Philosophical Review

Man, Mind and Morality: The Ethics of Behavior Control by Ruth MacklinReview by: Stuart M. Brown, Jr.The Philosophical Review, Vol. 93, No. 1 (Jan., 1984), pp. 104-106Published by: Duke University Press on behalf of Philosophical ReviewStable URL: http://www.jstor.org/stable/2184417 .

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BOOK REVIEWS

of such feelings) will seem severely limited in the caring professions, and literature (which expresses and evokes feeling) will seem central. Although Downie and Telfer in their Conclusion recognize this mistake (p. 160), throughout much of their book they appear to be making it.

STUART M. BROWN, JR.

Cornell University

The Philosophical Review, XCIII, No. 1 (January 1984)

MAN, MIND AND MORALITY: THE ETHICS OF BEHAVIOR CONTROL. By RUTH MACKLIN. Englewood Cliffs, NJ., Prentice-Hall, 1982. Pp. x, 130.

This is the second book in the Prentice-Hall Series, Philosophy of Medi- cine. In it, Ruth Macklin examines the ethics of behavior control. It is a short book of six chapters, each some twenty pages long, with minimal footnotes and a few suggestions for further reading. Of the six chapters, the first three are largely introductory, providing a theoretical foundation for the consideration of behavior control in institutional settings, which Macklin regards as posing the most pressing and serious moral problems. Such a book has been badly needed for some time, ever since interest in philosophy of medicine and biomedical ethics was first kindled over a decade ago. Unfortunately, Macklin's book is seriously flawed.

The major flaw is theoretical, the failure to provide an adequate descrip- tion of the set of phenomena comprising behavior control and to mark the boundaries which separate these phenomena from other related ones.

In this book [writes Macklin] I employ the notion of behavior control in its widest sense, to include everything from weak forms of emotional or intellec- tual influence and subtle efforts to shape ideas, to various modes of psycho- therapy, to invasive procedures that alter the brain or chemical workings of the body. What this usage lacks in precision, it gains in comprehensiveness and easy reference to a variety of ways of altering people's psychological disposi- tions (p. 2).

But this alleged gain in comprehensiveness and easy reference is pur- chased at the cost of ambiguity and muddle. Behavior control in its strict sense comprises forms of activity in which one agent regulates the behavior of another agent. These forms of activity have a proximate aim, which is regulation, and the activity itself is a means, employing some one of an array of techniques including deception, coercion, inducement, drugs, and surgery. This aim in conjunction with the use of these means subjects one

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person or sentient creature to the will of another and poses the moral problems of behavior control. It is to learn about the problems of behavior control in this restricted sense that general readers, teachers, and students will read Macklin's book. By contrast, Macklin's notion of behavior control in its widest sense is equivalent to behavioral change in any form, the forms which pose moral problems as well as those which do not. Behavioral change includes our capacity to learn from others and the capacity of others to teach us. It includes our capacity to examine critically our own goals, to modify them for good reasons, and to adopt appropriate new means to their attainment. It includes the capacity to adapt our behavior intelligently to our changing circumstances and surroundings. Behavioral change covers the whole of ethics and large areas of anthropology, biology, and psychology as well. Behavior control in Macklin's widest sense includes even self-control.

"Control of one's own behavior," Macklin writes, "must surely be thought of as part of the larger domain of behavior control" (p. 9; cf. pp. 34, 39). To which we must reply: surely not, if our interests in it are the moral issues posed by the regulation of one person's behavior by another. The kinds of moral issues posed by such regulation cannot even arise for clear cases of self-control.

On this view of behavior control as behavioral change, rational persua- sion aimed at changing behavior, either our own or another's, must be regarded as one of the techniques of behavior control alongside deception, coercion, psychosurgery, etc. Just as we can ask whether some of these techniques are generally preferable to others-coercion to deception, say, or coercion and deception to psychosurgery-so we may ask whether ra- tional persuasion is generally preferable to nonrational methods. Macklin actually asks this question, and in a three-paragraph section entitled "Rea- sons for Preferring Rational Methods" answers it in the affirmative. Not surprisingly, her answer is tentative and incomplete. The surprise is that her final appeal is to something very like autonomy as an outcome or consequence of rational behavior:

Rational behavior leads to these characteristic outcomes: the capacity for self- control; an ability to direct one's life purposefully and successfully; and per- haps most importantly, the proper assumption of moral responsibility. These are norms and virtues which people actually strive to attain. In the end, such values may be ones for which no further argument or foundation can be provided (pp. 39-40).

In brief, rational persuasion is preferable, not because it directly respects and protects autonomy, but because employed as a means in behavior control it tends to produce autonomous persons as a characteristic outcome.

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But this provides no foundation at all for an ethics of behavior control. As an argument, it is circular. Quite apart from that, however, it provides the wrong reason for preferring rational persuasion to nonrational meth- ods. It is just false that in particular cases we employ rational persuasion instead of deception or coercion on any such general grounds as these. The primary moral reason for employing it is that, presupposing an in- teraction of autonomous persons, rational persuasion directly respects and preserves their autonomy, leaving them free to do as they choose. Rational persuasion is morally preferable, because it does not subject one person to the will of another. It is preferable precisely because it is not a case of behavior control in the strict sense. How if at all we justify the high value we place upon autonomy is another matter. This is one of the points on which moral theories disagree; Macklin may be right in suggesting that there is no justification for it. But given this value, then rational persuasion exemplifies, respects, and preserves it.

When we are acting autonomously-doing what, upon reflection, we really want to do-rationality, in Macklin's view, has a dual guise: it is both the means by which we regulate our own behavior and a constituent ele- ment or aspect of our autonomy. But how is this possible? Rationality does have different uses and guises and enters into behavior in different ways. But how can it simultaneously be both a means to and an element of autonomous action? Macklin fails to tell us. She does not explain how in autonomous action rationality can be a means, nor does she provide us with any systematic analysis of autonomy and its relationships to ra- tionality, freedom, and self-control. She recognizes the central importance of these ideas and treats each of them separately, two of them (freedom and rationality) in considerable detail. But she relates them to each other only casually and in widely separated passages. In one sentence, she relates freedom and autonomy (pp. 4-5); in another, autonomy and informed consent (p. 32); in still others, freedom and rationality (p. 36) and ra- tionality, autonomy and self-control (p. 39). Sentence by sentence, the pieces of a theoretical foundation are all present. But they are never as- sembled, fitted to one another, and mortared in place.

This weakness in the theoretical foundations may explain the blandness which characterizes Macklin's position on the practical moral issues. Al- though she takes the issues seriously, she has no consistent, sharply de- fined point of view on them. She is judicious, balanced, noncommittal. She does not come down consistently on the side of autonomy or indeed on any side. This may be only good policy in a book of this kind, but I personally find it disappointing. Moral philosophy should be able to do more.

STUART M. BROWN, JR.

Cornell University

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