Copenhagen ethics are a good way to avoid blame

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People often want to act in a moral way [Citation needed] .  People often also subscribe to ethical rules that in general help them to be more moral.  But that's not the only goal that ethics help people achieve.  One of the very first things I blogged about here was a variant of the trolley problem that seemed to show that avoiding blame seems to be just as much a part of how people approach ethical decisions as any abstract notion of the greater good.

There's a tendency that people have, "affectionately" labeled the Copenhagen Interpretation of Ethics where if a person completely ignores a problem they usually won't receive any aprobrium at all but if they provide an inadequate amount of effort towards solving it they'll often get a ton of flack.  The person who doesn't get involved can just keep their head down and nobody will have any incentive to link them to the problem in the first place and if someone does that person is almost certainly equally guilty so the accusation won't have any teeth.   

This comes to mind recently because of all the furor I've seen on the internet around Paxlovid.  A lot of people have been upset about the end of the clinical trials for it before the drug is widely available.  To quote Zvi.

  1. It is illegal to give this drug to any patients, because it hasn’t been proven safe and effective.
  2. It is illegal to continue a trial to study the drug, because it has been proven so safe and effective that it isn’t ethical to not give the drug to half the patients.
  3. Who, if they weren’t in the study, couldn’t get the drug at all, because it is illegal due to not being proven safe and effective yet. 
  4. So now no one gets added to the trial so those who would have been definitely don’t get Paxlovid, and are several times more likely to die.

Obviously morality says that the trial should continue.  But consider, if they were to continue with the trial giving half the enrollees the drug then of the people that die in the placebo arm their families might get upset and sue the makers of Paxlovid.  But if they stop the trial entirely then nobody will be in a position to know that they might have gotten the drug and hence nobody will be in a position to blame the researchers in particular.  

As a net result this is, of course, terrible.  It's terrible that fear of blame makes people blanche from saving lives because of the blame resulting from the other lives they did not save.  Within the context of this pandemic it's obviously the wrong move but given the future good these researchers might do if they can avoid being sued into bankruptcy then it's not obvious they made the wrong call.

We as a society need a way to find more forgiveness in our hearts and to less eagerly find ways to tear down others if we're going to solve this problem.  But that's very difficult and in the meantime it's good to understand where our problems are coming from.

Comments

  1. Taymon A. BealDecember 5, 2021 at 9:54 PM

    This does not *quite* match my understanding of what happened. There's no need for the trial to continue, because the results that have already been gathered constitute proof that Paxlovid is safe and effective; that's *why* it's unethical to continue the trial (and the people who were in the placebo arm are now getting the real thing).

    The problem is the time gap between when that fact is established, and when the FDA actually approves the drug and makes it legal for people not in the trial to get it. It can't be zero, because somebody has to at least look at the data Pfizer collected and confirm that there's nothing obviously wrong with it. But that could be done in a matter of days at most, and instead it's taking weeks or months, because the FDA as a bureaucratic organization has a general practice of allowing things to take that long, and is not acting with the urgency warranted by the fact that COVID patients will live or die depending on how fast they act. (They are moving much faster than normal, but not as fast as they ought.)

    This isn't really a Copenhagen-ethics issue because the FDA actively prevents people from taking drugs that they haven't approved, and is therefore unambiguously morally liable for the consequences of unnecessary delays in such approval.

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