smoking, morality, doctors

[entfern]

Being born with a congenital heart defect is as self destructive as recklessly and willfully breathing in a mix of carcinogens, arsenic, radioactive polonium and a load of other shit on a regular basis...

Excuse me, but when the fuck did logic and reason leave your general area?

Being born with a congenital heart defect is not self-destructive. Not doing anything about it, when something can be done is.

If you are bleeding to death, you find a way to reduce blood flow, get help, and find a way to get more blood, to do otherwise is self-destructive. If you can't do anything about your condition. . . well then there is nothing you(personally or as the hypothetical doctor) can do.

But if you willfully choose to not seek treatment, I don't see how you are much better than the person who chooses to smoke, or the person trying to commit suicide.

[Darth Wong]

Being born with a congenital heart defect is as self destructive as recklessly and willfully breathing in a mix of carcinogens, arsenic, radioactive polonium and a load of other shit on a regular basis...

Excuse me, but when the fuck did logic and reason leave your general area?

Being born with a congenital heart defect is not self-destructive. Not doing anything about it, when something can be done is.

If you are bleeding to death, you find a way to reduce blood flow, get help, and find a way to get more blood, to do otherwise is self-destructive. If you can't do anything about your condition. . . well then there is nothing you(personally or as the hypothetical doctor) can do.

But if you willfully choose to not seek treatment, I don't see how you are much better than the person who chooses to smoke, or the person trying to commit suicide.

Since this person is currently seeking treatment as per the scenario, this argument seems like a complete waste of time.

[BlkbrryTheGreat]

Well if all else is equal, why not just hold an auction between the two; the one who bids highest obviously considers it a higher priority then the other guy.

They are equal, they both bid the same amount at the same time. Why do you insist on wasting bandwidth?

An auction means that both cannot bid the same amount at the same time. That means that there can be only one winner- meaning that the last person to bid before the "cut off point" would be the winner, assuming we accept your premise that they would BOTH have an identical cut off point.

At any rate, lets accept this silly hypothetical and continue down this line of questioning. The obvious choice is the the non-smoker, for a number of reasons.

First among them is that is that smoking harms the body in many more ways then a congenital heart defect does. Even if the smoker recieves the transplant, he will live a much shorter live then the heart defect person would have if he had recieved the transplant.

Secondly, and completely related to the first is that the fact of the matter is the smokers "wounds" were completely self-inflicted- his condition was both forseeable and preventable. He is reaping what he sowed- meaning that with "all else equal" this tips the "scales" against him.

[Darth Servo]

Being born with a congenital heart defect is not self-destructive. Not doing anything about it, when something can be done is.

If you are bleeding to death, you find a way to reduce blood flow, get help, and find a way to get more blood, to do otherwise is self-destructive. If you can't do anything about your condition. . . well then there is nothing you(personally or as the hypothetical doctor) can do.

But if you willfully choose to not seek treatment, I don't see how you are much better than the person who chooses to smoke, or the person trying to commit suicide.

And where in the scenario did it mention that the guy with the congenital heart defect was NOT trying to take care of it?

Hey, if you really want to push for saving the smoker why not make the heart defect guy into a neonazi as well?

[entfern]

And where in the scenario did it mention that the guy with the congenital heart defect was NOT trying to take care of it?

Hey, if you really want to push for saving the smoker why not make the heart defect guy into a neonazi as well?

Where did it mention that he was trying to take care of it? True a congenital defect even when treated can cause sudden problems, but like I have stated, if he is already seeking treatment, is there anything that we can do for him? So I am making the assumption that he didn't(for the previously mentioned statement that if treatement has been ineffective. . .)

So. . . if he didn't seek treatment, I really don't see how he is any better.

[entfern]

I just realized I should mention that I am seeing this as a doctor dealing with two patients on the verge of death, and not as a friendly check up. . .

[Darth Servo]

Where did it mention that he was trying to take care of it?

See DW's last post in this thread.

[Broomstick]

Where did it mention that he was trying to take care of it? True a congenital defect even when treated can cause sudden problems, but like I have stated, if he is already seeking treatment, is there anything that we can do for him? So I am making the assumption that he didn't(for the previously mentioned statement that if treatement has been ineffective. . .)

OK, let's try this again.... where does it say the heart guy hasn't sought treatment? YOU are the one making this assumption.

Congenital conditions present at birth may, nonetheless, not make themselves known until adulthood. Aneurysms are one such problem - you can be born with an inborn weakness in a major blood vessel of which you are totally unaware until you have a blow out, at which point you have a sudden, catastrophic emergency. And that's just one such problem, there are others. And yes, we can do something for such people that will enable them to live long, meaningful lives with a high quality of existance - provided we catch the problem in time and the medical procedures are successful.

Were you assuming congenital heart defects were always untreatable? That they were immediately apparent at birth? Both false.

The scenario is that you have two patients - one smokes, the other has a congenital heart condition, and that's all you know. It might be more helpful if we had more information, but we don't. The scenario here might not even involve smoking-related or heart-related conditions. Maybe they've both been snake-bit and you only have enough anti-venom for one. Maybe they've been in a major accident in a remote location and you only have enough blood to transfuse to save one of them. We really don't know.

[The Third Man]

What should the doctor do, do you think it is a moral dilemma?

He/she should try to as hard as possible to avoid making decisions based on how the patient came by the injuries, or to what extent the patient will risk their health in future. Although the smoker/non-smoker case is a fairly easy decision to make, once a doctor has made a decision on one case based on these criteria, then he/she - to be morally and ethically consistent - should apply the same decision to all other cases. The doctor would then face more tricky decisions, say, between treating someone who engages in a high-risk sport (say, pot-holing), and someone who leads a completely sedentary, stay-at-home lifestyle.

[RedImperator]

All other things being equal, the person with the congenital defect should be saved, because he didn't bring about his illness through his own actions. I'd say that same if you had two traffic accident victims, one of whom was run over by an out-of-control car while walking on the sidewalk, the other run over while he was crossing the street against the light.

I feel compelled to add, however, that all oher things are rarely equal.

[Drooling Iguana]

What should the doctor do, do you think it is a moral dilemma?

He/she should try to as hard as possible to avoid making decisions based on how the patient came by the injuries, or to what extent the patient will risk their health in future.

So what, pray tell, should he base the decision on? Or should he just sit there with his finger up his ass until they're both dead?

[Boyish-Tigerlilly]

One problem with doctors and trying to use a utilitarian ethic, is that you cannot make the most educated discision you could if had time to do research or look it over.

It's very difficult for a doctor to get the required information to make such a decision, which could be good if he could. A lot of doctors have to make snap decisions, which sometimes I dont think Utility is good for doing.

Cesteris Paribus is a good strategy, but I guess youc ould, as a doctor, go by the best information you could get, even if it's not perfect.

[mr friendly guy]

Ignoring the fact that these patients would very likely be treated by 2 different specialties, ie they would most likely not be seeing the same specialist (one would likely see an oncologist if smoking led to lung cancer and the other would likely see a surgeon);

then I would go for the one with the congenital heart disease. If all other things are equal, the only factor to consider would be the number of years of life added and quality of life. A smoker unless they stopped smoking, would likely end up back in the same situation, while the other patient isn't, so would gain more years of life.

[Aaron]

Personally, I'd save the one who'd appreciate it more and wouldn't work at killing himself again with toxic fags. But, a doctor is not really meant to deny such treatments unless it's ER or a field medic who has to make quick assessments to save those that may just make it on limited resources (I forgot the proper terminology).

The term your looking for is triage.

[tharkûn]

He/she should try to as hard as possible to avoid making decisions based on how the patient came by the injuries, or to what extent the patient will risk their health in future. Although the smoker/non-smoker case is a fairly easy decision to make, once a doctor has made a decision on one case based on these criteria, then he/she - to be morally and ethically consistent - should apply the same decision to all other cases. The doctor would then face more tricky decisions, say, between treating someone who engages in a high-risk sport (say, pot-holing), and someone who leads a completely sedentary, stay-at-home lifestyle.

Okay here is a nice easy one for you, and this has the added benifit of being real world. There is a finite supply of donor organs, there is a larger supply of patients needing organs. Should recipients be given preference based upon life choices? Should someone who burned their kidney's out on hard drugs be given the same weight on the list to some one who had them gutted as the victim of a car wreck? Should alcoholics be ranked lowered on the recipient list because they will most like trash a new one? Should a recipient serving consecutive life sentences for homicide be given equal dibs on a kidney as a normal person - even those his were both shot out in a gun battle with cops?

Yes in a perfect world there would be no downside to treating the scum of the earth with the same care as anyone else. Yes in a slightly less perfect world there would be a perfect system for objectively weighting who merits what ranking. But in the real world I think it is unethical for innocents to de facto suffer because some one else's choose to damn themselves.

[Queeb Salaron]

Personally, I'd save the one who'd appreciate it more and wouldn't work at killing himself again with toxic fags.

As a toxic fag, I resent that remark!!



My two cents: If I were the doctor, I'd save the guy who was easier to save. Really, when a problem like this presents itself, and if we assume that all other things are equal, we have to look at human nature. When a person gets a new lease on life, they generally go out and do something crazy to appreciate it more: bungee jumping, skydiving, swimming with sharks, etc. The theory is that if you live life dangerously, you'll appreciate it more. In doing so, you're putting your life at risk and severely decreasing your life expectancy. We know the smoker isn't going to be running around doing these things; his lungs won't allow for it. The other guy, though, may very well wish to experience some of these things.

In this case, knowing what I do about human nature, I'd put the life expectancy for both patients in the same general ballpark, and save the one that's easiest to save.

Moral dilemmas.

[Alyeska]

If a doctor has two patients a smoker and one that isn’t a smoker, the doctor can only save one (the other one will die). The smoker is ill because of the smoking (he has been a smoker for more or less his entire life) and the other has a problem with his hearth (he was born with the problem). What should the doctor do, do you think it is a moral dilemma?

Lets modify this somewhat.

The smoker is a scientist on the verge of curing all Cancer, but only he can do it and his death will set cancer research back 100 years. The person with a bad heart is a member of the KKK and is known to beat his wife.

Suddenly the circumstance of the illness isn't quite so important.

[Alyeska]

My two cents: If I were the doctor, I'd save the guy who was easier to save.

You are presented with a gunshot wound to the chest and someone with a broken leg. Who do you work on first? I doubt it will be the one thats easier.

[Queeb Salaron]

My two cents: If I were the doctor, I'd save the guy who was easier to save.

You are presented with a gunshot wound to the chest and someone with a broken leg. Who do you work on first? I doubt it will be the one thats easier.

Alyeska, if you took time out of your busy day to actually read the entirety of my post (which, at a whopping 35 lines or so, would have kept you up all night, I'm sure,) you'd realize that this point you just made, while correct, has abso-fucking-lutely nothing to do with what we're talking about.

Two patients, both dying (guys with broken legs haven't died since the advent of Penicillin). One smokes, one doesn't. Save the one that's easiest, because they're both going to die soon anyway. This is assuming that all other things are equal (which means we're disregarding the scientist/Klansman argument).

Read posts before replying. Thankyouverymuch.

[tharkûn]

Two patients, both dying (guys with broken legs haven't died since the advent of Penicillin).

Depends on the break. If you have comminuted compound fractures, particularly ones that risk nicking the femoral artery ... yes you can be dying from it. Exsanguination may take a bit, but it will eventually kill you.

In any event there are numerous lethal conditions that take time to run their course, far less than is needed to treat far more complicated injuries. Kidney failure will kill you, but is easy to treat - just hook up dialysis. Bullets lodged in organs are far more complicated. You treat the bullet wound first because the kidney patient takes longer to die. If you treat the kidney patient first the bullet patient may die before you are done, it is much less likely to kill the kidney patient if you work on the bullet patient first.

[Queeb Salaron]

Two patients, both dying (guys with broken legs haven't died since the advent of Penicillin).

Depends on the break. If you have comminuted compound fractures, particularly ones that risk nicking the femoral artery ... yes you can be dying from it. Exsanguination may take a bit, but it will eventually kill you.

In any event there are numerous lethal conditions that take time to run their course, far less than is needed to treat far more complicated injuries. Kidney failure will kill you, but is easy to treat - just hook up dialysis. Bullets lodged in organs are far more complicated. You treat the bullet wound first because the kidney patient takes longer to die. If you treat the kidney patient first the bullet patient may die before you are done, it is much less likely to kill the kidney patient if you work on the bullet patient first.

Oh for the love of Jesus H. Tapdancing Christ on a pogo stick, point conceded!