfamiliar to many readers. However, we will see that, even with the special features we must attend to, Henry’s situation has a certain universal quality that makes it readily accessible to us. Although, inevitably, we will be introduced to new ethical concepts along the way, there are no insuperable barriers to understanding and evaluating the essential features of the situation. That, at any rate, is my working assumption here and in the chapters that follow, which span a variety of countries and cultural traditions in Asia.

The moral environment, wherever the practitioner resides, consists of three main elements: personal convictions or ideals, standards of professional ethics, and prevailing moral sentiments and understandings. These elements appear, in one form or another, in each of the five case studies. Here I offer my own assessment of their place in Henry’s story, before turning to the specific incident that generated his conflict.

Personal Ideals

Although living in cosmopolitan Singapore, Henry grew up in what he describes as a traditional Chinese family. His father believed the family should maintain its Chinese roots and follow traditional Chinese customs. Accordingly, Henry was sent to a Chinese school, to be educated in Chinese history and literature. About 70 percent of Singaporeans are of Chinese descent, but not all families nurture such a close cultural identification.

His father’s idea, which Henry grew to share, was to fashion one’s life so as to preserve fundamental Chinese values, while adapting to Western science and technology. This idea—holding on to core values but making use of advances in knowledge—has a long history in Chinese accommodation to the modern world, going back at least to the middle nineteenth century when, in response to Western incursions along the eastern seaboard of China, many native groups adopted the slogan “Chinese learning for essential principles, Western learning for practical functions.” The distinction between essential principles and practical functions is not a simple, stable distinction. Yet it helps us frame the personal and collective struggles about identity and self-understanding that many individuals or nations experience when cultural meanings and local traditions are invaded by outside forces and called into question. In terms of a child’s upbringing in late twentieth-century Singapore, the effort to preserve what is of value while adapting to new circumstances means that the acquisition of knowledge and the pursuit of a professional vocation are secondary to becoming a particular sort of moral person, a junzi. That is the project Henry’s father set for him in his formative years.

As described initially by Confucius and elaborated by scholars and practitioners over the centuries, a junzi is a person of exemplary character, with a life-long commitment to learning and self-development, a general concern for human well-being, and life in service to others. In Confucius’s time (sixth and fifth centuries, BCE), the term junzi was commonly used for members of the nobility (“gentlemen”) and referred to an inherited social status. Confucius transformed it into an idea about nobility of character, which everyone, regardless of social class, could aspire to and strive to attain. The special focus of the ideal is the quality of one’s relationships with others, emphasizing the virtues of loyalty, respect, trustworthiness, prudence, and empathic concern. It also alludes to more purely personal qualities such as humility, frugality, and diligence or the resolve to do one’s best. Whatever the specific content, it is a very demanding ideal, not easily practiced, and requires a lifetime of effort to realize. If successful (so Confucius believed), the junzi has a powerful effect on others, evoking emulation and thus serving as a model for how to lead a worthy life.

In Henry’s case, the Confucian ideal acquired a foreign overlay when, at the age of 13, he became a Christian and very active in church organizations. He had encounters with evangelical movements and charismatic renewal, before developing a deep commitment to the Anglican Church. The presence of the Anglican Church in Singapore was a legacy of British colonization, and it was not uncommon for members of the professional and social elite in Singapore to adopt many of the practices of their colonizers, even long after Singapore had gained its independence. (Currently, about 20% of Singaporeans are members of a Christian faith community.) Importantly, Henry did not regard his Christian beliefs as incompatible in any way with his resolve to lead an exemplary life as a junzi. For a while, he took up theological studies and became a leader in the Anglican Diocese of Singapore, participating in many community service activities.

This brief account begins to reveal some of the complexity of Henry’s moral consciousness and testifies to the seriousness with which he set out to shape a particular kind of life. For some readers, elements of this account will be a bit elusive. Some will have difficulty with the idea of the junzi, others with what it means to be an Anglican (or what it meant for Henry). What is important is not so much the details of these personal ideals and commitments as the place they had in Henry’s life. In particular, they exemplify how self-cultivated (or family-cultivated) values set yardsticks of rightful conduct and are a constant source of demands on the individual whose values they are. How one should act is, in part, a function of who one is—or trying to become. Achieving integrity, in this sense, is a fundamental concern of the moral person and can be identified by its characteristic features: awareness, restraint, and commitment. Thus, integrity is not just about logical consistency and avoidance of hypocrisy, that is, it is not just about the divergence of act and belief, of conduct and professed values. It is the conscientious working out of what one regards as an admirable human life. Henry, clearly, had such a project.

Different individuals, of course, have their own, often idiosyncratic, ideas of which kind of life would be worth living, and they attempt to realize their idea either alone or in communion with others. The components of an admirable life are not exclusively moral, but moral matters are usually at the core. People hold themselves to certain standards and judge themselves accordingly, without necessarily implying disapproval of those who make different choices and act otherwise. What is crucial is faithfulness to one’s own ideal. Pursuing a particular vocation, or engaging in ritual observances, or adhering to certain dietary restrictions are common examples. Such standards figure into an ethic of personal grace or purity.

Personal integrity, understood this way, serves as a psychological foundation of moral competence in relation to others. The kind of self-knowledge and emotional stability involved in working out a life-ideal enables one to relate responsibly to others: to trust and be loyal, to cooperate. To that extent, personal and social morality are connected. But the claims of integrity, as I understand it, are also independent of any such social connections. We admire people of integrity, as I admire Henry, even apart from their relationships with others. If they falter in the effort to live by their own ideals and commitments, we may share their distress, because we realize that personal integrity is a basis for self-respect. In this way, we recognize that people have a moral interest in integrity, which accounts for the sense of obligation people have in striving to bring it about.

Because of the moral interest in integrity, we often, where possible, create a protected space for claims of conscience, such as objection to participation in war or, as in Henry’s case, as we will see, participation in certain medical procedures such as abortion. This is a dimension of morality that is irreducibly individual. It cannot be understood apart from the point of view of the individual who is pursuing a specific ideal of how to live. At the same time, integrity is not a matter of self-interest as usually understood. That notion is either reductive or incomplete: reductive in narrowing (and misrepresenting) human motivations, incomplete in failing to address the interests of the self as a moral being. A moral self has moral interests. Any notion of self-interest that fails to take them into account is radically deformed.

Integrity thrives, if it does, in a world full of obstacles to its maintenance. An individual’s guiding ideal helps identify core concerns, which inform deliberation and action. Think of the difficulties faced by young Islamic women in France who wish to wear a headscarf (hajib) in public spaces, including school. There is, to be sure, no one reason why these young women make this choice. But whatever the social or political ramifications, for some of them wearing the headscarf is deeply personal, a central element of their religiosity, their sense of wholeness as spiritual human beings.

So, the case for personal integrity as a source of obligation should be clear, at least in outline. At the same time, we need to understand its limits, as well. When people act in an official or professional capacity, claims of conscience are not immune to challenge. Even the most carefully thought-out judgment of an individual could be mistaken, and in any event has no automatic authority for others. Individuals are as much repositories of error and ignorance as they are sources of novel ideas. And, in the public sphere in which practitioners operate, novel ideas are on probation until agreement is reached with other reflective participants.² Through reciprocal correction, in civilized deliberation, agreement might be achieved. Even then, the agreement is subject to revision in light of further discoveries or reflection.

The practitioner’s challenge, accordingly, is to be sensitive to the difference between personal beliefs about right and wrong and reasoning that carries weight in public and professional settings. Abraham Lincoln grasped this point when he based his opposition to slavery in the United States not on personal conviction but on the Declaration of Independence. Lincoln understood that, in a democratic polity, practitioners do not have the luxury of idiosyncratic belief. Principles that are important, even foundational, to oneself do not necessarily have a claim on anybody else. The good practitioner, rather, has a duty to act in accord with practices and principles that are publicly explicable and authoritative. Acceptable grounds of decision are beliefs and values that citizens generally are committed to, or could be after collective deliberation. Thus, Lincoln appealed to the ideal of equality expressed in the Declaration, the nation’s defining statement of common moral principle. Even though he saw implications in that document that not everyone saw, the logic of his appeal was public, not personal.

Henry understood the importance of this point in his own life and was sensitive to the difference between personal belief and public duty. Although his personal values and religious beliefs made up one essential component of his moral thinking, he knew that, as a doctor, he needed a publicly authoritative basis for what he did. As we will see, at the crucial moment when he confronted the newborn baby, he thought first about his Christian beliefs but then appealed to his professional code of ethics.

Professional Codes of Ethics

Henry’s father believed that medicine was the best profession for becoming a junzi. It is also a profession that is highly esteemed in Singapore, and the competition to enter medical school is fierce. Only about one-in-five candidates survives the interview process.

The reputation of the interview process is well known among applicants; it is a grueling ordeal in which candidates are often peppered with absurd questions. Knowing the dismaying experience of some of his classmates, Henry said a little prayer when his turn came to meet the interview committee and told God he would leave everything in His hands. The first question, indeed, was outlandish. Henry was asked to provide details about the female companions of Henry VIII, the English king who shared his name! After struggling a bit with the question (perhaps there was a Catherine?), Henry resolved that, since he had decided to leave everything to God, he would simply tell the interviewers that he couldn’t answer the question. They were kind enough to give him another chance. They noticed his Chinese education and said: “OK, since you are from a Chinese school, you may not be familiar with English royal history, but you should be familiar with Confucius. Tell us, if you were a doctor, which saying of Confucius would you hang up as a scroll in your office?”

At that point, Henry felt that God’s hand was on him. He replied that it would not be a saying but the Chinese character ren, which has two elements: a person and the number two. Ren is commonly understood as benevolence or humanity, but Henry said that the fundamental meaning of ren—the central theme of Confucian ethics—is the appropriate relationship between two persons, such as ruler and subject, parent and child, friend and friend. In medicine, it is doctor and patient, a relationship governed by benevolence. The interviewers were satisfied by this answer, and the remainder of the session was very cordial. Henry walked out believing that God and Confucius had led him to the medical profession.

Henry was aware that professional roles are not just functional but normative: a source of new motives and new duties. Entering a profession is a critical step in a process of self-transformation. On the day he registered as a medical practitioner and began practicing, Henry took the physician’s solemn pledge to dedicate his life to the service of humanity and make the health of his patients his first consideration. The pledge also included the obligation to maintain due respect for human life. These resolutions were reinforced by the guidelines of the Medical Council in Singapore, which bind doctors, among other things, to be advocates for their patients’ care and to ensure that patients suffer no harm. Such commitments are commonly summed up by reference to the Hippocratic Oath and the admonition “first, do no harm” (primum non nocere). But this injunction by itself provides little guidance. For example, it cannot mean “cause no pain,” since pain is often a necessary part of the healing process. Closer would be “don’t make things worse.” But how are “better” and “worse” to be determined? Does assisting a terminally ill patient who wishes to commit suicide make things better or worse for the patient? We will see in a moment that social norms have a lot to do with understanding, concretely, what a doctor’s obligations are.

To gain perspective on the Hippocratic Oath, it helps to examine the original version, which is commonly attributed to Hippocrates in late fifth century BCE. It begins: “I swear by Apollo the healer, by Aesculapius, by Health and all the powers of healing, and call to witness all the gods and goddesses that I ma...

Table of contents

• Cover
• Title
• Introduction
• 1   A Gift of Life: Developing a Framework for Ethics
• 2   The Prison Master’s Dilemma: Ethics in a Non-Ideal World
• 3   Missionaries in China: The Ethics of Exporting Ethics
• Addendum to Chapter 3   Exporting the Rule of Law to China
• 4   The Woman in the Corridor: Caring across Boundaries
• 5   By the People: Becoming a Practitioner of Democracy
• Conclusion: Moral Competence in Public Life
• Index