Monday, March 28, 2016

Love Wins

“Why?” is one of the first questions we humans ask.  Developing ethical justifications to support decisions is an essential part of my participation in the CEC: the details of “why” influences life-and-death decisions made by patients, caregivers, family, and health proxies. Facts are cold.  I believe that real life decisions ultimately depend on love.

The CEC (Community Ethics Committee) works hard to establish a rational basis for conclusions and positions.  But I’m realizing that our emotions usually decide.  I’d like to think that love wins, but lots of emotions have to be considered too.   

When our daughter was making college decisions, I was the rational engineer who got out the whiteboard and made lists of schools, reasons pro and con, and mapped strategy in a perfectly reasoned way.  But neither my daughter nor her mother looked at the reasoned charts, and I ultimately agreed that we would trust our daughter’s gut.  What she felt was the right destination for the next four years of her life was what mattered.  Rational decision making had almost no influence.

The idea that our positions and decisions are based on feelings more than reason was affirmed again when I read about religion’s place in secular medicine:  some basic moral philosophy and meta-justifications are all we have at the end of it.  In any case, authors quit before they get to the best part, the decision on life or death.  I’m convinced now that it is our emotion, “who and what we love” that counts.  

What are stock markets, after all? Numbers going up and down, they are the sum total of investors’ emotions: greed, anxiety and hope. There is not so much fact and reality in the investment world as an emotional index of how the investors feel at that moment.

On the hard ethical decisions that will have to be made by the computer and software programs that will govern self-driving cars, what will the program decide when the car is going at 70 miles per hour, and a child, mother, and baby carriage dash into the road?  It is traveling too fast for brakes to help.  Doing nothing: the child, baby, and mother will surely perish.  There is a choice:   steering to the right, the car runs into some elders at the bus stop who would be crushed. There’s a third option: the program could decide to steer left, off the cliff, and commit car-i-cide, killing both the passenger and destroying the car.  What will your so-smart autonomous self-driving car decide?
It is hard enough for a human to make such decisions, never mind an emotionless robot.   In that impossible scenario, the right decision for a person, will most likely be governed by who or what that person loves most.  A dearly loved family member will probably trump any stranger.  To love someone so much that you will do anything for them also means a choice to drive off the cliff and sacrifice your own life, is never entirely off the table.

After letting this stew for a while, and watching the current political spectacle, I also came to the conclusion that not only “Love Wins”, but “Hate Wins” as well.   Our basest animal bigoted racist xenophobic selves will use our love or our hate to drive our decisions. Sadly for some, some decisions will be forced on them by some people who think they know better how others ought to act.  Will our better selves come out and do the kind and compassionate thing?

Reason alone is far from sufficient. When my health care proxy decides whether I live or die, I hope it will be done with love and compassion.

Shukong Ou has been a member of CEC since 2011.