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Do I see that an old woman is being humiliated, or do I infer it? Moral perception on a night shift

Elin Hedqvist Fellow
· 5 replies
Meta-ethicsAnalyticModern EuropeanArthur SchopenhauerIris Murdoch#attention#iris-murdoch#moral-perception#nursing
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Its coordinates: 3.1 Meta-Ethics · 3.1.1 Moral Realism vs Anti-Realism · 3.1.2 Moral Semantics +1 more

Last month, when I went with one of our residents to the hospital, a senior doctor spoke to her as if she were not there, discussing her bowels with a junior doctor across her bed. I did not reason my way to the thought that this was humiliating for her. I saw it, the way I see that someone is cold. Her face told me, and her hands on the sheet.

The junior doctor, a perfectly decent young man, saw nothing. When I raised it afterwards he was genuinely surprised.

This made me think about whether moral knowledge works like perception. Some philosophers apparently say it does: that we perceive cruelty or humiliation directly, the way we perceive colour, and that ethical training is partly training in what to notice. Iris Murdoch's The Sovereignty of Good (1970) has an example I keep returning to: a mother-in-law who thinks her son's wife vulgar and tiresome, and who, by looking again, justly and lovingly, comes to see her as fresh and spontaneous. Murdoch's point is that this change of vision is moral work, even though the mother-in-law does nothing outwardly.

Two questions for the forum:

  1. If moral features can be perceived, why did the junior doctor not see what I saw? Is that a failure of vision, or of training, or of character?
  2. Can perception mislead in ethics the way it does with optical illusions? I have certainly “seen” rudeness that turned out to be exhaustion.
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5 replies

  1. Nadia Haddad

    Fellow

    Elin, I see the same thing on the unit where I volunteer in Montreal, and I think it is mostly training, but training of a peculiar sort. Nobody taught me to see humiliation in a dying patient's face. I learned it by being present for hundreds of them, and by being corrected now and then by older nurses who saw more than I did. That is how perceptual skill is learned in any field: by exposure and correction. Your junior doctor has mostly been trained to see results.

    Helpful · 1
  2. Priya Raghavan

    Fellow

    Cognitive science would back you on point 2. On predictive accounts of perception, what you see depends heavily on what you expect. Your mistaking exhaustion for rudeness is just what such a system does when its expectations run ahead of its evidence. If moral perception is real, it will have its illusions, and they will be predictable from what you are primed to see. That is an argument for moral perception, actually, not against it: illusions are what perceptual systems have.

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  3. Claire Dubois

    Fellow

    Murdoch took the word attention from Simone Weil, for whom attention was close to prayer: a waiting, an emptying of oneself so that the other can appear. I think that answers your first question. The junior doctor was not looking at the patient at all. He was looking at a case. Seeing her required him to stop being the protagonist of the scene for a moment, which is a moral achievement, not just a perceptual one.

    Helpful · 3
    1. Elin Hedqvist

      Fellow

      Claire's “looking at a case” is exactly right, and I will borrow it. I spoke to the junior doctor again when he came by and asked him what he had noticed about her. He listed her numbers perfectly. I think that is the answer to my first question: his attention was full, but full of the wrong things. Training can change that. I am less sure it can be done by argument alone.

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  4. Moon Ha-eun

    Fellow

    Hearing is trained in exactly this way. A beginner cannot hear that a note is slightly flat; after a year, they wince. Nothing new was added to the sound. Their ears learned to register what was always there. I have always found Schopenhauer's idea that compassion is a kind of seeing-through the separation between people more convincing when I think of it like that, as a hearing that has to be trained.