Are Intentions All That Matter?
Of warfare, health care, and arsenic for salt.
“Amazing Things Happen When Your Intentions Are Pure.“ You become trusting, energized, creative; make new friends . . . “the most incredible results.”
Incredible indeed. Much as I would love to believe this site, I can’t. You probably don’t, either.
Yet we sometimes talk as if good intentions erase blame. “You meant well. What happened isn’t your fault.” Sometimes that’s true, but not always. And the broader claim -- “Intentions are all that matter” – is just false.
Your intentions were good; you’re not to blame
Often good intentions absolve us. Philosophers like simple (often absurd, but useful) examples: Someone put arsenic in the salt bowl. You dip your guest’s margarita glass, and soon she dies. It’s not your fault, although you will feel terrible. (And it’s right that you do. More on that later.)
You had no desire to hurt anyone. The only thing you wanted was to help your guest enjoy the evening. The result of your effort was completely unexpected and unwanted. There is no sense in which you could be held responsible.
In real life, though, the question of blame is less clear.
The consequence was unexpected
Often the question is not whether you knew, but whether you should have known. If the seafood you served had gone bad, your intentions are only part of the picture. Seafood is tricky, and it was your responsibility to be careful.
This is dramatically true in public affairs. Take, for instance, public health programs aimed at controlling a single deadly disease (AIDS or TB, for example). They sometimes sap local health care systems. Health care professionals may flock to the higher paying and better equipped clinics. Too few can be left to help with childbirth, administer vaccines, treat diarrhea or pneumonia or malnutrition. Overall sickness and death rates can rise. Those in charge had not expected that result. Should they have?
The consequence was unwanted
That’s more complicated, too. We hide our real intentions from ourselves; it’s a normal defense mechanism. Teasing, for instance, can be affectionate and innocent, but it can also be a way to hurt or dominate. Teasers themselves might not realize what they really want. In time, perhaps aided by therapy or meditation, we sometimes learn to know ourselves better.
Examples in public policy are even more complex. Any project’s official aim can be a cover for other, less wonderful, goals. And since any project involves a lot of people, there can be a lot of different goals. To return to international public health programs: Some of the sponsors may want power or glory, some of the workers may want to build a resume or to see the world. Motives, personal or political, are usually mixed.
Still more complicated: Double effects
Much of what we do has more than one result, each expected. Injections keep a baby healthy, but they’re also painful. Being honest can clear the air, but also be hurtful. Both results are expected, and so the nurse and the truth-teller are accountable for both. It’s not enough to say “I didn’t intend the pain.”
In public affairs these issues can involve life and death. In health care, for instance, opioids can ease the suffering of a dying patient, but incidentally hasten death. In warfare, bombing a military base usually kills nearby civilians.
The issue is age-old, and there’s a widely accepted standard for thinking it through. It’s called the principle of double effect.
PHILOSOPHY SIDEBAR: The principle of double effect has several requirements: The bad effect must be (1)unintended in itself,(2) less weighty than the expected good, and (3) only a side effect, not a means toward the good end. And there must be no other way to achieve the goal.
Bombing a military base in spite of inevitable civilian deaths can satisfy all these provisions. But in World War II both sides bombed cities, hoping that massive civilian deaths would make their government surrender. In that case, the deaths were not a side effect but a means. Similarly, giving enough opioids to relieve a dying patient, even though the dose might be lethal, satisfies the principle. But an overdose given to kill the patient, in the belief that only death will ease the agony, does not.
The principle is widely used. It was first formulated by Thomas Aquinas; within Catholic circles it is doctrine.
For my purposes what matters is that “good intentions” is vague, and doesn’t settle the question of blame.
Other problems with “good intentions”
Underlying assumptions can play a role. “White savior” interventions build on the idea that native populations can’t do the job. Their knowledge, skills, and desires end up being ignored.
Cmpetence matters, too. Someone can act with an uncomplicated good intention, yet do serious harm. A pharmacist might confuse one drug with another and mis-fill a prescription. Her good intention would matter; if she had been trying to harm someone, she would belong in jail. But her good intention would not free her from accountability.
Intentions are not all that matter. Why do we keep saying they are?
Partly because they do matter. They’re just not the only thing that matters. But there are other reasons we find the idea so attractive. More on that later.
No post next week. Thanksgiving break.
Good one, Judith. I like this. It brings to attention that we must think deeply about possible consequences of acts, both personal and at a policy level. Good intentions are not an excuse for sloppy preparation or careless execution. "The road to hell is paved with good intentions." And yet, ultimately, the fear of potential bad outcomes cannot paralyze us. We must act. Sometimes we must act knowing that we may have made the wrong choice, yet doing nothing is worse (and is still an action). This is one of the ongoing challenges of every adult life.