With the villain of the story presented and the hero called, let us get into the nitty-gritty of how the DREMSI method would solve the ethical riddle.
The DREMSI ethical resolution method is composed of two phases:
- Phase 1, Injury identification – is about the identification of possible injuries we may cause with our actions to others. This includes the application of a label if an action is ethical or not.
- Phase 2 – Decision taking –is about the decision of which action to take. This part includes a normative component, in other words, judgment guidance to take the action with the least injuries. To make it practical, the question if one should go beyond expectations and behave altruistically is included in this phase.
The first phase, the identification of injuries, is the most important aspect of the whole exercise, and so in this episode I will devote more time to this part as I’ll clarify in detail some of the concepts and definitions that are used in this theory. The whole idea is that by the end of phase one we will know: who are we affecting? do we cause any injury? and at which intensity?. With all this information we can determine if the action is ethical or not.
There is so much to tell about the method but one shouldn’t bake a large cake when all we need is a small bite, hence I’ll be brief on this episode and you can find full details of the method in episodes 5 and 6.
As the objective is to highlight the steps of the DREMSI methodology, instead of analysing each ethical dilemma in isolation, I will analyse them all at the same time, going step by step. Let us then begin to analyse the ethical riddle.
1.1 – Defining the Standpoints
The first step is the presentation of the options in a dilemma, the formalization of the standpoint to judge. I call them standpoints because calling them actions or options is a bit problematic, on one side, not all the standpoints come with an action, and on the other side the word option is too neutral compared to the inherent intentionality of a standpoint.
In these simple dilemmas, we will only work with two standpoints, “to act or not to act”, “to save one life or to save five lives.” Is very important to remember that the DRESMI method only cares about injuries to other stakeholders, it doesn’t care about the actor and it doesn’t care about the benefits. So, to write a standpoint we need three elements: an action or inaction, a possible injury, and a stakeholder. These standpoints are the first impressions of injuries and as we go through the methodology we will refine them so that we can formalize their ethical level and use them for making decisions. Let me visualize the standpoints for each dilemma:
- In the case of the trolley dilemma, we have standpoint one, to change tracks of the train causing the death of one person or standpoint two, to not change tracks causing the death of five people.
- In the case of the bridge dilemma, we have standpoint one, to push the fat person causing his death or standpoint two, to not push the fat person leading to the death of five people.
- And finally, in the case of the doctor, we have standpoint one to kill the tourist and harvest his organs or standpoint two, to not kill the tourist and let five people die.
As we can see, from the very beginning we place all attention on the injuries to other stakeholders, and just by the presentation of the standpoints, one may already have a little prejudgement on the situation. However “the devil is in the detail” so let’s go further in the methodology to bring clarity to each of them.
1.2 – Role and stakeholders
The second step is the formalization of the roles one plays and the stakeholders involved, to recognize who is affected and what is our relationship with them.
Most of the time, the role we play is very easy to identify, the conductor, the doctor, the father, the boss, etc. However, at times it can get a little tricky, this because roles can as well be situational. As small guidance, I currently classify roles in two types:
- Official roles are roles that we constantly play during our life’s such as a father, a friend or an employee. These ones are common within specific relational spaces and one may argue “you wouldn’t call it a family if there are no parents”.
- Contextual roles are roles that are temporary, specific to a situation. For example: If you are driving in a car and hit someone by accident, you become the offender. If you are walking in the park and a dog starts chasing you, you become the victim, or If you are travelling to another country and people want to identify you, you become the foreigner.
Contextual roles come in many shapes and can be tricky to identify but for this episode, we don’t need to get too much into detail as the dilemmas are not that complex. One of the most important aspects to recognize is that roles are stakeholder dependant, meaning you are a father to a son, a boss to a subordinate, etc; hence by formalizing one’s roles that are involved we are formalizing the stakeholders as well.
With this short introduction of roles in place, let us define the roles for each dilemma:
- In the case of the trolley case, you are the conductor, you have an official role toward the passengers, the workers and the train company
- In the case of the doctor dilemma, you are the doctor, you have an official role towards the traveller, the hospital and the patients.
- In the case of the bridge dilemma, is a bit more complicated as you don’t really have an official role but more of a contextual role, which we will define as “the walker”. You just happen to be walking at the right time on the bridge and hold no relationship towards the train company, train passengers, the workers or to the fat person.
Given that taking actions can lead to the formation of roles and relationships, for example, if you push the fat man you change from “a walker” to “the saviour” of the passengers, is important to always look at the situation a priori any action. What I mean is that we should define the roles just as the situations are expressed before the actor takes any actions.
1.3 – Social Expectations
With step three finished, it’s time to finally highlight the social expectations involved in the situation. I like to believe that this is the juicy part of the method, where the magic happens and the rabbit comes out of the hat. Although roles identification sets the tone, is the accurate understanding of expectations the critical aspect if we want to get better at ethics.
Social expectations are expectations of behaviour that are effective to the roles in relation to a specific stakeholder, for example, “a father towards a son” is different than “a father towards a mother”. Is important to visualize these expectations as a series of responsibilities that can imply either an action or an inaction, something you ought to do, or ought not to do; I like to cluster them into two categories, warm and cold expectations.
- I refer to cold expectations as the expectations that imply you will not take actions that can cause injuries to others. In other words, you will restrain yourself from taking certain actions. This is similar to the silver rule – “do not to others what you don’t want them to do to you.” but the silver rule expects a certain mirroring reciprocity which is not comprehensive enough as there are cold expectations that are exclusive to certain roles.
- I refer to warm expectations as the expectations that imply an action. While cold expectations are about avoiding causing an injury, warm expectations are the ones that if we fail to do, we may be causing the injury.
To visualize both types of expectations:
- As a parent, you have the cold expectation not to hurt your children, and as a warm expectation, you should provide them with food and shelter.
- As a friend, you are expected not to betray the trust of a friend, and in the opposite sense expected to support when requested or take their side in disputes
I know, I know, I’m aware that the words “warm and cold” don’t really bring the right message I expressed above, language is a tricky thing. I was thinking to use “positive and negative expectations”, however, I don’t like the instinctive value of the words “positive and negative”, it just sounds difficult to use, at least for me as a non-native speaker. What I like about using “warm and cold”, is that it can be used to express a gradient of levels in expectations; we could say that one has a “HOT expectation” as something that one must by all means do, the most important function in a role; in the opposite end, we could use the idea of “FROZEN expectations”, things that you, by all means, must never do. I plan to update this terminology as I get feedback from other parties but for the time being, we will leave it as warm and cold
Getting back to the assignment of expectations, let us review the ones that apply in each dilemma. To be practical I will not specify if the expectations are warm or cold, what is important to stress is if they are present and they run the risk to be broken. For example, almost everyone holds the cold expectation not to “yell at others”, so no need to highlight the obvious, only the ones that are at risk.
In the trolley dilemma, based on your official role as a conductor you will hold expectations
- towards all passengers, to ensure their safety during the train
- towards the train company, to follow your contract or protocols of behaviour in case of emergencies
- and the workers in the tracks, to not put their life at risk or cause them any harm.
In the same light, in the case of the doctor you hold expectations:
- towards each patient, to save their lives if possible
- towards the traveller, not to cause him any harm
- towards the hospital, follow your contractual agreement and not damage it in any way.
And on the bridge dilemma as you are just “a walker”:
- You only hold expectations towards the fat man, a mutual spatial expectation of I won’t hurt you if you won’t hurt me.
As I mentioned many times before, the role plays a very strong influence on the expectations that apply to our situation, and in the case of the bridge dilemma, we simply don’t have any social expectations from “the walker” to the train passengers. While on the trolley and doctor dilemmas, there are contrasting expectations that apply to the role, in the case of the bridge dilemma there is actually no dilemma, the “walker” only has one stakeholder to which it holds some sort of social expectation.
With the expectations set, the final step is to estimate injuries and assign ethical labels to the respective standpoints.
1.4 – Estimating Injuries and assigning ethical labels
The estimation of injury intensities is never a perfect process, and always requires a strong contextualization of the situation and damages. Even if it’s not perfect, is a process that is good enough to be effective in most situations, especially in the analysis of classical dilemmas which always bring “critical damages” (the death of someone) to question.
Important to remember that the first phase is only descriptive, hence it only describes if there is an injury or not, and with this, identifies if it’s ethical or not. The injuries are classified in thresholds based on the level of damage, with uncomfortable, serious, and critical levels. This in turn will make the standpoint ethical and unethical, and in the case is unethical then the question is how unethical it is, where we will follow the same labelling of the thresholds. Let us visualize it with the dilemmas.
In regards of the trolley problem,
- Standpoint one, pulling the trigger leading to the loss of one life is unethical, critically bad. The conductor fails to save the life of one person causing a critical injury. In addition, it causes large reputational damage to the company it has a contract with.
- Standpoint two, not pulling the trigger leading to the loss of five is unethical, and critically bad. The conductor fails to save the life of five people causing a critical injury. In addition, it causes large reputational damage to the company it has a contract with.
I would like to clarify a couple of points that are very specific to the trolley problem.
First, is the fact that both actions are unethical; whether you act or you don’t act, you will be unethical. This methodology does very well at assigning accountability; since both actions cause injuries, both actions are unethical and hence one cannot hide away from the damages it causes. By labelling both unethical, we stress that there are damages done by both actions, and even if one makes the best decision, it doesn’t make it less unethical.
Second, we tend to focus all our attention on the critical damages and ignore the reputational damage the company suffers. In this particular situation is easy to miss it but reputational damage is very hard to estimate and in some instances, it will be critical to the stakeholder, especially at the individual level where our reputation can be highly influential to our possibilities in life.
Moving on with the review of the dilemmas, let us have a look at the doctor dilemma:
- Standpoint one, taking the life of the traveller is unethical, critically bad. The doctor fails to respect the life of the traveller, causing a critical injury. In addition, it breaks all the explicit protocols and contractual agreements with the hospital, causing another large damage, serious at the very least.
- Standpoint two, not taking the life of the traveller is ethical. The doctor doesn’t break any social expectations. We may assume that it fails to prevent the death of five people, but given the context of the hospital, it is easy to see that nobody expects the doctor to kill patients to save others, hence the expectations are respected so long the doctor makes his best effort within reasonable conditions. These expectations are heavily reinforced with protocols that clarify and formalise expectations for these kinds of situations.
Unlike the trolley example where both actions were unethical, in this case, only the action to kill the traveller is unethical. In this example, we can see how certain social expectations are reinforced by protocols and contracts that confirm and make sure everyone is on the same page about it.
Let’s close the review of the bridge dilemma
- Standpoint one, pushing the fat person is unethical, critically bad. “The walker” fails the mutual respect expectation with the fat person causing a critical injury. As the “walker” had no expectations with the train passengers, we could only call his action altruistic, going beyond expectations. I’ll comment further in phase two.
- Standpoint two, not pushing the fat person is within expectations is ethical. The walker doesn’t fail any expectations as it had none with the other stakeholders.
In this dilemma one action is unethical, pushing the fat man, while the other one is not unethical as it doesn’t cause any damage under social expectations.
As we can see, in both, the doctor and the bridge dilemma, social expectations play a critical role in how we judge actions they make a cutting line on how we analyse situations. I wouldn’t be surprised if you may be ready to challenge this whole idea “How come social expectations are so important, “That’s not what ethics is all about”. I have mentioned many times, “division of labour is a priori reality”, as such one can only judge the person actions if one knows their role. Let me give you an example that I think explains this perfectly:
We see a group of parents with their kids playing in the park, suddenly one of the kids starts yelling and swearing towards others, a clear misbehaviour. For anyone considering to take action or making a judgment, before doing anything… one has to wait, one has to wait to see the actions the parents take, is not like one can simply get up and educate someone else’s children.
This kind of direction might sound illogical as a whole, but once we use it a couple of times and become used to the mechanical way of analysing situations, one begins to understand how we have been doing it all along, we just never call it within an official process.
With this, we finished phase one and have identified if the actions are unethical or not and to which degree. However, the process is not over, we still need to come to terms if we act or not, that is what we discuss in detail in the next section.
Phase 2. Ethical Decision taking.
After discussing so much about roles, stakeholders, expectations, injuries and intensities. It has come time to take decisions, To select a standpoint to take. This is officially Phase two of the methodology, and it asks us to review the two standpoints from three angles:
- First, Injury minimization, I advocate for taking the decision that would minimize injuries. In simple terms, choose the one that causes the least damage.
- Second, Conflict with other social norms, we review if there are implications against other social norms, in specific to check if the action is legal.
- Third, The realm beyond expectations, we ask ourselves if we should try to behave altruistic or push for social change on this situation, in other words, should we act even if we are not expected to do so.
For this phase, I’ll analyse each dilemma on an individual format as it would provide a more coherent conclusion. Looking into the dilemmas the easiest one is perhaps the bridge dilemma:
- Injury minimization: The lowest injury is Standpoint a, not pushing the fat person as the other one causes a critical injury.
- Conflict with other social norms: Standpoint A has no issues with the Law, on the other hand, standpoint B (pushing the fat person) would get one in trouble
- Beyond expectations: should we behave altruistically and try to save the passengers and train works?. I would naturally advocate for this, as it is in the prevention of a critical injury, but as I expressed earlier. “only in the prevention of critical injuries and without causing other injuries of the same intensity, one should consider breaking social norms, peruse altruistic behaviour or push for social change” In the conditions stated in the dilemma we cannot consider going beyond the expectation.
- Conclusion for the Bridge dilemma: The best action from an ethical perspective is not to push the fat person.
Let’s continue with the doctor dilemma:
- Injury minimization: the lowest injury is not to kill the traveller to harvest its organs
- Conflict with other social norms: this action is completely legal with no other social norms implications. Killing the traveller would cause a legal problem.
- Beyond expectations: We run into a very similar situation as the bridge dilemma, we cannot justify taking a life for the sake of saving a life.
- Conclusion for the Doctor dilemma: The best action from an ethical perspective is not to kill the traveller
Even if both dilemmas have the same kind of result, there is a different relationship to social expectations in each of them. While on the bridge dilemma there is a lack of social expectations, in the case of the doctor dilemma there is an extra layer of clarification of expectations that comes from the hospital contracts and protocols. The reason why we know that the doctor shouldn’t kill the patient is because we have regulations in place that have shaped role expectations. On the romantic side, we have the famous Hippocratic Oath, Sworn in the name of Apollo, Hygiea and Panacea, in which the doctor should cause no harm and will do its utmost to help the sick. On the most pragmatic side, we have the four ethical principles of medicine in place, taken as prima facia moral commitments “non malevolence”, “beneficence”, “autonomy” and “justice”. All those principles of behaviour are constantly used by doctors in their everyday operations.
The last dilemma to decide on is the trolley one. This one Is a bit trickier as both standpoints pretty much have the same values. Let me visualize it
- Injury minimization: both standpoints cause a critical injury. So there is no clear ranking indication as of which one is worst.
- Conflict with other social norms: both standpoints could be considered illegal.
- Beyond expectations: both actions require us to cause critical damage if we want to save others, hence in both of them one shouldn’t be altruistic.
- Conclusion for the trolley dilemma: Inconclusive using the method, but given that everything is equal, using the objective of the minimization of injuries as an anchor, we can focus on the number of lives as a deciding factor, hence the recommendation is to save five instead of one.
I am not advocating for a mathematical valuation of life, in which a larger quantity is better But in this dilemma we truly don’t have any other contextual criteria. As such the only way to solve it is to quantify lives as is the only parameter open that would fit the general direction of ethics, the minimization of injuries. Ill further develop this view in the next section.
We have gotten into the nitty-gritty of this methodology and we have finally come to a conclusion about which action to take for each dilemma. I am aware of how uncomfortable some people in the audience might feel, so in the next section, I want to address the uncomfortable aspects of the methodology.
