smoking, morality, doctors

[Grog]

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?

[Admiral Valdemar]

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).

[Terr Fangbite]

Save the guy with the heart problem. Unlike the smoker, he didn't cause his body to be crapped up.

[Darth Wong]

I would be curious how one would produce an ethical argument for saving the smoker over the guy who inherited a defective ticker.

[Melchior]

I would be curious how one would produce an ethical argument for saving the smoker over the guy who inherited a defective ticker.

The guy with the defective ticker could have, for example only one month of life left.
If this is not the case, it is obvious that it is better to save the one whose problem is not his fault.

[Wicked Pilot]

Let's say you're on a boat when a large wave washes two of your friends overboard. Both friends are being pulled away quickly and there is no readily available safety gear. You're a very strong swimmer and are fully capable of jumping in and pulling one at a time to safety, but there is not enough time to get both. Friend A is absolutely terrified of the water and as such doesn't know how to swim. Friend B does know how to swim, but simply refuses to do so. Who will you save? I'll go after Friend A. Friend B could have/should have saved themselves. I'd use the same logic for the OT.

[Boyish-Tigerlilly]

I think it would also depend on what type of relations and family the guy who smokes has. If the guy with the heart problem is older, has no or few relatives, and little to no friends, when he and the smoker are juxtaposed, I would go with the smoker, since the smoker's death would affect more people.

If they have relatively equal numbers of dependents, friends, family etc, i would go with the healthy (but heart problem person, unless that person were to have little chance of living long anyway).

[aten_vs_ra]

What is the point of saving someone with no regard for his own life? I see hardly any dilemma here.

[Boyish-Tigerlilly]

You aren't just affecting 1 person, the smoker. THere are many other variables to consider, if you have the knowledge of them, however. If you don't, then you cannot consider it, but if you do, you ought to consider what good the smoker is doing, with whom he has relationships, who are dependents etc.

[Wicked Pilot]

Or let's think about it this way. One person is about to fall off a building, while another is about to jump off. Given the chance I'd go for saving both, but if pressed to choose one over another I'd save the one who chooses to stay alive. You're more likely to receive help from others if you make an attempt to help yourself.

[Darth Wong]

I think it would also depend on what type of relations and family the guy who smokes has. If the guy with the heart problem is older, has no or few relatives, and little to no friends, when he and the smoker are juxtaposed, I would go with the smoker, since the smoker's death would affect more people.

If they have relatively equal numbers of dependents, friends, family etc, i would go with the healthy (but heart problem person, unless that person were to have little chance of living long anyway).

Osama Bin Laden has an extremely large family; would you save him over someone else?

[Guardsman Bass]

Assuming that, as a emergency doctor, he doesn't know the backgrounds of the patients other than their health background, I would choose the heart person, because(all things being equal) unlike the smoker, they aren't as liable to screw up their health.

[Morilore]

Osama Bin Laden has an extremely large family; would you save him over someone else?

I understand that you are not comparing smoking to running a terrorist organization, but be reasonable: Tigerlily is merely saying that considering who our decision hurts should be more important than our judgment of the acceptability of an individual's choices. He is not saying that the size of the family is the only determinant.

Let's say you're on a boat when a large wave washes two of your friends overboard. Both friends are being pulled away quickly and there is no readily available safety gear. You're a very strong swimmer and are fully capable of jumping in and pulling one at a time to safety, but there is not enough time to get both. Friend A is absolutely terrified of the water and as such doesn't know how to swim. Friend B does know how to swim, but simply refuses to do so. Who will you save? I'll go after Friend A. Friend B could have/should have saved themselves. I'd use the same logic for the OT.

I'm curious: would you say the same thing if the OP said that the smoker patient had attempted to quit many times throughout his or her life, at regular intervals? What if the smoker was currently engrossed in such an attempt?

[Boyish-Tigerlilly]

Osama Bin Laden has an extremely large family; would you save him over someone else?

Family size isn't the only variable to consider when making an Ethical calculation, just as "does he help himself?" isn't. It's only one, but I don't think it is always outweighed by "did he cause his own condition." That can be a factor, yes. That's totally not thinking of the other factors. One should consider what type of person he is, and this is covered under "whom does he affect" like earlier. It's more complicated than "do I save the smoker or the person with the heart problem" based on whether or not one is responsible for his own problem.

1. What type of people are they generally?
2. What are their family relations (size, likeability, status)
3. Are there dependents on each side?
4. Will the person who caused his own problem do it again, thus raising the costs relative to the benefits of saving him?
5. Can they both be saved?
6. What are their chances of living after each respective procedure?


For example, if we had two individuals ( A and B ) I would try to apply some type of calculation to them based on their situation. It would always be a different calculation, and it would be vague. I also cannot think of everything to put in here, so if you could help, it might be better.




A is a good citizen who doesn't go about killing or harming others.*

A. He has a natural disease, which can be cured*

A. Has a wife, but no children. He has one parent left alive who lives with him, has no job and is old.*

A. Does not have a disease which will come back again if the patient isn't careful.*

A. Will live a fruitful life after the procedure, as far as doctors can tell.*



Well. I would try to calculate it as follows:

1. Since Man A is a good citizen, he harms no one directly and doesn't seek to kill other people. He isn't a mass murderor, so I give him 30 utils.

2. Since Man A will be cured and can have a fruitful life after the procedure, with little chance of repeating it, I would give him another 20 Utils due to cost/benefit.

3. Since Man A has a wife, I allot him 10 Utils for her pain suffering (given that they care about each other), and since Man A has 1 dependent who is old, and would probably go into a home or be reliant on the wife, I award him another 10 utils.
------------------------------------------------------------------------------------

B. Is a law abiding citizen who doesn't harm or kill others.*
B. He has a self-induced disease that can be cured*
B. Has 1 child and a wife, doesn't really get involved with his other family members.*
B. Has a disease that potentially could come back again, making everyone have to go through the same costs, suffering, thus potentially lowering the benefits compared to costs of saving him. (-10)*
B. Will live a fruitful life after the procedure, as far as doctors can tell.*

1. Law abiding citizen = 30 Utils

2. Has a disease that can be cured, but could potentially cause the problem again, but I am not sure, so I give him U=(20/2)=10 Utils with penality.


3 . Has a wife and a child, but doen't really have much of other family members. I give him 10 utils for the child, 10 utils for the wife. I know it's hard for a single mother to put a child through college, so I award them 5 bonus utils, where as the other man has no children, which can cut a lot of costs.

Final Calculation: Man B: U=(25+30+10)

Utils = 65

Man A: U=(20 + 20 + 30)

Utils = 70

As a result, my calculation would be, in this situation, that man A get the treatment, but this would change if he had no children, no wife, or no family which relied on him. It's not very smiple.


As for Osama Bin Laden: No, I wouldn't save him just because he has a large family, because I would penalize him in other categories, namely a large penality for deliberately killing, hurting others, having most of his family who doesn't like him, and having them be relatively well of wealth wise.

*****
Extra consideration: if there is a chance that man B could have the same problem, then one would have to consider: would the next competitor for treatment end up outweighing him. You would add the calculation of man C to man A to confront Man B.******

[Trytostaydead]

Well, there's not enough info in that one.

Is this some emergency case in the ER? If so, it doesn't matter about the long run, but a decision is based off of whether or not a patient can be stable to work on the other one.

Or are we talking about some magical cure cancer type drug and we can only give it to one?

[Darth Servo]

The guy with the defective ticker could have, for example only one month of life left.
If this is not the case, it is obvious that it is better to save the one whose problem is not his fault.

But thats not the situation. The Dr. gets to SAVE one of them. That in no way implies the patient will keel over in another month.

For points like family, ect, all other factors should be considered equal.

[entfern]

I'm not entirely sure that the patient with a heart problem is any less self destructive than the one with the smoking problem. Like the smoker, he knew that his condition existed, assuming that treatment exists for him, it should have been his responsibility to have gotten the treatment before it got to the point where he was more or less gambling for his life. His not seeking treatment earlier is as irresponsible as the smoker continuing to smoke despite the surgeon general's warning. If there is no treatment, I personally would prefer someone letting me die peacefully without a false hope for survival. . .but that's me. . .

[Broomstick]

Having a congenital problem does not mean you're doomed to being a hopeless cripple or an early death. Millions of people are born with minor cardiovascular/heart defects that cause no serious or significant problems until old age, if even then. Heart murmurs, for instance, may be of no significance in a normal life.

Nor is heart disease always the "fault" of the sufferer, nor does it always mean an early death. There are, again, thousands of people who have never been overweight, excercise regularly, eat properly... and still have heart disease.

So... who would I save? My first inclination is to save the person with the congenital problem, not the smoker. But a lot depends on the "heart problem". If it's minor, yes, I'm inclined to save the heart patient and not the smoker. On the other hand, if the heart patient is in end-stage cardiomyopathy with congestive heart failure, pulmonary complications, and deteriorating kidneys and other major organs - hell, I'd save the smoker if they were relatively healthy and upright because the other guy's life most likely won't be prolonged more than a month or two at best, and it will be a painful, miserable existance tied to a hospital bed. A smoker still in relatively good health at least has a chance to clean up his/her act and improve their situation.

In sum, there's not really enough information here for a definitive answer.

[Xenophobe3691]

On the information given, save the non-smoker.

But at no time, ever, is a decision that simple. Ever. This is like projecting Michelangelo's David onto a line and asking on our opinion.

[Drooling Iguana]

You aren't just affecting 1 person, the smoker. THere are many other variables to consider, if you have the knowledge of them, however. If you don't, then you cannot consider it, but if you do, you ought to consider what good the smoker is doing, with whom he has relationships, who are dependents etc.

Heart-condition-guy could also have relationships, dependants, etc. This isn't just a question about whether you save the smoker or let him die. If it was, you'd have to be some kind of monster not to try to save him. This is a question of having two people at death's door and only being able to save one of them. In that case, even the slightest differences between them would have to decide it one way or the other.

[Darth Wong]

Let's be reasonable; normally in an ethical situation like this, one would presume that "all other things being equal" is part of the scenario without having to be laid out explicitly.

[Keevan_Colton]

I'm not entirely sure that the patient with a heart problem is any less self destructive than the one with the smoking problem. Like the smoker, he knew that his condition existed, assuming that treatment exists for him, it should have been his responsibility to have gotten the treatment before it got to the point where he was more or less gambling for his life. His not seeking treatment earlier is as irresponsible as the smoker continuing to smoke despite the surgeon general's warning. If there is no treatment, I personally would prefer someone letting me die peacefully without a false hope for survival. . .but that's me. . .

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?

[tharkûn]

Heart patient in a second. Personally I'll go with the guy less likely to be poisoning his friends and family, because let's face it the number of smokers who don't subject others to their filthy habit is far, far too low.

[BlkbrryTheGreat]

Let's be reasonable; normally in an ethical situation like this, one would presume that "all other things being equal" is part of the scenario without having to be laid out explicitly.

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.

[Wicked Pilot]

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?