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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 60. Go back in thread:
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...
Posted by alexandra_k on March 1, 2005, at 14:54:03
In reply to Re: (2) One or Six???, posted by Broken on March 1, 2005, at 7:18:29
> I agree. The two senarios are different, for me personally.
But it is hard to specify just how they are different...
>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.
But don't you owe the other 6 people the best treatment possible as well??? Especially if every patient in the case is YOUR patient...
> 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.
Aaaah. Yes. Just because there is a fuzzy boundary doesn't mean there isn't one. I do hear what you are saying... But you seem to think that your professional morals would dictate that this is an immoral act. Do you want to say it is an immoral act - or that all things considered it is actually the moral thing to do?
> 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)Yeah. You can do the same thing with 'we should send $1 to charity. We should send $2 to charity etc. Until you send everything you have to charity and find yourself dying on the street.
> 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.Please do go there. You could start it on a new thread.
Posted by alexandra_k on March 1, 2005, at 15:26:13
In reply to Re: (2) One or Six??? » alexandra_k, posted by TamaraJ on March 1, 2005, at 10:19:49
> -- 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.
Yeah. It is certainly true that a lot more people find passive euthenasia acceptable than active euthenasia...
>Maybe I am off base here, but I find the act of "passive" euthenasia a far less humane act.
ALWAYS a 'far less humane act' or SOMETIMES?
> Passive euthenasia is, as I understand it, more than just do not ressusatate.
'Passive euthenasia' refers to a variety of practices only one of which is 'do not resussatate'.
>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.
Yes, that surely happens in some cases.
Rachels is well known for his arguments that there isn't a morally relevant distinction between active and passive euthenasia. If it is acceptable to euthenise someone (and he thinks it is acceptable in SOME cases) then the most humane way should be employed regardless of whether it is 'active' or 'passive'.
> 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.
Yes. This is a utilitarian, consequantialist based viewpoint (it looks at the consequences of the act to see whether it is morally justified / acceptable or not). That can be contrasted with intrinsic value theories or theories such as Kant's moral law which say that some acts are good or bad, right or wrong IN THEMSELVES - regardless of consequences. (E.g. It is morally wrong to kill. Active euthenasia is killing. Therefore active euthenasia is morally wrong. And: it is sometimes but not always morally wrong to let die. Passive euthenasia is letting die. Therefore passive euthenasia is sometimes wrong - but not always).
>The difference between the two is accentuated because we frequently hear of terrible cases of active killings, but not of passive killings.
Starting to change though...
With respect to the active / passive distinction consider the following case:
X is on life support.
If X is taken off life support X will die.
According to those who consider active euthanasia to be wrong it is morally unacceptable to give X a lethal injection.
According to those who consider passive euthanasia to be acceptable in some cases it may be acceptable to take X off life support.What is the morally relevant difference between killing and letting die when the consequence is the same? (That is his point - that there is none).
Now in this case the 'active euthenasia' requires someone to ACT in the sense that someone has to ADMINISTER the injection...
Now in this case the 'passive euthenasia' requires someone to ACT in the sense that someone has to TURN OFF the life support...
An action is required either way...
So the 'active' / 'passive' distinction breaks down...It seems arbitrary to consider one acceptable and the other unacceptable.
Surely they are either both acceptable or both unacceptable...
Now the non-consequentialist will try to say that there is something intrinsically different about administering a lethal injection (which is wrong all by itself) and flipping a switch (which is not wrong all by itself).
But this doesn't work (IMO) because the injection can only be referred to as 'lethal' because of the consequences (in the sense that it 'causes death'). It is only 'lethal' because of that consequence.
So 'all by itself' there doesn't seem to be anything wrong with administering and injection...
Likewise with flipping a switch - that doesn't even seem to be a moral action unless we take the consequences into account (I mean it isn't a moral action when I turn on the light)...> And, this debate, which has gone on for centuries, will continue.
Yes. But hopefully the laws will change in the near future IMO.
thanks for your thoughts :-)
Posted by alexandra_k on March 1, 2005, at 15:28:42
In reply to Re: (2) One or Six??? » jay, posted by Gabbi-x-2 on March 1, 2005, at 3:01:25
Posted by Gabbi-x-2 on March 1, 2005, at 16:11:29
In reply to Re: Welcome Back Gabbi!!! (nm) » Gabbi-x-2, posted by alexandra_k on March 1, 2005, at 15:28:42
Thank-you, you have mail on the way. I've been a little behind. These are great questions.
(((Alex)))
Posted by alexandra_k on March 1, 2005, at 16:47:41
In reply to Alexandra!!, posted by Gabbi-x-2 on March 1, 2005, at 16:11:29
(((((Gabbi)))))
I thought you might like Applied Ethics ;-)
Posted by alexandra_k on March 1, 2005, at 16:57:22
In reply to Re: Gabbi!! » Gabbi-x-2, posted by alexandra_k on March 1, 2005, at 16:47:41
... why do people tend to like ethics and philosophy of religion better than philosophy of language and philosophy of mind???
I'll ask y'all about the meaning of meaning one day... But I fear I won't get as many responses
;-)
Sigh.
Posted by alexandra_k on March 1, 2005, at 16:59:55
In reply to Re: What I want to know is..., posted by alexandra_k on March 1, 2005, at 16:57:22
What kinds of things should appear in our ontology
(If we are cataloguing things that exist).Do protons exist?
How about chemicals?
How about dogs?
Chairs?
Voices?
Cities?
Money?
Numbers?
Mind?
God?
Phlogiston?Its okay, you can just ignore me if you like...
Posted by medhed on March 1, 2005, at 17:20:58
In reply to Re: (2) One or Six??? » medhed, posted by alexandra_k on March 1, 2005, at 14:49:16
> > 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...
>
>No, 6 dead people are better than one dead, save the guy and give him a morphine OD while he's in recovery. that would be 7 dead violators of this earth. Don't you think we (people) are a freak of nature anyway? They allow us to kill animals when overpopulation is a problem to the environment, and animals are innocent...
Posted by alexandra_k on March 1, 2005, at 17:30:21
In reply to Re: (2) One or Six??? » alexandra_k, posted by medhed on March 1, 2005, at 17:20:58
> No, 6 dead people are better than one dead, save the guy and give him a morphine OD while he's in recovery. that would be 7 dead violators of this earth. Don't you think we (people) are a freak of nature anyway? They allow us to kill animals when overpopulation is a problem to the environment, and animals are innocent...
The Land Ethic it is.
Do you really believe this is the morally right thing to do???
Posted by alexandra_k on March 1, 2005, at 17:32:02
In reply to Re: (2) One or Six??? » alexandra_k, posted by medhed on March 1, 2005, at 17:20:58
> No, 6 dead people are better than one dead, save the guy and give him a morphine OD while he's in recovery. that would be 7 dead violators of this earth. Don't you think we (people) are a freak of nature anyway? They allow us to kill animals when overpopulation is a problem to the environment, and animals are innocent...
Ps. Given that, are we morally obliged to kill ourself???
Posted by jay on March 1, 2005, at 19:57:35
In reply to Re: (2) One or Six??? » jay, posted by alexandra_k on February 28, 2005, at 22:04:13
> > You aren't "killing" anybody if you operate on this guy,
>
> No, you aren't killing anybody. You are letting them die.
>
Death being a natural occurance, it is not I who is letting them die. I didn't give them 'organ failure'!> >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...
>It's a simple logical positivist argument. Just because this person has organs to donate, as do millions of others, does not mean they should die for the sake of *each of the other individuals.*>>>You are lumping the six people together as if they are the only people in a world of millions that need an organ transplant. Do ya know what I mean?? Huh? :)
> >...that's just how it is...etc...
>
> 'How things are' does not imply anything about how things *should* be or what we *should* do.
>No, we are given certain choices...a..b...c..you either do or you don't. *Should* is based on a number of variables...from cultural norms and values to individual ones. Sociology and psychology come into play here.
> >and B) fate is the weight of circumstances.
>
> ???
>I take it you haven't read much Kierkegaard, eh? :) (It's a quote from a translation of one of his texts.)
> >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.
>
Sorry, but I still see these as 6 individual seperate, deaths. Each of those individual persons are putting one other person at risk of death for the want of an organ transplantJay :)
Posted by alexandra_k on March 1, 2005, at 21:01:44
In reply to Re: (2) One or Six??? » alexandra_k, posted by jay on March 1, 2005, at 19:57:35
> Death being a natural occurance, it is not I who is letting them die. I didn't give them 'organ failure'!
No, you didn't give them organ failure. But you can choose to save them and you choose not to...
If a child is drowning and you are an able swimmer you could stand on the bank and watch - after all you did not throw her into the water...
> It's a simple logical positivist argument. Just because this person has organs to donate, as do millions of others, does not mean they should die for the sake of *each of the other individuals.*In the above case there aren't any other possible donors. (You could imagine this to be happening on an island somewhere and noone from outside can come in if you like). The people mentioned in the scenario are the only people on the island etc.
If you alter the case so there is the possibility of other donors then you can alter what you think we *should* do in the new situation. But that is not an answer to the case the way it was set out.
You can of course say that the way the case is set out can't occur in reality (that it is not possible). Since it is necessarily hypothetical it is senseless to say what we *should* do. This is the line my office mate takes. (Ah - but now he accepts the island case!).. But is it really impossible as a matter of principle? Isn't the island situation possible (though highly improbable to be sure)? If it isn't impossible then we should be able to say what we *should* do in that situation...
>>>You are lumping the six people together as if they are the only people in a world of millions that need an organ transplant. Do ya know what I mean?? Huh? :)
Yeah. I think my above point covers that???
> *Should* is based on a number of variables...from cultural norms and values to individual ones. Sociology and psychology come into play here.
Sure, if you are a moral relativist that is the way things go...
> > >and B) fate is the weight of circumstances.
> > ???> I take it you haven't read much Kierkegaard, eh? :) (It's a quote from a translation of one of his texts.)
But the consideration (case) is from a utilitarian perspective. How the circumstances came about is irrelevant (my office mate says).
No. I haven't read any of his stuff. I am an analytic philosopher and he is of the continental tradition...
> > I guess they are. But in this instance one other. We have to choose between six deaths or one death.
> Sorry, but I still see these as 6 individual seperate, deaths. Each of those individual persons are putting one other person at risk of death for the want of an organ transplantOffice mate says... To see his point above...
:-)
Because: Rights based arguments don't apply to utilitarian cases.
But it is begging the question (in favour of letting the one die) to consider it to be a utilitarian case...
(to go 1+1+1+1+1+1=6 and lump them together)You can say that letting him die is wrong because it is wrong to let people die. But then it is also wrong to let the others die.
You are doing the wrong thing either way.
Same with the first case - wrong thing either way.
Same for the 'real life' case given in one.Guilt and *wrong* action all round :-(
Posted by alexandra_k on March 1, 2005, at 21:13:38
In reply to Re: (2) One or Six??? » alexandra_k, posted by jay on March 1, 2005, at 19:57:35
PS. If you see it as a rights based case then you are left with genuine moral dilemmas. Wrong action is unavoidable.
If we accept utilitarianism then there isn't a moral dilemma, there is a course of action that is morally acceptable.
PS. In my view an answer to the first case is that the correct thing to do is to divert the train because GIVEN THE SITUATION you are doing the best possible action (saving 1+1+1+1+1=5 lives).
In the 'real life' case I think it is morally acceptable to shoot the son, (saving 1+1+1+1+1=5 lives). If it was the choice between saving ones own son versus the deaths of 6 strangers then either the above course of action would be acceptable or one could justify saving ones son because we have greater moral obligations to children who are dependant on us. Either way could be acceptable (depending on ones REASONS for making the choice). - But that latter one was a different case from the one that was laid out.
In the second case (the way it was laid out) then I think the morally correct thing to do is to let the one die to save the (1+1+1+1+1=5).
BUT: Fortunately the case (as it was laid out) probably does not occur very often in the real world!!!
In the real would such considerations would come into play as:
1) There is always the possibility of other donors
2) People will not volounteer to donate after death if they think doctors are less likely to save themetc etc.
Which probably justify saving the one...
Fair enough???
(Please feel free to disagree).
Posted by TamaraJ on March 1, 2005, at 21:32:33
In reply to Re: And my answer to the cases is..., posted by alexandra_k on March 1, 2005, at 21:13:38
> 1) There is always the possibility of other donors
> 2) People will not volounteer to donate after death if they think doctors are less likely to save them
>
> etc etc.
>
> Which probably justify saving the one...
>
> Fair enough???
>
> (Please feel free to disagree).Just to add a third possibility which is that the patient may have AIDs of some other disease which would preclude any organ donation.
Posted by alexandra_k on March 1, 2005, at 21:39:51
In reply to Re: And my answer to the cases is... » alexandra_k, posted by TamaraJ on March 1, 2005, at 21:32:33
Yes...
It is unlikely that the surgeon responsible for the man will have knowledge of how many other people could 'benefit' from his demise...
Typically those who give organ transplants are different from those who give emergency surgery (I suppose, I don't really know...)
If that is so then it isn't the case that there is one person with conflicting duties of care.Of course this doesn't solve the issue at the higher level...
SOMEONE would know...
Or the information would be there...
Go forward in thread:
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