Towards an Objective Definition of Morality

What is Morality?

On a recent flight across the country, the person next to me commented on an article in the seat-pocket magazine on "Molding Morality" by Michael K. Myerhoff [1]. This article was written around the following case. A pay phone in a college dormitory returns money that students put into it, but the connections go through anyway. All the students take advantage of it, but the father of one of the students says it is "not right," and that student ultimately reports the trouble to the telephone company. Mr. Myerhoff applauds the father's discretion for judging the action without judging the student. That seems like a good point, but it falls short of equipping the student to resolve future moral questions without help.

According to Mr. Myerhoff, the moral judgements of children are fairly predictable from their social and religious backgrounds. He goes on to say that the moral judgements of adults are less predictable because many diverse skills are needed to make sound moral judgments. But he says that sound moral judgements are distinguishable from unsound ones by examining the reasoning behind them. Thus Mr. Myerhoff seems to believe that moral judgements are characteristically ones on which responsible adults can convincingly disagree. I prefer to take a more constructive approach by defining what I will call objective morality. If someone wants to disagree, let them produce counter examples that are clearly moral issues but do not fit the definition.

Working Definition

Some philosophers have argued that morality is based on reason, and others have found an emotional basis for it. If morality is based on reason, we may hope to learn its principles and thereafter apply it confidently without help. If morality is based on emotion, it must be a weak effect because moral issues often manifest themselves as conflicts between reason and other, stronger emotions that we recognize to be amoral. Now, if we can't trust our own emotions, we will have to find a rational basis for morality anyway. My suggestion is that, to a first approximation, an action should be considered moral or immoral to the extent that it tends to lengthen or shorten another person's life. On this scale , the merit of resisting the temptation to take advantage of a defective payphone is insignificant.

It is especially immoral to endanger another person for momentary pleasure, yet people still find excuses for it. For a while, it looked as though antibiotic drugs had eliminated the accountability that goes with having intimate contact with more than one other person. Unfortunately, the sexual revolution failed, and the tyranny of sexually transmitted diseases goes on. A person who engages in behavior that potentially spreads such diseases risks only his or her own life on the first occasion. After that, a responsible person should have a check-up before having another affair. Otherwise, that third person's life is potentially at risk as well. The sin is knowing that you could be infected and doing it anyway.

A Possible Counter Example

I admit that my definition of objective morality might not always work. For example, suppose that a person has a terminal disease and is in great pain. Actually, pain management can give a terminally ill person an opportunity to reach closure with the people they are close to. This kind of relatively happy ending is probably medically possible in most cases, but it is probably often psychologically unfeasible. A savvy patient who is bitter and weary of life may lie about the pain with suicidal intent. Although physicians are not likely to be fooled in such cases, it may be kinder for them to play along in mutual deception. Thus it seems possible to me that shortening a life is not necessarily immoral if it prevents great suffering, even if the suffering is partly psychological.

We might say, against the working definition, that an action that shortens somebody's life might be morally justified if it eliminates unnecessary suffering. The problem is, who can decide whether suffering is necessary or not, keeping in mind that the physical pain can probably be managed? Just now Jack Kevorkian is pushing the limit of the law on this point [2], and he has even gotten himself convicted of murder. My intuition is that a qualified impartial judge should be called on to decide whether suffering is necessary or not in each case. Certainly, a family member or another person who is emotionally or financially involved cannot be objective, and even physicians have traditionally refused this burden. This is very clearly stated in the Hippocratic Oath [3] in the line "I will give no deadly medicine to any one if asked, nor suggest any such counsel ..." I think the point was probably to reassure patients that the advice and medicine they receive will always be for their own good.

Incidentally the sentence quoted from the Hippocratic oath continues "and in like manner I will not give a woman a pessary to produce abortion." I have been told that students at some medical schools now take an updated oath that does not preclude abortion, and I want to characterize this as a hypocritical oath instead of a neo-Hippocratic oath. If circumstances arise where abortion is necessary to eliminate unnecessary suffering, so be it. But it would be hard to argue that a human life is not shortened thereby, so I think a qualified impartial judge should be consulted in every case. I hasten to add, as Mr. Myerhoff's father's silence implied, that women who have had abortions are "not wrong" and even doctors who have performed thousands of abortions have good intentions and can be redeemed.

A Case in Point -- Needle Sticks

According to OSHA [4], at least 800,000 accidental needle sticks occur each year. The gravity of these incidents was assayed by a study done in the Johns Hopkins Hospital emergency room. Of 2500 patients tested there, 18% were seropositive for hepatitis C, 5% were seropositive for hepatitis B, and 6% were seropositive for aids. The probability of being infected with aids from a contaminated needle is currently estimated to be 0.3 %. This means that about 144 infections probably result each year from 48,000 exposures to aids through accidental needle sticks. (This number is about 3 times the number of documented cases.) Hepatitis B and C are much more transmissible through needle sticks, but fortunately vaccination has been reducing the incidence of acute cases of hepatitis B since the mid-80s. However, health-care workers are about twice as likely to die from this disease as the average for the general population. There is no vaccine or cure for hepatitis C, which is a major cause of chronic liver disease. It has been estimated that more than 500 health-care workers contracted this disease through occupational exposure in 1995.

Currently, health care workers are admonished to take "universal precautions" under which the blood and certain body fluids of every patient are deemed potentially hazardous. Health-care workers are hardly reassured by this pious BS. Gloves and face shields are used routinely, but they are ineffective against needle sticks. From the time a needle is withdrawn from a patient, until it is inside a puncture-proof disposal container, a used needle is rather like a loaded gun. It can be handled safely if given one's undivided attention, but often there is a lot going on in treatment rooms. My suggestion to health-care workers is that they should yell "...NEEDLE..." loudly as they withdraw one from a patient, and everybody else who is present should freeze and be mindful of the needle until it has been safely disposed of.

The problem of handling contaminated needles became a moral issue in medicine when a retractable syringe became available [5]. This needle disappears into the body of the syringe immediately after delivering its contents. The unit cost for this retractable syringe is currently about 50 cents. The unit cost of conventional needles is much lower, and a 1000-bed hospital may use about 500,000 needles per year. Hospital administrators are therefore probably hung up on the incremental annual cost of about $250,000. Health-care workers, on the other hand, should and probably do know that they save their employer less than 50 cents each time they risk exposure to a contaminated needle. If hospitals were required to use retractable needles, the unit cost could come down very rapidly and the difference might eventually become negligible. This is because of the well-known learning curve effect [6], which says that the unit cost of almost anything decreases by about 25% for each doubling of its cumulative production.

Who should decide whether health-care workers should risk exposure to contaminated needles at an incremental benefit to their employers of less than 50 cents per exposure? It is a moral issue because health-care workers' lives are being shortened by the decision that most hospital administrators have made to date. The moral aspect of the issue is probably magnified because anecdotal evidence suggests that talented individuals are leaving active health-care delivery to pursue other, safer opportunities. If this is true, the remaining pool of health-care workers contains relatively untalented and apathetic individuals. Is this the kind of health-care worker you want to encounter when your health is at stake?


  1. Michael K. Myerhoff, "Molding Morality," Hemispheres Magazine, October 1998.
  2. Ira Byock, "Dying: After the Court Ruling," The Wall Street Journal, 06/27/1997.
  3. MacLean Center for Clinical Medical Ethics, "Physician Codes and Oaths."
  4. Occupational Safety and Health Administration, "Needlestick Injuries," revised November 2, 1998.
  5. Phillip Zweig and Wendy Zellner, "Locked Out of the Hospital," Business Week, March 16, 1998, pp. 75-76.
  6. S. Maital, "Economic Concepts for Engineers and Managers," MIT Advanced Study Program.

(last updated June 4, 1999)

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