THE INTEGRATIVE POWER OF "WHY"
Somerville is Professor of Bioethics in the School of Medicine
at the University of Notre Dame Australia. Until recently, she
was Samuel Gale Professor of Law, Professor in the Faculty of
Medicine, and Founding Director of the Centre for Medicine, Ethics
and Law at McGill University, Montreal. Her most recent book is
Bird on an Ethics Wire: Battles about Values in the Culture
Wars. This article originally appeared in Commentt
been writing about the role of amazement, wonder, and awe in our
lives and how these experiences might be connected with finding
meaning. To find meaning we need to feel that our lives have a
purpose, that we have what concentration camp survivor Viktor
Frankl called a “why” to live. So, as I prepared this
article, I mused on whether the presence or absence of experiences
of amazement, wonder, and awe might in some way also be connected
with the presence or absence of “integrity.”
of amazement, wonder, and awe can help us to find meaning, that
is, to feel that our lives have a purpose or an ultimate “why,”
might those experiences, along with our finding meaning, also
be connected with the generation of integrity or integration,
especially moral integrity?
there is a thread linking our experiences of amazement, wonder,
and awe; our finding of meaning; and whether we have integrity.
The meaning or purpose we find in our lives can be described as
the integrating power of the “why.” I propose that
giving people a why is necessary if they are going to live integrated
lives, which in turn is the necessary condition of their having
integrity. Let’s explore this claim.
OF INTEGRITY IN THE CONTEXT OF ETHICS
let’s look at what the word “integrity” means.
When in doubt start from the dictionary definition. I found that
there are two senses of “living with integrity,” and
I want to consider how wonder, amazement, and awe conjoins them.
Here’s the definition of “integrity”:
the quality of being honest and having strong moral principles.
synonyms: honesty, uprightness, probity, rectitude, honour,
honourableness, upstandingness, good character, principle(s),
ethics, morals, righteousness, morality, nobility, high-mindedness,
right-mindedness, noble-mindedness, virtue, decency, fairness,
scrupulousness, sincerity, truthfulness, trustworthiness
the state of being whole and undivided.
synonyms: unity, unification, wholeness, coherence, cohesion,
undividedness, togetherness, solidarity, coalition
definition captures the two ways in which integrity can be viewed.
In the first sense, “ethics” is a synonym for “integrity,”
and this definition of “integrity” is also an excellent
definition of “ethics.” It describes the characteristics
of a person with integrity, which also describe an ethical person
or group of people, organization, institution, or society.
second definition defines integrity in the sense of an entity
being integrated as a whole in contrast to its being disintegrated.
What interests me is the relation between the two definitions:
that integrity in the sense of integration, especially moral integration
or consistency, might be required in some circumstances to promote
and realize integrity or ethics in the first sense.
INTEGRITY WHEN WE ENCOUNTER IT
not easy to delineate what constitutes personal integrity, at
least precisely. It could be one of those entities that we know
is present, or indeed absent, but it’s difficult to articulate
exact, comprehensive criteria that could be universally and consistently
applied to determine a person’s integrity. Perhaps we intuitively
judge integrity on the basis of how a person acts toward others.
And maybe we can only judge it in others, not ourselves.
whom we regard as having integrity are those we cannot imagine
acting contrary to their conscience, even at great expense to
themselves not to do so. Maybe we can judge it in ourselves on
the basis of whether we follow our own conscience. Might the test
of integrity be that we do not see conscience as a commodity?
For those with integrity, conscience is never for sale, no matter
how high the reward offered or serious the harm to oneself avoided.
we could think about integrity in terms of healing and, its opposite,
disintegration, whether that disintegration is physical, mental,
or spiritual in nature.
is also a challenging term to define. For instance, Balfour Mount
and Michael Kearney, my former colleagues in the Faculty of Medicine
at McGill University, defined healing as “a relational process
involving movement towards an experience of integrity and wholeness.”
It has been operationally defined by Thomas Egnew as “the
personal experience of the transcendence of suffering.”
paper that my colleague Donald Boudreau and I wrote for the British
Medical Bulletin, we proposed that euthanasia is not medical
treatment, because it contravenes the healing mandate of medicine.
We argued “that healing does not require biological integrity.
Although it may seem counter-intuitive at first glance, it has
been pointed out that if a sick person is able to construct new
meaning and is able to achieve a greater sense of wholeness, that
individual may ‘die healed.’” So healing the
person, as compared with their body, requires recovering a sense
of “wholeness” or integrity.
only individuals need to be healed. Families, communities, organizations,
institutions, societies, and our world also need healing.
healing involves reintegration in a situation that threatens disintegration,
whether physical, mental, or spiritual in nature. Reintegration
promises restoration of integrity in one or more of these regards;
disintegration, loss of integrity in one or more of these regards.
a person has found meaning in their lives—that is, has found
a unifying purpose that informs their actions—can be especially
influential in decision-making in situations in which the person’s
integrity is challenged. In A Doctor’s War, Rowley
Richards, an Australian medical doctor who was a prisoner of war
in World War II, speaks of maintaining one’s integrity in
making decisions in horrible circumstances:
as I could see, what distinguished one human from another in captivity
was his ability to make very different decisions: to accept his
fate or make active judgements about the life he chose to lead,
regardless of his circumstances. A prisoner of war might be treated
like an animal, but he still holds the power to choose to not
become one, or act like one. Equally, a guard might be ordered
to act like an animal, but he still held the power to choose not
to become one, or at least one not so vicious. The life of a human
is always filled with decisions. The ultimate challenge for us
as prisoners of war and individuals, was to search for the right
kind of answers that might lead us home—with our integrity
observation, in turn, again brings to mind Frankl’s insight
that when you have a “why” to live you can find a
“how.” Frankl wrote, “Any attempt to restore
a man’s inner strength . . . has first to succeed in showing
him some future goal. Nietzsche’s words, ‘He who has
a why to live for can bear with almost any how,’ . . . Whenever
there was an opportunity for it, one had to give them [the concentration
camp victims] a why—an aim—for their lives, in order
to strengthen them to bear the terrible how of their existence.”
words, having a “why” to live is necessary to prevent
us from “falling to pieces,” that is, disintegrating.
OF LOSS OF INTEGRITY
this perhaps offer an explanation for the loss of integrity in
our societies? Have we lost a “why” to live? Is this
loss of purpose and meaning the source of our disintegration?
without a purpose, we can no longer know what a “coherent”
life is, which makes it very difficult, if not impossible, to
find integrity. One can’t find something that one does not
recognize. It’s even more difficult than finding a needle
in a haystack—at least we know what the needle looks like.
forces of modernity that often fragment and compartmentalize our
lives include loss of religion; loss of experiences of transcendence;
broken families and loneliness; the predominance of a ubiquitous
philosophical base of moral relativism, which makes it harder
to find integrity, as there is no solid foundation for our values
and decisions, no givens; radical individualism at the expense
of the “common good”; a failure of courage and fear
of speaking out against ethical wrongdoing; feeling powerless
to protest “post-truth” developments (for instance,
we know politicians are lying but we expect that they will and
we are powerless to change it); and loss of respect for and trust
perhaps many, of these losses occur for good reason. Take, for
instance, just the last one, loss of respect for and trust in
authority, especially on the part of young people. Two anecdotes
allow us to easily understand that loss, indeed that it is inevitable.
been reported that police in Sydney, Australia, have been fulfilling
the quota of RBTs (Random Breath Testing for alcohol) they are
required to administer by taking the test themselves and including
those results in their reports. There are also reports of ambulance
workers who are addicted to opioid narcotics, using the injectable
Fentanyl in the ambulance supplies and substituting it with ampoules
of normal saline or water. Apart from other wrongs, this could
cost some people needing emergency care their lives.
profoundly distressing to recognize, it’s also possible
that a person, family, community, or even a society can lose their
physical, mental, or spiritual integrity as a result of the acts
of others undertaken with an intention to achieve just that. Situations
in which this can happen include torture and the appalling, dehumanizing
ways in which, for example, asylum seekers and refugees, aboriginal
communities, homeless people, people with disabilities, or old
and fragile people are often treated. We are disintegrated because
others have torn us apart.
INTEGRITY: LESSONS FROM BIOETHICS
we counteract these losses of integrity and promote integration,
particularly in a world where we don’t agree on the “why”?
We might consider some lessons from bioethics, not least because
implementing ethics promotes integrity and vice versa.
and scientific ethics burst into public consciousness in the 1970s
with the first heart transplant and the first IVF baby. We were
astonished and asked, “Are these developments ethical?”
Up to that time we almost always assumed that we could trust physicians
and scientists, because they were ethical and should decide what
should and should not be done. Questioning the ethics of the use
of the powerful new technoscience, such as genetic and reproductive
technologies, led to public discussion of ethics, and this spread
to questioning the ethics of other institutions, organizations,
and professions, including politicians and governmental bodies.
to ensure that scientific research was ethical, we learned valuable
lessons with wider application. First, ethics must be embedded
in science from its inception and not be seen either as a hurdle
that is jumped at the beginning of the research and can then be
forgotten, or as simply an add-on after the research is completed.
In short, ensuring ethics and the integrity of scientists and
scientific research is an ongoing process, not an event.
we choose to research, who funds it, who undertakes it, who benefits
from it, who is put at risk or harmed, for what purposes it is
used, and so on all raise ethical issues that must be addressed.
We could no longer accept the old argument that the search for
knowledge through scientific research is value neutral and ethics
is only needed when the technology that research engenders is
must be embedded in our science from its inception through a comprehensive
and coherent system. The same requirement is true for our political
systems, our armed forces, our legal system, our financial institutions,
our commercial and business enterprises, our governments, and
is: How best to achieve that embedding? The “ethical tone”
of an institution is set by a very small number of its leaders:
if they are ethical, the institution and its employees are likely
to be ethical; but if they are unethical, the opposite is likely
to be true. As few as five people at the top of an institution
with around one thousand employees can set its “ethical
people who have been taught ethics can also bring ethics into
an institution. My anecdotal experience is that medical students
who have studied ethics and respectfully challenge their superiors’
views on ethics can cause the latter to question those views and
the conduct to which they give rise and to seek ethics education
for themselves. The most resistant group is made up of those in
the middle who have bought into the ethics of the old medical
system but have not yet reached leadership positions. In short,
a high ethical tone in an institution is set by both ethical leadership
from people at the top and ethical pressure from those at the
AND INTEGRITY IN OUR PRIVATE LIVES
goes beyond our public and professional lives and needs to be
embedded in all aspects of our lives, including our private lives.
As James Smith writes, “one of the dangerous compartmentalizations
of late modern life is to imagine that ‘ethics’ is
something that can be restricted to some sphere or compartment,
letting other facets of our lives be governed by self-interest
or profit or self-actualization or what have you. In other words,
by sequestering the ethical, we give ourselves permission to be
amoral—‘beyond good and evil,’ as it were—in
vast swaths of contemporary existence.”
intimate form of integrity is articulated in Polonius’s
advice to his son in Shakespeare’s play Hamlet:
“This above all: to thine own self be true, / And it must
follow, as the night the day, / Thou canst not then be false to
any man.” It’s easy to be true to oneself—to
be a coherent whole, to have integrity—when others agree
with the values we espouse; but when they disagree, being true
to oneself and one’s values requires courage. Personal moral
integrity is linked with courage, and maintaining it may require
integrity requires a consistency of moral behaviour. In contrast,
psychologists speak of superego lacunae—I would call them
moral lacunae: A person who in general has integrity and is ethical
can regard some acts, such as petty theft from an employer, as
not contravening ethics. These ethical lacunae are like the holes
in a Swiss cheese and can result from insensitivity, dulled moral
intuitions, or denial of wrongdoing; and loss of ethical sensitivity
in relation to them is reinforced by habitual behaviour. As with
the cheese, when the holes become too large or there are too many
of them, the structure of the cheese or moral system becomes fragile
and can collapse.
we see as harmed by such acts can affect whether we regard them
as ethical wrongdoing. Most of us are likely to see stealing from
an immigrant shopkeeper in a small corner store struggling to
support his family and whom we know personally as wrong. In contrast,
we might not see stealing the same item from a large department
store in the same way, unless the impact of our wrongdoing becomes
personalized, as when we learn that a young woman student employee
had to compensate the store for the stolen merchandise.
institutions, governments, and societies can all have moral lacunae.
When they exist at all levels, the probability of unethical conduct
and loss of integrity, in both senses of that word, is exponentially
increased. The challenge is how to plug or repair these holes
in our individual and shared moral fabric.
MORAL LACUNAE: HOW TO FOSTER INTEGIRY
in this section are by no means meant to be a comprehensive list
of ways in which we might make integrity and ethical conduct more
likely, but I hope that they might contribute to achieving that
BELONGING TO THE SAME MORAL COMMUNITY
even though we disagree on the ethics that should govern many
issues, we need to create some situations where we can experience
belonging to the same moral community. For example, whether we
are pro- or anti-euthanasia we all agree that we must relieve
terminally ill people’s pain and suffering. Where we disagree
is as to the interventions we may or must not undertake to achieve
belonging to the same moral community is likely to help us to
find more agreement than would otherwise be possible. Starting
from disagreement and often not moving beyond that also reinforces
polarization. On the contrary, starting from where we agree and
moving to where we disagree allows us to recognize that we all
want to be ethical; we just disagree about what that requires.
previously, integrity and ethics are related to the search for
meaning in our lives. To seek meaning is of the essence of being
human—indeed, the feature that distinguishes us from other
living conscious beings. Questions that arise include: Is loss
of meaning the basic issue and problem causing loss-of-integrity
postmodern ills such as corruption? Or is our mistake that we
are seeking meaning in entities, such as great financial wealth,
that cannot provide it? Can you have integrity or find meaning
when you believe there is no such entity as absolute truth, that
is, that all humans have within them a deep innate sense of right
and wrong? Does being a moral relativist (there are no absolute
truths) or a conservative (there are absolute truths) affect the
person’s integrity? Are finding meaning and having integrity
linked to the experience of transcendence?
TRANSCENDENCE AND THE ‘HUMAN SPIRIT’
is the experience of feeling that we belong to something larger
than ourselves and that what we do matters to more people than
just us, including future generations of humans. We must not leave
them a world in which no reasonable person would want to live.
component of transcendence is what I call the human spirit, “the
intangible, immeasurable, ineffable reality to which all of us
need to have access to find meaning in life and to make life worth
living—a deeply intuitive sense of relatedness or connectedness
to all life, especially to other people, to the world, the universe
and the cosmos in which we live; the metaphysical—but not
necessarily supernatural—reality which we need to experience
to live fully human lives.”
experiencing transcendence and respecting the human spirit require
us to connect with other people and to a reality larger than ourselves.
If we believe that is important because it helps us to find meaning
in life, then we are, at the least, more likely to act ethically
and with integrity than might otherwise be the case.
OUR METAPHYSICAL ECOSYSTEM
realize that our physical ecosystem—our physical environment—can
be irreversibly damaged by our conduct, unless we intentionally
act to protect it. The same is true of what we can call our metaphysical
ecosystem—the collection of shared values, attitudes, norms
of behaviour, the stories we tell each other and buy into to create
the glue that binds us together as a society, and so on—which
we must also hold on trust for future generations. Acting with
integrity and promoting this is a central requirement for honouring
there is a place for analyzing and critiquing what we see as ethically
wrong or at least regretful, that is, as lacking integrity, we
must not be only negative and finger wagging. We need to propose
a positive, aspirational ethical vision to replace that which
we see as wrong. We need to present in a compelling and persuasive
manner what we are for and the values that support that stance,
not just, as so often happens among people with conservative values,
decry the values and conduct that we are against. As explorer
Ernest Shackleton said, “Optimism is true moral courage.”
I could articulate my proposal for generating integrity and ethical
conduct in a formula:
AWA - C = H + E
which translates as “amazement, wonder, and awe” minus
“cynicism” equals “hope and ethics.” I
call it the “wonder equation.”
experience amazement, wonder, and awe in both the ordinary and
the extraordinary, whether in nature or at what 21st Century science
reveals and the astonishing new powers it gives us, which no humans
before us have ever had. Experiencing amazement, wonder, and awe
is so important because it can enrich our lives, help us to find
meaning, and change how we see the world. It can change the decisions
we make, especially regarding values and ethics and how we live
our lives. It can help us to act ethically and with integrity.
to be the only species that can experience amazement, wonder,
and awe; these capacities are uniquely human characteristics,
the very essence of our humanness. Consequently, we have an enormous
responsibility not to damage or destroy them or the opportunities
to experience them. Rather, we must hold them on trust for future
A LEGACY OF HOPE AND MEANING
do we owe to future generations? Above all, we must leave them
a legacy of hope. In doing so, we will also create hope for ourselves,
because hope is generated by a sense of connection to the future.
Hope and integrity are related, because hope makes us more likely
to ask ourselves what we owe to future generations and what that
requires of us in terms of our acting with integrity.
is the oxygen of the human spirit. Without it our spirit dies.
With it we can overcome even seemingly insurmountable obstacles.
Hope is to our human spirit as breath is to our bodies. Hope is
not passive. Just as we make war and make peace—indeed “make
love”—we need to intentionally make hope. Eliciting
hope needs to be an intentional goal.
to leave a legacy of hope can also help us to find meaning, because
feeling that our lives will have meaning after we are no longer
here—that we will have left a legacy—is an important
element in finding meaning in the present.
of hope is cynicism, which is lethal to the human spirit. Experiences
of amazement, wonder, and awe are an antidote to cynicism and,
thereby, a protector and even promoter of hope.
repeating that experiencing amazement, wonder, and awe can influence
how we live our lives, the decisions we make, what we view as
ethical or unethical, and whether we can find meaning in life
and will act with integrity.
marvel at the fact that the great diversity of all life, including
among humans themselves, is coded by just four nucleotides and
regard that fact as an unfathomable mystery, we are more likely
to accept that we have a serious responsibility, for instance,
to maintain and protect the integrity of nature and the natural,
especially the essence of our humanness. In view of the incredible
powers the new science provides, such as genetically designing
future generations, recognizing this responsibility will be central
to maintaining the integrity of ourselves and our world.
has told us that we come from stardust—every atom in our
body is billions of years old. Pondering from whom or what our
atoms might have come should fill us with amazement, wonder, and
awe; and hope, through a deep sense of connection not only to
the past but also to the future. We need an integrated past, present,
and future, which a shared religion used to provide to most individuals
and societies. That is no longer the case in secular, postmodern,
multiracial, democratic Western democracies, where radical individualism
and presentism (focusing on only what individuals want and only
the present) are the norm.
as our ancestors have done and ancient cultures continue to do,
learn from collective human memory to inform the present. And
we must engage our collective human imagination to view the future
if we are to make wise ethical decisions on which to build a future
in which individual, institutional, and societal integrity are