Central Consideration for this Article: How can understanding the difference between knowledge and wisdom promote people to make more ethically sound decisions?
Emily Hagen graduated from Cornell University in May 2017, with a degree in Human Development. In college, she realized her passion for bioethics and conducted research on the topics of wisdom and ethical decision making in the context of medicine. She currently works in New York City and is conducting clinical research on kidney cancer, as well as applying to medical school.
Jen: Emily, thanks so much for being here today. We’re going to jump right into the big questions. How do we as human beings learn what is ethical?
Emily: I’m happy to be here! So a big part of that involves reflection, critical thinking, and careful processing of our experiences and observations – to uncover what we believe to be right or wrong. A class that really solidified interest in bioethics was called Ethical Challenges in the Brain and Behavioral Sciences. I studied frameworks in ethical reasoning, such as Dr. Robert Sternberg’s eight step model of ethical reasoning. We also studied firsthand accounts of ethical dilemmas that professors and students faced in their psychology work, such as when teaching and conducting research. We assessed the framework the person in the scenario used, considering what they did well and what they perhaps could have done differently to promote the most ethical behavior. This class was a small, discussion based course. Even though I didn’t live through the experiences that these students and professor wrote about, I was able to gain an understanding through analysis and reflection of their stories. To me, this meant considering what is ethical, that is, when and how did they make sound decisions and where was ethics possibly breached in their actions. However, I don’t think you take just one class relating to ethics and then know what’s ethical. I think it is an ongoing process and also involves our own lived experiences.
Jen: So “ethical reasoning” is one type of intelligence. But there are other types of intelligence, for example, the type that allows someone to acquire the knowledge to do well on the SAT. Does the latter type translate into ethical reasoning?
Emily: Factual knowledge is a type of intelligence that allows someone to do well on knowledge-based tests. It is also known as crystallized intelligence. Ethical reasoning and crystallized intelligence are two different realms. The skills that we use to engage in strictly knowledge based questions differ from how we approach ethical reasoning. An ethical dilemma can involve people’s emotions, conflicts of interest, and various stakeholders. Knowledge will be important for unraveling that dilemma and gaining context, but I think of ethical reasoning as taking knowledge further in realizing how to apply that knowledge in effective ways. That is why ethical reasoning and knowledge are different. This was evidenced by the ethical reasoning study I conducted. A main suggestion of the study is that one’s ability to engage in ethical reasoning in the context of medicine is different from one’s ability to use cognition and knowledge. Also, the study found no statistically significant differences in the participants’ ability to engage in ethical reasoning in medicine between pre-medical and non-pre-medical students. This implied that the possession of domain-specific knowledge, in this case, pre-medical science, does not suggest greater ethical reasoning abilities in the context of medicine. Therefore, I don’t think you can think that just because we are teaching knowledge and measuring how we do well on tests in school, we are also making great future leaders, decision makers, and ethical professionals that our world needs.
Jen: This makes me think of a doctor, who must have the scientific understanding (the knowledge) and also the bedside manner (the ethics). How would you say the current medical school admissions process is evaluating candidates for their ethical reasoning?
Emily: I think in more recent years, medical schools have fortunately been doing a good job at assessing ethical reasoning and these more humanistic skills in their applicants. When discussing the medical school application process with my uncle, who is a physician, he said that when he applied to medical school, admissions was more-so based on GPA and MCAT scores. I think this presupposes that if you obtained good grades and did well on the MCAT – you’re smart and deserve to go to medical school. How I see it, medical schools today are expressing a greater interest in the more humanistic dimensions of people. Now, medical schools are not just looking at our GPAs and MCAT scores. They are asking us to write thoughtful essays, which can display our critical thinking skills and ability to reflect on our experiences. They also demonstrate how we gained important lessons and skills from our experiences, and how they can make us better doctors. Also, the MMI (multi-mini interview) interview format is an example of this shift. The MMI is a respected measure of an individual’s interpersonal and critical thinking skills, which cannot just be seen by looking at one’s GPA or MCAT scores. Additionally, the Association of American Medical Colleges has a list of core competencies that medical schools look for in their applicants. They are a framework for understanding how prepared an applicant is for medical school in regard to humanistic skills – one of them is Ethical Responsibility to Self and Others and is defined explicitly.
Jen: So you’ve done research on wisdom. What is it, and how does it relate to ethics?
Emily: Wisdom is the practical application of knowledge. This involves the use of one’s experiences and good judgment. There are two major ways of thinking about wisdom. Implicit theories of wisdom are laypeople’s views of wisdom. Studies have surveyed people’s thoughts of wisdom, and revealed that people see wise people as experienced, empathic, and pragmatic. Explicit theories are experts’ views on wisdom, such as those of Erik Erikson (the stages of psychosocial development) and Robert Sternberg (balance theory of wisdom). Regardless of the definition of wisdom we’re referencing, wisdom is important. Wisdom leads to effective decisions and judgments that can improve people’s lives. I believe that when wisdom is practiced, human dignity is respected and a common good is prioritized.
Wisdom relates to ethics because when people act and make decisions wisely, they are also acting ethically. Specifically, they are being considerate of the complexity of the situation at hand, such as the myriad factors affecting the decision, the emotions of the people involved, and the potential implications of their decision. As Sternberg posited, positive ethical values are a key ingredient for achieving a common good, which is an end goal of wisdom.
Jen: How and why should ethical reasoning be fostered among members of society?
Emily: In a general education sense, I think it is important that we teach students modes of thinking that will allow them to make ethical decisions about everyday life problems they may face. These include effectively solving problems, critically thinking, reflection, and balancing interests. I think we can start teaching ethical reasoning, and wisdom too, to students of young ages. For example, when middle school students read a book in English class, they can be taught not just to think about what happened, but to also consider how the situation relates to everyday life, the decisions people made, and how the chain of events led to outcomes in the book.
Our society currently advances students on the basis of test scores. If we are mainly focused on the development of knowledge, and yet decisions with arguably a lack of ethics are still occurring, doesn’t that then raise questions about the importance of knowledge? If a person has knowledge, but doesn’t know how to apply it, what good is that going to do the individual and the world? For every discipline, I believe that we can make the case for why ethical reasoning and wisdom are important. Every discipline would benefit from the ability of people to make sound, wise decisions that respect people and promote a more civilized world. I believe complex issues facing the world today cannot be solved with knowledge alone.
Cover Photo Source: https://journalofethics.ama-assn.org/article/balancing-practice-policies-patient-needs/2015-05