What does it mean to be an expert? What does it take? And when does someone’s expertise become beneficial to others? I think about these ideas, particularly in today’s world, as I work as a professional ethicist. Do I understand morality more than others, and if so, what is my role to others as an expert? These thoughts remind me of a patient encounter I had a few years back.

Don’t Murder My Mother

The patient was an 84-year-old female in the intensive care unit, suffering from multi-system organ failure. For lack of better words, she was dying—actively dying—and there was nothing that the medical team could do to prevent it. She was on multiple blood pressure medications, receiving continual dialysis, and breathing entirely dependent on a mechanical ventilator. Because of how sick she was, she was not able to communicate with the team, and we did not know what her medical wishes were.

She had two family members involved in decisions for her: her husband and her son from a previous marriage. Her husband said that she would not want to continue on like this if there was no chance of her making a full recovery. But her son did not agree. After days of conversation, the decision needed to be made: do we continue ventilation through a tracheostomy, or do we remove the ventilator?

At this, her son became very angry and said that the medical team could not do that—that it would be killing her, and that would be murder. The attending physician said we would not be killing her, but rather letting natural things happen. We would be letting her die, which was different. The son did not agree and demanded to speak with someone who was an expert on the difference between killing and letting die, and how intention and language change the morality of an action.

Truth v. Perception

The physician said, “I know just the expert.” So I was asked to have a conversation with the son and discuss all the dimensions. In the end, the son felt understood and supported in his perspective but also agreed it was best to let his mother pass.

That was interesting, particularly because of how I was involved. I was brought in to serve as an expert. That made me uncomfortable, even though it was an area of study that I was well versed in and probably had a better understanding than many of the medical team—thus the request for me to have the conversation. But I could not help but consider Plato’s Ring of Gyges and how that related to expertise.

In the thought experiment, a man finds the Ring of Gyges, which can make him invisible, and he realizes he can commit crimes without any consequences. What would an average person do? Would the average person be moral? Then, it becomes a puzzling question: would you rather be a moral person but considered by society to be a criminal, or would you rather be a criminal who is held in high regard and seen as a moral person by society? The truth versus public perception.

Bioethicist as Expert

I think of myself in these terms: am I an expert, or am I simply regarded as an expert? And what is the difference? Expertise is a challenging concept because it all comes down to how society views and compares individuals to others, possibly rather than to any objective truth.

I keep my perspective that it does not matter if I’m an expert or not. What matters is what I do with my knowledge, skills, and experience. It did not matter if I was an expert to the patient and family, but what did matter is that I was able to talk with and support a struggling son. He came to a better understanding of his mother’s condition because of our conversation. Expertise holds little value to me if it is not used to help others. That’s what really matters.