Normative Ethics vs. Descriptive (Empirical) Ethics
Understanding the basic taxonomy of ethical inquiry is a necessary first step for deciding what questions are feasibly answerable through empirical means and how those answers can inform normative analysis.
In the first chapter of their book, Methods of Medical Ethics, Daniel P. Sulmasy and Jeremy Sugarman outline three basic schools of ethical inquiry: (1) normative ethics, (2) metaethics, and (3) descriptive ethics. They define the categories as follows:
Normative Ethics: “gives answers to questions regarding: What ought to be done? What ought not be done? What kinds of persons ought we strive to become? It sets out to answer these questions in a systematic, critical fashion, and to justify answers offered.”
Metaethics: “investigates the meaning of moral terms, the linguistics of moral reasoning, and the fundamental questions of moral ontology, epistemology, and justification. It is abstract, but vital to normative investigations since all normative inquiry rests on fundamental answers provided to metaethical questions. Metaethics asks: What does “right” mean? What does “ought” mean? What is implied by saying “I ought to do X”? Is morality objective or subjective? Are there moral truths that transcend particular cultures? If so, how do we know what those truths are?”
Descriptive (Empirical) Ethics: “does not directly engage questions of what one out to do or the proper use of ethical terms. It asks empirical questions such as: How do people think they ought to act in this particular situation of normative concern? What facts are relevant to this normative ethical inquiry? How do people actually behave in this particular circumstance of ethical concern?” Empirical ethics methods include surveys, qualitative interviews, observational study, etc.
Of these three schools, normative ethics and descriptive ethics are the two which fall squarely in the domain of bioethics. It is vitally important, though, not to incorrectly characterize research endeavors when using invoking these categories; a descriptive study which merely surveys physician’s views on how to respect patient autonomy does not by itself deliver any decisive normative punch, unless normative work takes place to either (1) directly justify or support the views expressed by the physicians, or (2) justify why we ought to accept the physicians in this case as the relevant/appropriate moral authority. Knowing what kinds of normative inferences are sound is critical to conducting responsible bioethics research and accurately framing findings. Some classic illicit normative inferences consist of the following (Sugarman and Sulmasy):
The Is/Ought (Fact/Value Distinction/Naturalistic Fallacy): The “is/ought” distinction refers to the limitation of using fact-based “is” statements in making “ought” claims or coming to moral conclusions.
Historicist Fallacy: Historical facts do not entail normative conclusions. Ex., “Humans have been doing this for centuries, so it must be permissible!” (See. Lerner, Caplan, 2016).
Argumentum ad populum Fallacy: Majority opinions and behaviors do not entail normative conclusions. Individuals may not share group beliefs and whole cultures can be mistaken in moral beliefs. Surveys are best viewed as tools to examine what clinical or social factors might be associated with opinions about moral issues (e.g., African Americans are less likely to want to forgo life-sustaining treatment).
The Legal/Moral Conflation: The mere fact that something is legal or illegal does not make it moral or immoral.
Argumentum ad Verecundiam Fallacy: The opinions of experts do not necessarily entail moral conclusions. They should be taken seriously and there is practical value to reliance upon expertise and tradition, but experts disagree and can be wrong—at times it is appropriate to challenge expertise.
The Biological Fallacy: The mere fact that something is biologically true does not entail automatic moral conclusions. Ex., fetal brain waves and the morality of abortion.
These fallacies highlight some of the limitations which empirical bioethics must address carefully and responsibly. When these pitfalls are avoided, however, normative and empirical ethics can provide powerful insight into the ethical dimensions of medicine.
Works Cited
Bachman, Jerald G, David J Doukas, Richard L Lichtenstein, and Kirsten H Alcser. “Assisted Suicide and Euthanasia in Michigan.” The New England journal of Medicine 331, no. 12 (1994): 812–813.
Hume, David. A Treatise of Human Nature. Dover ed. Dover Philosophical Classics. Mineola, N.Y: Dover Publications, 2003.
Sugarman, Jeremy, and Daniel P. Sulmasy, eds. Methods in Medical Ethics. Washington, D.C: Georgetown University Press, 2001.
Lerner, Barron H., and Arthur L. Caplan. 2016. “Judging the Past: How History Should Inform Bioethics.” Annals of Internal Medicine 164 (8): 553. https://doi.org/10.7326/M15-2642.