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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 60. Go back in thread:
Posted by snoozin on February 28, 2005, at 18:22:57
In reply to (2) One or Six???, posted by alexandra_k on February 28, 2005, at 18:07:36
This is why I'm not a doc or a conductor. Yuck.
But I find this question fascinating.
I think that the doctor must operate and save the one man. The reason this differs from the first scenario is that there was no other option in the train situation. Someone was going to die.
In the physician situation, there are a few variables. One, the doc has a duty to his patient. The other folks on the donor list are *not* his patient and he has no ethical or professional duty to them. Two, the donor universe is not closed and those other people could possibly receive donations from others. Of course there's also the possibility the seriously injured guy isn't a match for the others. All that.
But I say again. Yuck. Not fun decisions to make.
S.
> Case Two:
>
> You are a surgeon. A person is brought in with severe injuries. If you do not operate on him then he will die. If you do operate on him then (let us say) he will live.
>
> You also know that there are many people on the waiting list for organ donations (heart, kidney, liver etc). Without a donar they will die and this man is a match and an organ donor. If you let the man die then you will be able to save 6 lives by harvesting his organs. Let us say that without doing this the 6 people will die because they will not get the organs they require in time.
>
> Should you let the man die to save 6 lives, or should you save his life (thereby - in effect killing 6)?
Posted by rainbowbrite on February 28, 2005, at 18:28:59
In reply to Re: (2) One or Six???, posted by alexandra_k on February 28, 2005, at 18:08:55
i missed this....it is differnet because the doctor is playing god if he chooses to not save the man. the chioces of life and death are differnt. you can save a person but you can not KILL.
Posted by alexandra_k on February 28, 2005, at 19:20:12
In reply to Re: (2) One or Six???, posted by rainbowbrite on February 28, 2005, at 18:19:47
> Ok this one is easy, If you can save one man and he is right there in front of you, you have no right to make the call on his life! The doctor has a responsibilty to save his life. At this point you are playing god.
So he has a duty to save one even when the consequence of that is that 6 others die???
Posted by alexandra_k on February 28, 2005, at 19:25:05
In reply to Why they are different » alexandra_k, posted by snoozin on February 28, 2005, at 18:22:57
> I think that the doctor must operate and save the one man. The reason this differs from the first scenario is that there was no other option in the train situation. Someone was going to die.
But in this case if he acts to save one man then 6 others die because they do not get the organs they need.
> In the physician situation, there are a few variables. One, the doc has a duty to his patient. The other folks on the donor list are *not* his patient and he has no ethical or professional duty to them.
Ok. Suppose they are all his patients??
>Two, the donor universe is not closed and those other people could possibly receive donations from others. Of course there's also the possibility the seriously injured guy isn't a match for the others. All that.
Can we suppose that it is inevitable that they will die without? Perhaps they need the organs within a certain amount of time and their time is almost up... Suppose that he is a perfect match... I agree the case is highly improbable. I just need it to be POSSIBLE though..
If our only options are(a) save 1 (by operating) and 6 die or
(b) let one die (by not operating) to save 6.Does this change what you think should be done?
Posted by alexandra_k on February 28, 2005, at 19:32:46
In reply to Re: (2) One or Six???, posted by rainbowbrite on February 28, 2005, at 18:28:59
Both of the cases are typically considered to be 'moral dilemma's'. A moral dilemma is supposed to be a situation where you do the wrong thing either way.
But others argue that clearly one of the options is the *right* thing to do GIVEN THE SITUATION / CONTEXT whereas the other is *wrong*.
> i missed this....it is differnet because the doctor is playing god if he chooses to not save the man. the chioces of life and death are differnt. you can save a person but you can not KILL.The doctor can choose (through inaction - failing to operate on the one) to let him die. This is a 'passive move'. He simply allows him to die by not interveaning.
The train conductor, on the other hand can choose to let the train run its course (by failing to divert the course of the train). This is a 'passive move'. He simply allows 6 people to die by not interveaning.
If the difference between the cases is that 'letting die' is acceptable while 'actively killing' is not then it would seem that the doctor should allow the one to die and the train conductor should allow the train to kill 6.
Does this seem correct, though???
Wouldn't we prefer it to be the other way around??That was a good response, though :-)
A lot of people think there is a clear difference between 'active' and 'passive' euthenasia, for example. The former being unacceptable (not allowed to give lethal injections) and the latter being acceptable (do not resussatate order).These are hard cases. Both individually and taken together. But I find it a challenge to think about them...
Posted by rainbowbrite on February 28, 2005, at 19:35:41
In reply to Re: (2) One or Six??? » rainbowbrite, posted by alexandra_k on February 28, 2005, at 19:20:12
yes!
The person is not dead, how can he make the decision to end a life? that would be murder, if he has the means to save him! The train is a decsion made based on the best outcome...you have to have at least one person die in the end so do you try to save 6 or let one be hit...hmmm I say one. The 6 people the doctor knows do not have priority over the other person in hospital. That person owns his organs until he dies. the doctor has a moral and ethical duty to save and not think about killing for another. I do not see the two as similar in anyway. The doctor will not be thinking "OH in hawaii there is a heart needed and in california there is a spleen needed....I will just let him die. No nature takes its course with the ones waiting....a doctor is not nature.
Posted by alexandra_k on February 28, 2005, at 19:46:50
In reply to Re: (2) One or Six???, posted by rainbowbrite on February 28, 2005, at 19:35:41
The doctor isn't doing anything to kill the patient though, he is simply refraining from helping him out...
Why shouldn't the latter case be based on the best possible outcome too (where 1 person dies instead of 6)???
>The 6 people the doctor knows do not have priority over the other person in hospital.
No. Though if all people have an equal right to life then there is 1 life on the one hand and 6 lives on the other...
>That person owns his organs until he dies.
Yes. But that doesn't bear on whether his death should be 'allowed' or 'prevented'. They will wait till he dies to harvest the organs.
Remember that if 'nature takes its course' then he will die. It is only human intervention that can save him...
Posted by alexandra_k on February 28, 2005, at 19:47:56
In reply to Re: (2) One or Six??? » rainbowbrite, posted by alexandra_k on February 28, 2005, at 19:46:50
Ps. I should say that I don't believe that it is right to allow him to die.
But justifying that is harder than might be initially supposed....
Keep trying to 'convince' me if you like :-)
Posted by rainbowbrite on February 28, 2005, at 19:58:03
In reply to Re: (2) One or Six??? » alexandra_k, posted by alexandra_k on February 28, 2005, at 19:47:56
UGH I might!!! I am tring to write an essay and you keep stumping me....i hate being stumped lol
Ok so the answer is it is just a bunch of moral crap. the more I think about it the more confused I get :S....
Posted by alexandra_k on February 28, 2005, at 20:00:59
In reply to Why they are different » alexandra_k, posted by snoozin on February 28, 2005, at 18:22:57
You might want to say that GIVEN the choice between one and six we should choose one over six.
But given the way the world works although this sort of case might be possible in principle is really isn't very plausible as a matter of fact.
My officemate is the real ethicist. I just get a bit interested every now and then... He doesn't think there really are any moral dilemmas. He thinks the problem comes of philosophers making up very abstract cases because they can't find any in the real world...
Thats why the surgeon case sounds fairly contrived...
You could try that. You could say that the surgeon should save the one because other organ donors can always 'just turn up'. You could say that the surgeon should save the one because if other people hear of this then nobody will want to be an organ donor anymore!
Does this seem ok to you or do you think it may be just bypassing a deeper issue???
Posted by alexandra_k on February 28, 2005, at 20:02:27
In reply to Re: (2) One or Six???, posted by rainbowbrite on February 28, 2005, at 19:58:03
Get back to work!
Whats your essay on???
Posted by rainbowbrite on February 28, 2005, at 20:19:24
In reply to Re: :-) » rainbowbrite, posted by alexandra_k on February 28, 2005, at 20:02:27
hahaha
My essay is on how internet communities replicate the real world. There are differnt personalites and how each personality contributes to the community... I never got it in way back, had to get an extention :-) Its dumb but I needed something really different.
Posted by rainbowbrite on February 28, 2005, at 20:24:01
In reply to Re: :-) » alexandra_k, posted by rainbowbrite on February 28, 2005, at 20:19:24
I want to add in something about the benifits or hazards of internet relationships, when comparing to real world....OK Do some work Rain!!
Posted by rainbowbrite on February 28, 2005, at 20:31:08
In reply to Re: :-) » rainbowbrite, posted by alexandra_k on February 28, 2005, at 20:02:27
before I go do work, what time is it? 3:30 pm tuesday?? have my math skills impolrved lol I think you said 18 hours. So how is tomorrow? Will I like it?
Posted by alexandra_k on February 28, 2005, at 20:42:53
In reply to but wait...what is tomorrow like? » alexandra_k, posted by rainbowbrite on February 28, 2005, at 20:31:08
Cool topic :-)
Yes, do some work ;-)
Today is ok.
How was yesterday - I forget ;-)PS. Your math was pretty much spot on. Well done.
Posted by rainbowbrite on February 28, 2005, at 20:49:26
In reply to Re: but wait...what is tomorrow like? » rainbowbrite, posted by alexandra_k on February 28, 2005, at 20:42:53
Im so mathmatical I am impressed, today/yesterday is pretty cold, But it was a good day lol...almost over
Posted by jay on February 28, 2005, at 21:57:53
In reply to (2) One or Six???, posted by alexandra_k on February 28, 2005, at 18:07:36
You aren't "killing" anybody if you operate on this guy, because A) as Einstein said, God does not play dice,...that's just how it is...etc... and B) fate is just the weight of circumstances. Why not reverse it, and say those six people are putting others at risk for death because of their needs?
Th- Th- Th- Thi- Think about it...:)
Jay
Posted by alexandra_k on February 28, 2005, at 22:04:13
In reply to Re: (2) One or Six??? » alexandra_k, posted by jay on February 28, 2005, at 21:57:53
> You aren't "killing" anybody if you operate on this guy,
No, you aren't killing anybody. You are letting them die.
>because A) as Einstein said, God does not play dice,
So because Einstein believed the subatomic world was not indeterminate (despite him fairly much showing that it is) we should not allow this man to die? I am afraid I do not follow the argument...
>...that's just how it is...etc...
'How things are' does not imply anything about how things *should* be or what we *should* do.
>and B) fate is just the weight of circumstances.
???
>Why not reverse it, and say those six people are putting others at risk for death because of their needs?
I guess they are. But in this instance one other. We have to choose between six deaths or one death.
> Th- Th- Th- Thi- Think about it...:)
>
> Jay
Posted by Gabbi-x-2 on March 1, 2005, at 3:01:25
In reply to Re: (2) One or Six??? » alexandra_k, posted by jay on February 28, 2005, at 21:57:53
> as Einstein said, God does not play dice,...
I don't understand what "God does not play dice with the universe" as Einstein meant it, has to do with people's fates, I think he was referring to lack of faith in quantam theory, which held too many uncertainties for him.As for the fate of the man on the operating table.. Einstein said specifically that he believed in a god who concerned himself with the harmony of the universe, but not with the particular fates of human beings. (Spinoza's God)
Posted by Rach on March 1, 2005, at 3:59:52
In reply to (2) One or Six???, posted by alexandra_k on February 28, 2005, at 18:07:36
Save the man. That's my job.
Besides, there's no guarantee that I will save him. And there's no guarantee that the others won't get organs from somewhere else.
Posted by medhed on March 1, 2005, at 5:46:49
In reply to (2) One or Six???, posted by alexandra_k on February 28, 2005, at 18:07:36
Six is better than one. Fix him up.
Posted by Broken on March 1, 2005, at 7:18:29
In reply to Re: (2) One or Six??? » alexandra_k, posted by medhed on March 1, 2005, at 5:46:49
I agree. The two senarios are different, for me personally. The second would be an easier call. I would owe that person the very best treatment possible. Even if he were a guaranteed match for all 6, I'd still have to save him. I think the interesting part is when do the numbers change your moral stance? 6 is not enough, but what if it were 60? Then I would toss my professional morals and save the 60.
Funny how right or wrong seem to change in my mind as the numbers change. At what point do the needs of one outweigh the needs of the many? (The Star Trek thing was just begging to be used)
This is headed toward an even bigger question that is pertinent to today's headlines, but I won't go there for fear of all hell breaking loose.
All the above represents only my personal views, not anyone elses.
Posted by TamaraJ on March 1, 2005, at 10:19:49
In reply to Re: (2) One or Six??? » rainbowbrite, posted by alexandra_k on February 28, 2005, at 19:32:46
> A lot of people think there is a clear difference between 'active' and 'passive' euthenasia, for example. The former being unacceptable (not allowed to give lethal injections) and the latter being acceptable (do not resussatate order).
--------
-- It is my understanding that the AMA (although some argue otherwise), Christian churches and some philosophers have accepted the principle and act of "passive" euthenasia but not "active" euthenasia. Maybe I am off base here, but I find the act of "passive" euthenasia a far less humane act. Passive euthenasia is, as I understand it, more than just do not ressusatate. As a result, a person is who being passively euthenized could end up suffering for days, weeks, even months. As somebody said in the thread on this topic on the Relationships board, we treat the family pet better.
Here is an extract from something I had read a while ago. "One of the most cited contemporarly discussions on the subject of euthanasia is "Active and Passive Euthanasia" (1975) by University of Alabama philosophy professor James Rachels. Rachels argues that there is no moral difference between actively killing a patient and passively allowing the patient to die. Thus, it is less cruel for physicians to use active procedures of mercy killing. Rachels argues that, from a strictly moral standpoint, there is no difference between passive and active euthanasia. He begins by noting that the AMA prohibits active euthanasia, yet allows passive euthanasia. He offers two arguments for why physicians should place passive euthanasia in the same category as active euthanasia. First, techniques of passive euthanasia prolong the suffering of the patient, for it takes longer to passively allow the patient to die than it would if active measures were taken. In the mean time, the patient is in unbearable pain. Since in either case the decision has been made to bring on an early death, it is cruel to adopt the longer procedure. Second, Rachels argues that the passive euthanasia distinction encourages physicians to make life and death decisions on irrelevant grounds. For example, Down's syndrome infants often have correctable congenital defects; but decisions are made to forego corrective surgery (and thus let the infant die) because the parents do not want a child with Down's syndrome. The active-passive euthanasia distinction merely encourages these groundless decisions.
Rachels observes that people think that actively killing someone is morally worse than passively letting someone die. However, they do not differ since both have the same outcome: the death of the patient on humanitarian grounds. The difference between the two is accentuated because we frequently hear of terrible cases of active killings, but not of passive killings. Rachels anticipates two criticisms to his argument. First, it may be objected that, with passive euthanasia techniques, the physician does not have to do anything to bring on the patient's death. Rachels replies that letting the patient die involves performing an action by not performing other actions (similar to the act of insulting someone by not shaking their hand). Second, it may be objected that Rachels's point is only of academic interest since, in point of fact, active euthanasia is illegal. Rachels replies that physicians should nevertheless be aware that the law is forcing on them an indefensible moral doctrine."
Rachels arguements were rebutted in "Active and Passive Euthanasia: An Impertinent Distinction?" (1977), by Thomas Sullivan who argues that no intentional mercy killing (active or passive) is morally permissible . . .. In a rejoinder essay, "More Impertinent Distinctions and a Defense of Active Euthanasia" (1978), Rachels responds to Sullivan's charges. (both of which I have only read summaries). Rachels points out that critics have traditionally attacked utilitarianism for focusing too heavily on happiness, and not enough on other intrinsic goods, such as justice and rights. Accordingly, Rachels offers a revised utilitarian version: active euthanasia is permissible since it promotes the best interests of everyone.
And, this debate, which has gone on for centuries, will continue.
Tamara
Posted by alexandra_k on March 1, 2005, at 14:48:05
In reply to Re: (2) One or Six???, posted by Rach on March 1, 2005, at 3:59:52
> Save the man. That's my job.
But it is also your job to save the other people who are waiting on an organ donation.
PS. Sometimes doing your job can be unethical as when you are employed as a terrorist ;-)
> Besides, there's no guarantee that I will save him. And there's no guarantee that the others won't get organs from somewhere else.Not if you change the case there isn't...
But what if those two things are guaranteed? What would your answer be then???PS. Going with your argument for the first case it would be acceptable for a surgeon to refrain from operating on the man (let him die) as it is okay to 'let die' just not to actively kill...
Posted by alexandra_k on March 1, 2005, at 14:49:16
In reply to Re: (2) One or Six??? » alexandra_k, posted by medhed on March 1, 2005, at 5:46:49
> Six is better than one. Fix him up.
You mean 'Six is better than one. Let him die'???
You may need to read the case again...
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