Catastrophe Ethics: How to Choose Well in a World of Tough Choices

Modern life can be full of tough and unsatisfying choices. On one hand, everything we do seems to matter and have great importance. But on the other hand, it can sometimes seem it’s all for nothing. To Travis Rieder, a faculty member at the Johns Hopkins Berman Institute of Bioethics, this realization led to an obsession in recent years with answering the question: How do each of us live a morally decent life in an era defined by problems that are too big and too complex for any one of us to solve by ourselves?

Rieder’s attempt to wrestle with this question led to his new book, Catastrophe Ethics: How to Choose Well in a World of Tough Choices (Dutton), a warm and personal guide that provides the tools to build a strong moral compass in today’s world.

Read an excerpt from Time Magazine.

From seemingly mundane issues like whether to use a disposable plastic water bottle, to booking a flight for a vacation, to bigger questions like investing in an electric vehicle or having children, Rieder shows how to navigate the issues that often seem to have no good or easy answers. The decisions people make daily all contribute to massive, structural, collective problems.

Catastrophe Ethics includes a tour of the contributions of philosophers like Plato and Kant, as well as old fashioned ethics exercises like trolley problems that involve sacrificing one person on a track for several people. But as Rieder points out, people need to expand their understanding of ethical concepts for modern society.

“I don’t think an ethic of purity is realistic, because we cannot excise ourselves from the massive problems of today,” Rieder says. “But I also want to resist the slide into nihilism. Just because you can’t save the world by yourself doesn’t mean that what you do doesn’t matter.”

Rieder is the Assistant Director for Education Initiatives, Director of the Master of Bioethics degree program, and Associate Research Professor at the Berman Institute. He is also a faculty affiliate at the Center for Public Health Advocacy within the Johns Hopkins Bloomberg School of Public Health.

In the book, Rieder offers an ethics starter kit to help readers solve the problem he calls “The Puzzle”: How do each of us live a morally decent life in an era defined by problems that are too big and too complex for any one of us to solve by ourselves?

Other topics include:

  • How to realize that even the most personal, intimate decisions do not escape responsibility and that how one chooses to live does matter, even if our actions don’t seem to make much of a difference. Whether it is through our decisions to travel, commute long distances by car, or even just our choices about what to eat, everyone contributes to many massive systems that cause harm—most of them without knowing it. Although it can feel that what we do does not matter, that line of thinking can lead to moral emptiness. Rather, facing a problem head on can lead to finding meaning.
  • Why ethics is hard to understand. Philosophers like Kant and Plato are important, but they did not face the same issues that we do today. There’s also the added difficulty of how to determine what we should do and how we should live, especially when psychological pressures make it seem like the choices that should be made are obvious.
  • How our moral duties include not engaging in disinformation. We all learn about the world every day and participate in the spread of information through discussion with others. We need to take care with how we get information, how we share that information, and holding others accountable whether they are family or friends, or even public figures.
  • That ethics is for both sides of the political spectrum. There are multiple ways to live a good life. With all the possibilities of political and personal engagement, it’s not a question of either/or, but of what specifically aligns with our values, preferences, and strengths.
  • How to use your moral tool kit. How can we decide what efforts to participate in and where to contribute our effort? One way is to map out the kinds of reasons that we have to withdraw from morally problematic activities and engage in good ones, and then to take a clear-eyed look at the challenges that stand in our way. We aren’t required to do everything, but we ought to do something, and this process can help us to organize our efforts.

“In a world where nearly everything we do implicates us in various systems and structures, there are a lot of opportunities to participate in good and bad, and so a lot of careful reasoning to do,” says Rieder. “The bad news is that this can feel overwhelming: everything we do seems to matter. But the good news is that we get to matter. The moral work is constant and creative, as we need to (get to!) decide constantly how to structure our lives so as to respond to the threats around us.”

Travis Rieder Publishes New Book, “In Pain”

For Travis Rieder, Research Scholar and Director of the MBE Program at the Berman Institute, experience with opioids began after a 2015 motorcycle accident. The medication helped him through six operations but, as he recovered from the injuries, he discovered that withdrawal from the drugs caused excruciating pain of its own. Rather than risk addiction by following his doctors’ advice to return to the opioids, Rieder endured the struggle of withdrawal. Combining this harrowing experience with his professional training, Rieder has written In Pain, a new book published this week by HarperCollins.

Media coverage associated with the book’s publication includes:

Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system.

Kirkus Reviews calls In Pain “A bioethicist’s eloquent and riveting memoir of opioid dependence and withdrawal—a harrowing personal reckoning and clarion call for change not only for government but medicine itself, revealing the lack of crucial resources and structures to handle this insidious nationwide epidemic.”

The book arose from a 2017 essay Rieder published in Health Affairs,entitled “In Opioid Withdrawal, With No Help in Sight.” An essay adapted from In Pain appeared in the June 17 Wall Street Journal.

2018-19 Seminar Series

Leading bioethics scholars from around the world lecture on vital issues in the field at our biweekly Seminar Series. Lectures, held at lunchtime, are free and open to the public.

2018-2019 Berman Institute Seminar Series
Seminars are video recorded and posted on our YouTube channel.

Upcoming Seminars

May 13, 2019
Holly Fernandez Lynch, JD, MBE
“Evaluating IRB Quality and Effectiveness”
Seminar Details
Feinstone Hall

Past Seminars

September 24, 2018.
Jonathan Moreno, PhD
“Bioethics is Advocacy: Is That So Wrong?”

October 8, 2018
Travis Rieder, PhD
“Bioethics, Pain Medicine, and America’s Opioid Crisis”

October 29, 2018
Matteo Bonotti, PhD
“Opportunity Pluralism and Children’s Health”

November 12, 2018
Peter Buxtun
“Marked Men: In Case You Didn’t Know about Tuskegee”

February 11, 2019
Alex John London, PhD
“Ethical and Regulatory Issues With Autonomous Vehicles”

March 11, 2019
David S. Jones, MD, PhD

March 25, 2019
Marion Danis, MD
“Engaging the Public in Setting Health Care Priorities”

April 8, 2019
Brian Carter, MD
Hutzler-Rives Memorial Lecture: “Insights from patienthood: A pediatrician and bioethicist’s reflections on pediatric palliative care”

April 22, 2019
Effy Vayena, PhD
“Digital Health Ethics: The Systemic Oversight Approach”

Maria Merritt, PhD

HONORS AND AWARDS

  • Hastings Center Fellow, elected December 2020
  • Recognition for teaching excellence as principal instructor of JHSPH course, Ethics of Public Health Practice in Developing Countries (221.616.01: classroom), 4th term 2016-17, 2015-16, 2014-15, 2012-13, and 2011-12; (221.616.81: online), 4th term 2017-18 and 2016-17; and as principal instructor of Ethics in Global Health Practice (604.603.86), 2018-19.
  • Student Assembly Special Recognition Award for Outstanding Commitment to Student Success, 2017
  • Principal Investigator, NIH award number 1R01AI114458-01A1, 2015-19, “Assessing Social Justice in Economic Evaluation to Scale up Novel MDR-TB Regimens” (award issued by National Institute of Allergy and Infectious Diseases)
  • Recognition for teaching excellence as principal instructor of JHSPH course, Ethics of Public Health Practice in Developing Countries (221.616.01), 4th term 2015-16; 2014-15; 2012-13; and 2011-12
  • Co-Investigator, NIH award number 1R01AI085147-01A1, 2010-14, “Ancillary Care in Community-Based Research: Deciding What to Do” (PI Holly A. Taylor; award issued by National Institute of Allergy and Infectious Diseases)
  • Greenwall Faculty Scholars Program in Bioethics career development award, 2009-12, “Researchers’ Obligations in Community-Based Research: Resolving Dilemmas of Care”
  • Faculty Innovation Fund, 2007-08, Johns Hopkins Bloomberg School of Public Health, “Ancillary Care in Public Health Intervention Research in Resource-Limited Settings: Researchers’ Practices and Decision-Making”(Co-PI Holly A. Taylor)
  • Faculty Fellow, Edmond J. Safra Foundation Center for Ethics, Harvard University, 2005-06
  • Postdoctoral Fellow, Department of Clinical Bioethics, National Institutes of Health, 2000-02
  • Rhodes Scholar, Oxford University, 1987-90

Alan Regenberg, MBE

Alan is also engaged in a broad range of research projects and programs, including the Berman Institute’s science programs: the Stem Cell Policy and Ethics (SCOPE) Program; the Program in Ethics and Brain Sciences (PEBS-Neuroethics); and the Hinxton Group, an international consortium on stem cells, ethics and law; and the eSchool+ Initiative. Recent research has focused on using deliberative democracy tools to engage with communities about their values for allocating scarce medical resources like ventilators in disasters like pandemics. Additional recent work has focused on ethical challenges related to gene editing, stem cell research, social media, public engagement, vaccines, and neuroethics. (Publications)