"F" Is for the Future

By Margaret R. McLean

If there is one thing that continues to fascinate us, it is the future. Whether it is the lure of the unknown or the promise of better days, we dream of tomorrow. Sometimes, we focus so much on the future that we forget about the present; at other times, the daily grind leaves no room for anticipation. Whether embraced or ignored, the future always comes.

Ethics asks us to think about both what we do now and the future that we expect. It asks us to act now and to plan for the future. There is a group of ethicists who believe that the future is so important that we ought to base all of our decisions on what is to come. Such people look to the future for guidance and ask questions about the results of our actions. They pose questions such as: "How will the spending of health care dollars now affect our children?" "How will today's cigarette or glass of wine affect future health?" "How will full financing of prenatal care for pregnant women affect the well-being of the mothers and their children?" Those who look to the future argue that it is the consequences of what we do--be it spending money or lighting a cigarette--that determine what should be done.

For those who concern themselves with results, doing the right thing resides in doing the most good for as many people as we possibly can. Doing the right thing requires that we look at the short term and long term effects of what we do. Doing the right thing asks who is helped and who is harmed by what is done.

We recognize that the future is uncertain but we dare to take our "best guess" at how our judgments will turn out. When we look to tomorrow, we do so with humility and a clear understanding that we do not have a corner on the truth. Things may not turn out as we planned; they may be better, they may be worse. But, we continue to be tutored by the past, to live in the present, and to anticipate the future--the ethical life demands no less. We act, for doing nothing also has its consequences. The future comes whether we plan for it or not; it seems best not to ignore it.

Margaret R. McLean is director of health care and biotechnology ethics at the Markkula Center for Applied Ethics.

Return to The ABC's of Medical Ethics.

Posted August 2006