Last night’s presenter is conducting her research from a relativist ontology. I believe a relativist ontology is an illogical, self-refuting orientation. The proof: no one lives as a relativist.
Once upon a time, I was facilitating an Instructional Skills Workshop. One of the new instructors going through the course was a long-term paramedic (an expert), and their 10-minute mini-lesson was on making triage decisions in emergency situations. When her lesson began, she explained: “You are at a crash site. You have to find, diagnose, and determine who is going to get medical attention. There are four index cards in this room. You have to find them. On the back of each index card are indicators that will tell you how to determine (a) whether they have a chance to live with immediate attention, (b) if they have a chance to live with moderate attention (1-2 hours), or (c) if they are likely to die no matter what you do. You need to make these decisions quickly and you should direct your attention to those who have the best chance of survival. In the next three minutes, I will tell you what to look for, and you will have five minutes to find the casualties and make your decisions. Then we will have a short debrief.”
She quickly outlined the criteria to look for, and we listened intently and took notes. Then she said, “Go save some people,” and we launched into action. We matched the likelihood of survival indicators to the four patients, and we sorted them accordingly. We followed the instructions perfectly. Person 1 needed immediate attention – without it, they were likely to die. Person 2 could wait a couple of hours (broken bones). Person 3 showed weak vital signs, meaning they were unlikely to survive. Person 4 showed signs they were near death and no intervention was possible.
And then the instructor revealed:
Person 1 was a drunk driver who was seriously injured, but with the right attention would likely survive.
Person 2 was the drunk driver’s passenger. They had broken bones and potential internal injuries, but based on their vital signs would likely survive without immediate attention.
Person 3 was an in utero child near term. Even with an emergency C-section, they were unlikely to live.
Person 4 was a pregnant mother with a serious head injury.
The lesson, as the instructor revealed at the debrief, was not actually about identifying vital signs. It was about making professional judgments. It was applied ethics for paramedics. It was about making the moral judgment to save the life of a person you might hate. The point of the lesson was that paramedics have to transcend habitually inherited value systems and just see the body, not the person. They needed to be able to look past their instinctual inclinations about who should be saved. As we sat in a state of shock, the instructor said she believed saving people you didn’t want to save is an unexplored part of post-traumatic stress disorder in paramedics, but there was no way to prove this.
It was the best ISW lesson plan I have ever seen, and it proves no one lives as a relativist.
Foucault, in The Order of Things, said that truth was an “arbitrary play of power and convention.” The argument that all truth is arbitrary and relative has been a powerful argument. The eminent historian Paul Johnson believes relativism was misappropriated from science but is the dominant ideology of modernity. Einstein saw moral relativism as a disease and social pandemic that led him to say towards the end of his life that he sometimes wished he had been a simple watchmaker (Johnson, 1992, p.4).
Relativism is powerful until you dare to ask Foucault: “You say all truth is arbitrary. Is your presentation itself true?” (Wilber, 1995, p. 29). Relativists exempt themselves from the very criteria they apply to other value systems. They make truth claims that deny all truth claims, except the privileged stance of relativism, itself a truth claim. It is worth listening to Ken Wilber at length on this point.
Nobody is denying that many aspects of culture are indeed different and equally valuable. The point is that that stance itself is universal and rejects theories that merely and arbitrarily rank cultures on an ethnocentric bias (which is fine). But because it claims that all ranking is either bad or arbitrary, it cannot explain its own stance and the process of its own (unacknowledged) ranking system. And if nothing else, unconscious ranking is bad ranking, by any other name. And the relativists are very bad rankers.
In short, extreme cultural relativity and merely heterarchical value systems are about as dead as any movement can become. The word is out that qualitative distinctions are inescapable in the human condition, and further that there are better and worse ways to make our qualitative distinctions.
In many ways, we want to agree with the broad conclusions of the cultural diversity movements: we do want to cherish all cultures in an equal light. But that universal pluralism is not a stance that all cultures agree with; that universal pluralism is a very special type or ranking that most ethnocentric and sociocentric cultures do not even acknowledge; that universal pluralism is the result of a very long history hard-fought against dominator hierarchies of one sort or another. (pp. 29-30)
Only when we admit that universal pluralism is a value stance can judgment systems such as nursing ethics, Cultural Safety and Human Flourishing make any sense. They are not all relative. The values of tolerance and appreciation for diversity are not values simply relative to our particular cultural circumstance. They represent some of the most highly evolved ideas of humankind, ideas that are still evolving and not universally shared across the globe. The individual human being, no matter who they are or where they are, matters. From the relativist perspective, however, if all value systems are equally valid, then all value-based decisions are equally worthless.
"Someone once remarked that the two great errors in moral philosophy are the belief that we know the truth and the belief that there is no truth to be known" (Wilson, 1993, p. 12). Without pretending to know the truth or be in possession of a dogmatic truth, we can affirm that we know quite a bit about what contributes to human flourishing and what does not. There should never come another day or time when the idea of Residential Schools makes sense or can be justified. It was wrong and will always be wrong. It’s NOT all relative. What if we encountered, as Wilson absurdly suggests as a philosophical counter-example, a society that believed torturing babies produced better crops?
Absurd, yes, but it is a variation of this absurdity that explains why feminists and those fighting for social justice have completely given up on relativist ontologies. Bloland (1995) describes the inevitable endpoint of relativist ontology very well:
If there are no legitimate bases for rewarding the privileged in our society, there are also no foundational standards for rewarding marginal groups. There are no grounded assumptions or moral grounds from which marginal groups can claim privilege. From this postmodern perspective, there is no compelling reasons for controlling groups to give grounds to others. (p. 529)
An uninformed opinion becomes as valuable as an enlightened opinion, and who needs nurses at that point? The death of values also means the death of expertise, and so let’s bring back leeches and bloodletting!
Bloland suggests that the only course of action left is to "listen and listen very hard and long to the 'other'” (p. 553), and in listening, create space for dialogue. I listened hard to the presentation last night and offer this in the spirit of dialogue. I hope the last night’s presenter will give up relativist ontology and choose instead to stand on these values of tolerance, diversity, and universal pluralism.
Done. Axe ground. I am stepping off the soap box.
Bloland, H. (1995). Postmodernism and higher education. Journal of Higher Education, 66(5).
Johnson, P. (1992). Modern times: The world from the Twenties to the Nineties. New York, NY: HarperCollins.
Wilber, K. (1995). Sex, ecology, spirituality: The spirit of evolution. Boston, MA: Shambhala Publications, Inc.
Wilson, J. Q. (1993). The moral sense. New York, NY: The Free Press.