This podcast presents an ethical dilemma regarding an MD who was assigned the duty of triage in catastrophic events such as Hurricane Katrina. Her duties were to treat critically care patients and disregard the chronic ones. In the case of Katrina, babies were priority patients. DNR patients were held back and their care was postponed. This must have been a very difficult decision for anyone to make. Her along with other health care providers in these situations had to “Play God” and decide who would get the chance to live and who would be left behind to die.
Reflection of the Ethical Dilemma
The podcast involving victims from Hurricane Katrina was terrifying to listen to. I could not imagine being a part of something so traumatic. Once the generator went out so many people lost their lives. The chilling scene when one of the survivors described when someone died in their arms was very emotional. Because supplies were so limited, making the most of what was available was the only option. I agree with the triage method: treating the acute patients first because this is common practice in emergency situations. Medical staff did the best they could with extreme limitations. It was very upsetting how these people were depicted by the media and abandoned by the government. There seemed to be greater concern over looting rather than the amount of fatalities. Another ethical dilemma involving this situation was regarding euthanasia. In a sense it was a means to an end for those suffering. In the situation, some thought euthanasia was the “most humane thing they could do”, while others were outraged by the idea. Although medical staff had good intentions surrounding the matter, euthanasia in this situation is unethical. I would imagine some people feeling suicidal and eager to accept euthanasia to end their misery. Terminally ill patients should be made comfortable with acceptable doses of morphine and versed, whilst the overweight stroke patient should not be given the same option. The patient’s quality of life is limited, and his weight and condition were an inconvenience for the staff. This should not be a good reason for euthanasia. Stroke patients recover and regain function every day. The criteria for the patients who gets to receive this deadly formula was not well thought out. Put in the situation though, I would have been conflicted as well.
Ethical Decision-Making Process
Step 2, 5, and 6 of the Ethical Decision-Making Model were followed. The type of ethical problem was identified. There was great deal of moral distress over if the lethal drug would be given and to who. Medical staff made tough decisions and acted upon it. After going to trial, staff were emotional over the outcome but stood by their decisions to euthanize the patients as an effort to minimize suffering.
Step 1 of the Six-Step process were not followed properly. More information could have been gathered from the overweight stroke patient before euthanizing him. His psychological status should have been assessed more thoroughly. Potential for chronic depression is likely due to his health status. This should be evaluated by a specialist once rescued. The staff mentioned his lack of movement which affects his quality of life. Since this is partially subjective, clarifying the patient’s goals is necessary. One must pay critical attention to the details of a situation. This means learning to distinguish clinical, legal, and ethical content.
Step 3 also was not followed. The goal is to analyze the problem using ethical theories and approaches. Euthanasia is not legal in Louisiana. There was no moral conduct or supportive literature used in making these decisions.
Step 4 was not followed. Medical professionals did not explore all possible options. Although the staff treated the acute patients with all available resources, other means of treatment outside of euthanasia was not discussed in this podcast. Giving these terminal or limited patients drugs to lessen their suffering and keep them comfortable until help arrived could’ve been the better option.
The outcome was impacted by the moral agents’ decisions to proceed with euthanasia. Medical staff faced potential criminal charges. They also were ridiculed and blamed for murdering those people. If they used proper ethical theories and approaches, their decisions would have been supported by the medical community and courts. In this case, one cannot judge the moral rightness or wrongness of an act based on its consequences alone.
Judgement must be geared towards action. Moral judgement must be applied while using this model. It will directly affect the decision-making process whilst in an emergency. Moral judgement is based on individual values. Someone in the position to “Play God” should always have a team of people to discuss and formulate the best plan of action. Leaving the decisions solely up to one person can be very dangerous and their values and moral may differ greatly. Clinical judgments can also be used. This indicates that medical professionals allowing patients to make their own health care decision when they are fully capable.
The ethical theory that best fits with the resolution of my peer’s dilemma is Deontology. Deontology theories hold that you are acting rightly when you act according to duties and rights. In other words, duties and rights are the correct measuring rods for evaluating a course of action and its outcome. Some actions are intrinsically immoral, no matter how positive and beneficial one might judge the consequences to be, and that other actions are intrinsically moral, no matter how negative the consequences might be. In short, he said that one cannot judge the moral rightness or wrongness of an act based on its consequences alone. In this case there was a gamble either way in making the decision to euthanize patients, but it was also the medical providers’ duty to make the best decision for the suffering patients at the time. You are right. Some sort of plan should always be in place just case something catastrophic happens. This will alleviate a lot of stress and pressure on the leader or moral agents in the matter. If there are clear guidelines to follow, there is less room for unethical dilemmas to happen.
- Adler, S. & McEwen, A. (Producers). (2016, August 21). Playing god [Audio podcast]. Retrieved from: https://www.wnycstudios.org/story/playing-god
- Doherty, R.F., & Purtilo, R.B. (2016). Ethical dimensions in the health professions (6th ed.). St. Louis, MO: Elsevier