The Heinz’s Dilemma

Another dilemma has a slightly different nature for it is widely used mainly in studies on psychology of moral development and not in philosophical analyses.

Still, it is widely known and characteristic. Heinz’s dilemma has been primarily used in L. Kohlberg’s studies¹⁷ published in 1963, and later in C. Gilligan¹⁸ in 1982. It goes as follows:

In Europe, a woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. The drug was expensive to make, but the druggist was charging ten times what the drug cost him to make. He paid $ 200 for the radium and charged $ 2000 for a small dose of the drug. The sick woman’s husband, Heinz, went to everyone he knew to borrow the money, but he could only get together about $ 1000 which is half of what it cost. He told the druggist that his wife was dying and asked him to sell it cheaper or let him pay later. But the druggist said: “No, I discovered the drug and I’m going to make money from it.” So Heinz got desperate and broke into the man’s store to steal the drug for his wife. Should the husband have done that?¹⁹

For L. Kohlberg, the situation is about a  typical conflict between two values: life and property. By answering a number of questions in an interview, it is possible to define the stage of moral development of a given person. The questions include: Is it husband’s duty to steal the drug for his wife if he can get it no other way? Would a good husband do it? Did the chemist have the right to charge that much when there was no law actually setting a limit to the price?

Why? If the husband does not feel very close or affectionate to his wife, should he still steal the drug? Why? Suppose it wasn’t Heinz’s wife who was dying of cancer but it was Heinz’s best friend. His friend didn’t have any money and there was no one in his family willing to steal the drug. Should Heinz steal the drug for his friend in that case? Why? These show the complexity of the situation and the difficulty resulting from the mentioned conflict of values. Even though the author treated this dilemma as a case primarily in a study on child development from the earliest phases to maturity, due to its structure it may be regarded as universal. Certainly, in this respect, its conclusions became part of a broader discussion, including on ethical grounds.

17 Lawrence Kohlberg, “The Development of Children’s Orientations Toward a Moral Order,” Vita Humana 1963, No. 6, pp. 11–33, reprinted in Human Development 2008, No. 51, pp. 8–20.

18 Carol Gilligan, In a Different Voice. Psychological Theory and Women’s Development (Cambridge Mass. and London: Harvard University Press, 2003).

19 Kohlberg, The Development of Children’s Orientations, p. 12.

The author understood moral development in the categories of enhancing cognitive powers of an individual and passage from the simplest methods of moral reasoning to more complex. Three fundamental levels have been distinguished: preconventional, conventional and post-conventional morality.

Each stage may further be divided into two phases. On the preconventional level: 1) Obedience and punishment orientation, where actions are evaluated in terms of possible punishment, not goodness or badness. Obedience to power is emphasized and the main question is “How can I avoid punishment?” At this level, the most probable answers to Heinz’s dilemma may be: “Heinz should not steal the medicine because he will consequently be put in prison which will mean he is a bad person. Or: Heinz should steal the medicine because it is only worth $200 and not how much the druggist wanted for it; Heinz had even offered to pay for it and was not stealing anything else.” 2) Pleasure-seeking orientation, where proper action is determined by one’s own needs. Concerns for the needs of others is largely a matter of “you scratch my back and I’ll scratch yours,” not of loyalty, gratitude, or justice and the main question is “What’s in it for me?” Probable answers are: “Heinz should steal the medicine because he will be much happier if he saves his wife, even if he will have to serve a prison sentence. Or: Heinz should not steal the medicine because prison is an awful place, and he would probably languish over a jail cell more than his wife’s death.”

Conventional level has two phases: 3) Good boy/good girl orientation. Good behavior is that which pleases others in the immediate group or which brings approval; the emphasis is on being “nice.” It can be titled also as conforming to social norms orientation. Probable answers to Heinz’s dilemma are: “Heinz should steal the medicine because his wife expects it; he wants to be a  good husband. Or: Heinz should not steal the drug because stealing is bad and he is not a criminal; he tried to do everything he could without breaking the law, you cannot blame him.” 4) Authority orientation. In this stage the emphasis is on upholding law, order, and authority, doing one’s duty, and following social rules. It can be described as law and order morality. Probable answers are: “Heinz should not steal the medicine because the law prohibits stealing, making it illegal. Or: Heinz should steal the drug for his wife but also take the prescribed punishment for the crime as well as paying the druggist what he is owed. Criminals cannot just run around without regard for the law; actions have consequences.”

Postconventional level has the following phases: 5) social-contract orientation. Support of laws and rules is based on rational analysis and mutual agreement; rules are recognised as open to question but are upheld for the good of the community and in the name of democratic values. It can be called exchanging charter of rights and freedoms orientation. Probable answers are:

“Heinz should steal the medicine because everyone has a right to choose life, regardless of the law. Or: Heinz should not steal the medicine because the scientist has a right to fair compensation. Even if his wife is sick, it does not make his actions right.” 6) Morality of individual principals. Behavior is directed by self-chosen ethical principles that tend to be general, comprehensive, or universal; high value is placed on justice, dignity, and equality of all persons.

This stage can be also described as universal ethical principles. Probable answers: “Heinz should steal the medicine, because saving a  human life is a more fundamental value than the property rights of another person. Or: Heinz should not steal the medicine, because others may need the medicine just as badly, and their lives are equally significant.”²⁰

Hence, it can be said that moral development progresses to autonomous decision-making based on principles. The more mature we are, the wider range of reason we tend to include and the more willing we are to take responsibility for the choice. However, this does not make the dilemma easier to solve; on the contrary, autonomous thinking allows discernment of more conflicting reasons resulting from conflicting values. Though the basic choice is between life and property, it may also be interpreted in the categories of conflict between an obligation to the wife and an obligation to the chemist. On one hand, we have not only an emotional relation, as predefined by the formulation of the dilemma, but also reliance on someone, dependence and trust. On the other, there is an institution demanding respect, based on precisely defined law and applying sanctions for its breach. Even if we accept that the wife’s reliance on her husband and his sense of obligation to help also result from an institution, namely marriage, it is of a different kind than property. Hence, the conflict is also between two types of institutional requirements. However, this does not provide criteria for solving the discussed situation.

Heinz’s dilemma shows yet another type of conflict. According to C. Gilligan, there are empirical proofs that the levels of moral development presented by Kohlberg correspond to the process of a  boy’s rearing and are inadequate as regards the analogous process in women. The masculine part usually believes that stealing is justified because life is of greater value than property. They are also convinced that the court would take this circumstance into account and would not punish the perpetrator. Girls, not questioning this way of thinking, also discern some ambiguity. They indicate that, although Heinz cannot steal the drug, he should not let his wife die. If he steals, then he will probably be sentenced and will not be able to help his wife in sickness. Hence, they propose

20 Particular works of Kohlberg are collected in two volumes: Essays in Moral Development (San Francisco: Harper & Row, 1981) and Essays in Moral Development (San Francisco: Harper & Row, 1984).

that Heinz talks once again to the chemist and presents him the situation in detail, and surely then they will find a  solution.²¹ The different answers also show that there is compassion and obligation to provide help, which take precedence over the law and rights. This pertains to Heinz as well as the chemist, which to some extent makes his decision unrelated to the extent of emotional engagement.²²

According to C. Gilligan, the examples show that the moral development of women is different from that of men, which provides a basis for distinguishing two alternative kinds of ethics. If we adopt Kohlberg’s perspective, it means that men attain full moral development because they reason with abstract moral principles, while women remain on the conventional level, trying to find solutions most appropriate for the model of their role – feminised in their case – and so they are directed by care and maintaining relations at all cost.

According to the author, this is an argument that Kohlberg’s theory should be treated with reserve, and that men and women develop differently. As far as the former are concerned, they head what can be termed ethics of justice, namely thinking about morality in terms of the distinction between rights and duties on the basis of universal criteria of weighing the principles. Women, on the other hand, head the ethics of care, namely seeing morality through the lens of ideals of compassion and sacrifice for another person. It has to be remembered that the thesis concerns sex uniquely in terms of culture, and does not mean biological determinism.

From the point of view of dilemmas, the conclusion is crucial. Although the starting points for the above authors are empirical experiments, they lead to an important analytical distinction, namely that there are many ways of conceptualising a given situation which cannot be reduced only to classifying the available options as falling into such categories as obligation, duty, right, principle, moral ideal, etc. On a more fundamental level, moral dilemmas raise the question of whether such qualifications help us in unsolvable situations, i.e.

whether they allow, by means of abstract logic, argumentation or the weighing of principles, in order to make a  choice. Perhaps it is more correct to treat dilemmas as situations revealing deep interdependencies between people, and to focus on the nature of a particular relation. Both approaches should be seen as mature, and the resulting theoretical proposals as serious. If they are mutually exclusive in the discussed situations, it means that moral dilemmas are also related to the conflict between ethics of justice and ethics of care.

21 Gilligan, In a Different Voice, pp. 25–30.

22 Ibidem, pp. 54–58.