How do ethics play within situations that can be lifesaving? Is it possible that what can save a persons life can be unethical? Within this paper we will look into a situation involving the wellbeing of victims with gunshot or stab wounds, and explore different ethical perspectives as to why or why not this activity will be ethically correct.
Doctor Peter Rhee believes he has found a way to keep humans alive up to two hours after they have gone into cardiac arrest. He has tested his findings on pigs that have been inflicted with wounds which are life threatening. After going into cardiac arrest the doctor pumped their bodies with a cold saline solution, first into their brain and heart, then the rest of their body. This cools the body and stops most cellular activity giving the doctor more time to fix their wounds, elevating their chances of surviving. Ninety percent of the pigs survived after the solution was pumped into their bodies; of the control group there were no survivors.
David King, a surgeon who works with animal testing, does not find this to be safe and does not believe that this should take part in all hospitals because, ultimately, it is too far out there and people should not expect a miracle. Could this mean that what could save someone’s life can be unethical? We will look into the perspectives of three different ethical views: Ethical Egoists, Virtue Ethicists, and Rule Unitarianism. To explain this matter further this paper will follow the “ABCD’s of Ethical Decision-Making: A Brief Guide.”
In this situation—involving the doctor who wants to change how the hospital will handle gunshot or stab wounds—one has to be aware of the situation they are in before making a decision (the first step in the ABCD Guide). This goes for all Ethical perspectives. The situation at hand may become a legal one if the doctor decides to go about his surgeries this way despite the ruling of the hospital or law. The doctor believes that this practice will save more lives because it has already been proven to work, however, if for some reason it works differently on humans than pigs, there could be lawsuits taking place.
The second step in “The ABCD’s of Ethical Decision Making” is Beliefs: what are my moral beliefs? Will my decision help me fulfill my ethical code? For an Ethical Egoist, a person that believes that for an action to be morally right it has to work in favor of one’s self interest (SEP, para. 19, 2002), they will pull in favor of completing the surgeries with the cool saline solution if they believe it will affect themselves positively. For the doctor to decide to work on his patients using the solution, he will personally gain because he will be using his own practice. He may also feel that this will affect himself positively because he could potentially gain recognition for his discovery and breakthrough in medicine.
If the doctor is a Virtue Ethicist his beliefs will be different. To have Virtue Ethics one believes in doing what is considered “right” even if it is not what they personally want to do (Vliet, para. 7, 2015). Epictetus created a list of ideas that he believes to be morally good and are ways each of us should live. Of his list he mentions that we need to have the ability to flip a switch and take action against adversity (Epictetus, p. 269). If we come to a problem where our beliefs are tested we need to find patience in order to continue down the path that has been declared right. Virtue Ethicist have to be aware of what is the right thing to do, and when looking at this case, if the doctor has Virtue Ethics he will believe that the saline solution is the right thing to do because it has the ability to give doctors more time when fixing fatal wounds. Nevertheless, the doctor could decide to not use the solution if he has been presented with many skeptics or has been told by an authoritative figure to not go through with the procedures.
If the doctor followed the Rule Utilitarianism belief, he would come to the conclusion that the saline solution will not be the most ethical option if the outcome would break a rule that was placed in order to benefit the people involved (University, 2008). Rule Utilitarian’s believe that rules have been set in order to create the best possible outcome. If there was a rule that doctors could not put any kind of cooling solution into human bodies, then the doctor would follow that rule because it was believed to be the right choice.
The third step in the “ABCD’s of Ethical Decision-Making” guide, is to be aware of the consequence and how it will affect others and yourself. An Ethical Egoist would find that if they were to go about the surgeries in this way, the consequence could be a possible living patient after a horrific accident and positive recognition. From this standpoint, the consequences can be good, and in fact, the doctor would more likely go about the surgery from this perspective if he is confident in his studies of the solution.
From a Virtue Ethics perspective, the consequence of going through with the surgeries may be negative. If the doctor is told by an authoritative figure that he should not use the solution then he may find the consequence of losing trust in an employer to be a big factor in making his decision.
On the other hand, a Rule Utilitarian’s will see the consequence of their action as wrong if there is a rule in place stating that this action is not approved. A Rule Utilitarian wants to follow ideas that have already been in place. For example, if a teacher is a Rule Utilitarian and they are considering skipping to class because they would rather sleep in, they would inevitably get out of bed and go to class because there is a regulation stating teachers cannot skip school without warning or reason. The teacher follows these rules as a Rule Utilitarian because he believes that they show what is the right thing to do.
The final step is to decide what will be the best action. Will I be proud of my decision years to come? Will I want others to mimic my behavior? For an Ethical Egoist, they may decide to go about the surgery because they believe that it will fulfill their self-interest. The doctor would be proud for others to follow in his footsteps where they took actions into their own hands and stick to their instincts.
For a Virtue Ethicist, they may decide in favor of not going through with the surgery because they have been presented with the skepticism of others. It may be wrong for the doctor to do the procedure if he has been advised otherwise or that the saline solution has not been tested on the level that it needs to in order to be allowed into regular medical practice.
If the doctor followed the Rule Utilitarian view then he could decide that the surgery is not a moral act because of any rules or regulations. If the hospital has not studied this matter further and there is no document or regulation in place that allows the use of the solution, the doctor will not follow through with the procedure.
The ethical issue described in this case is one that deals with the livelihood of individuals that have been inflicted with a wound from either a gun or knife. The views from the Egoistic perspective is that this can be, and should be, solved through the use of a cool saline solution. “Humans being help their fellow human beings because it is advantageous to do so” (Ethical Subjectivism, para. 41), meaning, the doctors actions will be one that has some positive outcome for himself. This ethical idea can create an issue, especially if the doctor is putting lives in more danger for a practice that has not yet been properly tested before humans.
The decision made on the Virtue Ethics perspective to either go forth with the surgery or not, is based on what they find and know to be the right thing to do. The issue with Virtue Ethics is that the subject has to be aware of the right decision. This could be a problem if the doctor is unaware of what morally is right. The surgery could save the patient’s life, however, it can also be wrong because it would not have been tested on humans before and not one hundred percent proven to work.
Along with the Egotistic and Virtue Ethics perspectives, Rule Utilitarianism can also be shown to have a downside. The doctor may decide not to go about the surgeries due to a regulation or rule set against it, however, if the surgery has worked on pigs, and has been proven to give the doctor up to two more hours to fix and wounds on the subject, the doctor may be limiting his ability to save patients. This may lead the doctor to settle for a less effective practice to attempt to save patients when he knows of a better way that has been proven to work ninety percent of the time.
In making any decision, ethical perspectives are important in deciding what path we will choose to go down. Ethical Egoism, Virtue Ethics, and Rule Utilitarianism are all based on what someone will deem morally correct. What one doctor may decide in this situation may in fact be different than another. We are all different in our ideas and in how we think different obstacles should be resolved. Think about how you would act in this situation. Would you go through with the surgery?
Epictetus. (n.d.). The Art of Living.
Ethical Subjectivism: Can’t we all just get along? (n.d.). Leadership Ethics.
Philosophy, S. E. (2002, November 4). Egoism. Stanford, California, United States.
Steps in Ethical Decision-Making Process: Easy as A, B, C, D? (n.d.).
University, O. (2008, February 23). Consequentalist theory Egoism and Utilitarianism.avi. (S. Busada, Ed.)
Vliet, F. v. (2015). Ethical Theory: Virtue Ethics. Baltimore, Maryland.
Cover Image: http://www.otago.ac.nz/healthsciences/about/infosheets/medicineinfo.html