Serious Ethics question - As seen on G's Anatomy - Which patient to heal???

[Ski2Doc]

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I dont really watch G's anat (doesnt seem like real med students), but saw the commercial for last weeks episode.
Big train wreck, 2 ppl stuck on one pole, if you pull the pole out one of them will die. Both are just as likely to live/die. I didnt see the episode, so am not sure if this Q came up there.

How do you decide who lives or dies?

Its easy(relatively speaking) when one patient is, say a nobel prize winner that is working on a cure for cancer and the other guy is a druggie with no hope.

But what if:
one guy is a career person (lawyer, doctor, teacher); pays his taxes, "contributes" to society.
The other is, say a guy working for cash somewhere; no dreams, no aspirations, not a "contributing" member of society.

(my examples are not exact, but roughly speaking)

How do you choose???

I know the politically correct answer but what are others thoughts? REAL thoughts on this issue?

 

[cardsurgguy]

in the show, both weren't as equally likely to survive

they took the one off the pole (and thus chose to "sacrifice" if you will) the person who had more severe injuries and who had the worst chance of survival

that's what I would do, try to save the one who has the greatest chance of survival

it's tough though

as for being exactly equal to survive

I think I'd start the bidding and have a mini auction right there in the OR!!
do I hear 25,000, 50,000, 50,000 going once, oh we got 75,000!!



ok seriously, I'd try to nitpick and find some reason to differentiate based on odds to survive

if it was still exactly equal, I'd next consider impact on family
in other words, if one was a single person who has nobody depending on him/her to survive and the other was a father or mother who had children to depend on them financially and otherwise, I'd pick the father or mother

I take a utilitarian perspective on it, if the two people themselves are equally likely to survive, pick the one that if he/she passed, more harm would occur to the external world (the children here in this case)

 

[BMW M3]

I thought at the time and still maintain that they had ENOUGH ROOM to fit a dremmel between the patients cut the pole there to separate both of them w/o moving the pole.

 

[dajimmers]

Heads or Tails?
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It's crazy, but similar cases can occasionally happen. At one interview the interviewer described (don't know if it was true or hypothetical) the premature-baby ward in a New Orleans Hospital losing power to the air supply for the babies, meaning they had to use hand-pumps to keep the babies alive, and had more babies than people. Do you help the weakest, hoping the strongest can breathe on their own, or save the ones with the greatest chance of survival?

 

[indo]

I thought at the time and still maintain that they had ENOUGH ROOM to fit a dremmel between the patients cut the pole there to separate both of them w/o moving the pole.

I'm with you. Lets cut the pole between them and save them both.

 

[Avenue Q]

Even if they were too close together to cut the pole, why did they have to totally remove one of them? couldn't them have slid them both back a bit slowly and then cut the pole? Its the removal of the pressure that is the problem, not their exact location on the pole. I mean, if they were already sliding one anyway, why not slide her as far as possible and then cut it?

Not to mention the fact that they didn't have two surgical teams there...

 

[Ski2Doc]

G' a is irrelevant. The idea is what i am getting at. You can ONLY save one period.

 

[prettygirl1908]

I thought at the time and still maintain that they had ENOUGH ROOM to fit a dremmel between the patients cut the pole there to separate both of them w/o moving the pole.

I felt the exact same way. There was a TON of room between them! Thats TV for ya, they want to dramatize everything.

 

[sunnyjohn]

Save the one most likely to survive.

For some reason TIVO lost its mind and recorded this episode.In a moment of weakness, I watched.

Yes, it was overdramatized for TV, but I think they said that even if they moved them one inch to use a Dremmel or they accidentally moved while someone was taking advantage of the limited space to saw them apart in an attempt to save them both, it would remove the tamponade from both their wounds.

They would both bled to death before anything could be done. The surgeons wanted to operate around the pole to control bleeding.

Since Seattle General only had ONE SURGICAL TEAm, of course it would be tragic. 😱

In real life, If one person is going to die no matter what you do, well....

Money or status should not matter, unless of course you need a kidney ora liver transplant. Then your better off it you're loaded or play professional sports.

 

[Chrissy]

dude that episode was amazing....i've never seen the show before and i got in bed sunday night and wasn't tired so i figured i'd pop on the tv and there it was....

i also think that a scenario playing out just like that one really ins't possible....i mean i know they were very close together but my guess would be they would come up with a more "fair" treatment....like finding a high powered saw to break them apart. there had to have been an inch or two of pipe between them no? and then operated on them separately....i gota say though it was some seriously good writing.....great idea

 

[the alchemist]

in the end, the show took the easy way out. the girl who was going to be
'sacrificed' agreed after they told her that her injuries were more severe and that they couldn't wait for her bf 2 arrive (who had trouble getting into the airport). plus, they also had the girl 'crash' b4 they pulled her off the pole, thus negating any need 4 a decision in the end (though i'll admit, they had already decided by then). it's hard but i think regardless of whether someone is a nobel prize winner, u probably (if u had 2 choose) would have 2 choose the patient who is more likely 2 survive. what if u choose the person least likely 2 survive cuz he was einstein or sth and then he died anyway, what would the other person's sacrifice been worth?

 

[daviddamoore]

heat up the pole so that you cauterize any open vessels etc., then slide both the bastards off.

 

[indo]

heat up the pole so that you cauterize any open vessels etc., then slide both the bastards off.

Can you cauterize the aorta and vena cava?

 

[Uncle_Tbag]

inka-dinka or one-potato-two

 

[willow18]

Can you cauterize the aorta and vena cava?

Those people wouldnt be breathing if the pole was stuck up their aorta or vena cava.

Proper procedure would be: cut down the pole to managable size (while drenching the pole with water to keep it COOL), get to the OR, then withdraw the pole slowly, suturing as needed...

Gotta run, I have a gsw coming in.

 

[Ski2Doc]

You guys are all missing the point, what if they are EXACTLY equal to survive. Furthermore, what if its not life an death but a more reasonable and very common choice.

Go work in a clinic/practice in say underserved areas where people are less likely to contribute to society or say work in an upper class neighborhood where you are helping say other doctors or other professionals that will (statistically and historically) be more productive in society.

 

[Sooz]

I saw that episode and by the end I was so annoyed with them both I wanted to reach through the TV and just rip the damn pole out and watch them both bleed out. Fortunately the remote was close so I opted to change the channel instead of trying my luck at reaching through the TV 😉

Seriously though, there are so many things that could be argued. But as far as the "not life an death but a more reasonable and very common choice." scenario, well if it's not life/death I would just treat them both, one at a time...