Ethics And Morality

[Dr. Nick Riviera]

Just read this on another forum, seemed like a good point of discussion;

you’re an anaesthesiologist. You are in charge of putting a women under who’s getting a face job. There are 5 people who are terminally ill. They all need organs: A heart, a liver, a kidney, a kidney and a lung. This one women is compatible with all of the people. You are able to make a “mistake” and kill her, harvest her organs and save five lives. WHAT DO YOU DO?

[Pashley26]

You don't make a mistake because the way our medical services work there would be a f**k up and they'd put the wrong organs in anyway.

[/thread]

[bikeperson45]

I don't think that I would kill her

That's a hard one, better than "would you f**k your Dad to save your Mum"

[Ash-Kennard]

Let the other 5 pass on, solves a few problems all in one go, our Tax goes down because they aren't draining the NHS, there'll be more houses to go around, and there'll be more food as well, so we solve a few issues all in one go. AND we'll have 1 better looking female to have a go on, think about it..It's all about the greater good.

yeah i think hes cracked it

[Haz]

Obviously harvest the organs and sell them for extortionate prices to the 5 people waiting for donors. No pay, no organ.

[NVWOCI WVS]

It would be a lot easier to fly out to the poorer parts of the middle East and buy the neccesary organs for less than £10 a pop, then fly back over here and sell them for profit.

[Fish-Finger-er]

Let the other 5 pass on, solves a few problems all in one go, our Tax goes down because they aren't draining the NHS, there'll be more houses to go around, and there'll be more food as well, so we solve a few issues all in one go. AND we'll have 1 better looking female to have a go on, think about it..It's all about the greater good.

but then to throw it right back at you, what happens if them 5 people will continue to drain the NHS on life support, housings a bit meh, as for food, last time i went to tesco's there was enough to go round. And what happens if shes still going to be a 50 year old munt, and these are all fit horny teenage girls who need these organs.

5 terminally ill people, after going through such an experience, will probably offer a greater good to the world (either through charity work, or near death "seeing the light/meaning of life" moments) than one rather vein women.

But it also raises the point of, its your job to anaesthetize, not to save people, why meddle in the unknown. does your answer change if the vein women is your mum?

does your answer change again, if the vein women is some randomer whose won the lottery, and the 5 people are all your family members?

On the save 5 vs kill 1, id say id probably stick her under, but theres a lot more than that(such as the 5 peoples medical conditions, where they selve inflicted?)

[JT!]

The 5 people though, they could have f**ked up their organs because they drank too much, were overweight etc etc.

[Fishy]

Kill all of them. Problem solved.

[Pashley26]

Kill all of them. Problem solved.

DIE DIE DIE !!!!

*I've been playing Carmageddon 2 all evening.....best game ever ?

[NVWOCI WVS]

The 5 people though, they could have f**ked up their organs because they drank too much, were overweight etc etc.

That is, of course, possible. However, a lot of people need transplants for reasons that are completely no fault of their own, or within their control. For example, my sister was born with a hole in her heart. She had open surgery shortly after birth, and has to regularly visit the hospital for checkups, and several follow-up operations as she's grown up, and is now fully healthy, but in later life there is obviously a much higher chance of her having heart trouble. It is completely plausible that she might need a transplant, and that isn't through her abusing her body.

[Tony Harrison]

Ethnics and morality? That's a contradiction in terms isn't it?

[Luke Rainbird]

Anaesthetise them all for sex? Technically they can't say no...

[Prawny Baby]

you've got to think of the knock on effect I'd say.

5 terminally ill people will have 5 families, who have, as sad as it sounds, all come to terms with the fact that their loved one is going to die.

If you knock off the woman who just wants to look a bit hotter, imagine the massive effect that could have on her family, her children could turn to drugs, and then kill many more people in a mass crime wave to pay for drugs.

they expect her to come out looking nicer, but she comes out in a box? not cool.

[Jaffacakes]

What kind of person would you be if you "accidently" killed her while puting her to sleep for a face job. I could never do that, let alone live with it if I did do it.

Chances are that 3/5 of those people would get organs and live anyway..

But obviously if those 5 people where good people and she was a bad person, then I would have to make the decisions. But I'd would never be an anesthetists and they'd never be the same blood group. Chances are you'd get caught and sacked too...

Im not that nice

[Mark W]

If you knock off the woman who just wants to look a bit hotter...

Which is the key, and indeed most misleading, part of that whole 'question'. If they'd said she was going under to, say, have a wisdom teeth removed or her appendix taken out or something, then no-one would think "I'd kill that random stranger without knowing anything about her", but because it's a cosmetic procedure, everyone starts thinking that that person doesn't deserve to live because they're shallow, superficial, or whatever. It's no different to you or me going into hospital for any kind of routine operation - I'm pretty sure you wouldn't want to be topped by someone who knew nothing about you, either.

[JT!]

That is, of course, possible. However, a lot of people need transplants for reasons that are completely no fault of their own, or within their control. For example, my sister was born with a hole in her heart. She had open surgery shortly after birth, and has to regularly visit the hospital for checkups, and several follow-up operations as she's grown up, and is now fully healthy, but in later life there is obviously a much higher chance of her having heart trouble. It is completely plausible that she might need a transplant, and that isn't through her abusing her body.

'Could have'.

[Elliot]

The five people that have something wrong with them will just pollute the gene pool if they dont die, and so just create a bigger burden in the future.

Besides, how long do people get once they have transplants? Certainly not a normal life expectancy, so if your just talking years lived, surly letting the letting the boob job live will be most favourable?

[JD™]

I'd scream "I HAVE HAD E-NUFFFFF OF THE GOD DAMN PRESSURES OF THIS GOD FORSAKEN JOB. f**k YOU, ALL OF YOU", while running out of the O.R, most likely with my penis out.

[Dr. Nick Riviera]

Looks like someone beat me to it

[Tomm]

Looks like someone beat me to it

Not really, just some people who are (understandably) very upset about their son's death, trying to find solace in a lawsuit. Stupid American litigation culture. From that article, there's no suggestion that he had any hope of living, so it's a different scenario to your question.

From a medical point of view, your scenario violates a lot of ethical principles which are taken as being fundamental, ever since the days of the old Greek philosophers. The three major components of any ethical argument are Autonomy, Beneficence, and Non-Maleficence:

A person has ultimate autonomy, I.e. they have control over their own body and what is done to it - whether or not the doctor agrees with their decision. That is a very difficult principle to argue against, for the simple reason that you wouldn't like someone else making decisions about you without asking, would you?

The anaesthetist has a duty of care to his patient, and no one else (I.e. not the potential recipients) - that's another fundamental medical ethical principle - "first, do no harm." This would be the 'non-maleficence'. You couldn't kill your patient without violating this principle, obviously. Even if she is a superficial vain idiot (which everyone seems to have assumed!).

So in killing the cosmetic surgery patient, you've already violated two out of three fundamental principles. Although I suppose you could argue that beneficence (I.e. doing good) could mean taking a world view and treating the five other people, you'd be on shaky ground. I'm fairly certain the beneficence applies to your patient only, not the other five. There are also a lot of other more practical issues like (as Elliott pointed out) the recipients wouldn't necessarily expect to live a full life etc.

So you've basically got two components (the principles of autonomy and non-maleficence) against, and possibly one (kinda shaky) component for what you are suggesting. Basically it could never happen.

[JD™]

Tomm, you make a lot of good points and I'm not trying to undermine the argument at all by asking whether you had considered that the other 5 patients are treated by the same doctor too? As I'm fairly certain there aren't doctors who just specialise in aneasthatising patients, there is a probability that this doctor could be contemplating it on a completely different level too - one of targets. Would you be taken as a 'better' doctor for saving 5 lives by making a 'mistake' on another?

I'm not saying that's the right way to think about it, but - and this is obviously why I'm not a doctor - I would seriously consider doing it to make myself look better...

[Dr. Nick Riviera]

Not really, just some people who are (understandably) very upset about their son's death, trying to find solace in a lawsuit. Stupid American litigation culture. From that article, there's no suggestion that he had any hope of living, so it's a different scenario to your question.

I was attempting comedy a little bit, nice to get your perspective on this though.

Do they still swear you in on the hippocratic oath? or is it a modern and legally binding variant?

[Tomm]

Tomm, you make a lot of good points and I'm not trying to undermine the argument at all by asking whether you had considered that the other 5 patients are treated by the same doctor too? As I'm fairly certain there aren't doctors who just specialise in aneasthatising patients, there is a probability that this doctor could be contemplating it on a completely different level too - one of targets. Would you be taken as a 'better' doctor for saving 5 lives by making a 'mistake' on another?

I'm not saying that's the right way to think about it, but - and this is obviously why I'm not a doctor - I would seriously consider doing it to make myself look better...

Well, there ARE doctors who specialise in Anaesthetics alone When a doctor is looking after someone, they are looking after that person and no one else. What you're talking about is beneficence (doing good) but for the bigger picture, which is fair enough, you can argue that there may be a 'greater good'. But a doctor's duty of care is to the patient they are treating at that moment. Also in killing the patient, you'd have to break two other rules of medical ethics (non-maleficence and autonomy), which are pretty fundamental in themselves. Otherwise people wouldn't ever go to the doctors. Imagine going there and the doc deciding that you were a waste of space and your body should be harvested for organs!

What I'm saying is that a doctor would have to look past what may be the 'greater good' and treat their patient as best they could. That's the medical point of view, which (paradoxically) looks further than the 'greater good'. Hmmm.

I was attempting comedy a little bit, nice to get your perspective on this though.

Do they still swear you in on the hippocratic oath? or is it a modern and legally binding variant?

As far as I know, you have to swear an oath but it's not the original one (most of which is kind of irrelevant now), and I don't think it's legally binding. It's not too formal either - it's just done in a group, not individually with your hand on a bible or anything.

[Haz]

Not really, just some people who are (understandably) very upset about their son's death, trying to find solace $5m dollars in a lawsuit.