6 ms·

Making no point about whether further control/regulation is appropriate, I'm not sure I like your logic. Treating lives as some fungible resource where the ends

by curun1r 11y ago

Making no point about whether further control/regulation is appropriate, I'm not sure I like your logic. Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. I sympathize with all the sick people who will die, but they were mostly selected for death naturally. The man who died (or will, as soon as life support is removed) was healthy prior to this study. Much like our justice system is supposed to value not punishing the innocent over punishing the guilty, our medical system is supposed to value not hurting the well over helping the sick. The hippocratic oath embodies this "first do no harm" principle.

logingone 11y ago
There's a train on the tracks, heading for a group of people, and on a fork on the tracks one person.... etc. (trolley problem).
- kens 11y ago
  I recommend this amusing parody of the trolley problem: http://www.mindspring.com/~mfpatton/Tissues.htm http://www.mindspring.com/~mfpatton/Tissues.htm
- eanzenberg 11y ago
  False analogy. These were healthy individuals who opted into a drug study.
RHSeeger 11y ago
> Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. To be fair, while that is generally considered the "right thing", it is reasonable to debate it. The question of "at what point does the welfare of the many outweigh the welfare of the few" is a rather complex one. One question that I think highlights this well is... > There's a train headed for a group of 5 people that it will kill. You can flick a switch and make it take another track. However, doing so will make it run over 1 (different) person. Do you flick the switch? Edit: To be clear, I'm not saying I believe that the needs of the many always outweigh the needs of the few. I'm only saying it's not as cut and dry as some people seem to say it is. It's something that should sometimes be discussed based on the situation.
- ams6110 11y ago
  I don't like the train analogy in this case. You are faced with two choices: Kill five people or kill one. Medicine is never that cut and dried. "First, do no harm" is a sound moral position in the later case.
  - Symmetry 11y ago
    If we really followed the prescription to "First, do no harm" then really we would have to stop doing surgery completely. If giving someone a drug which hasn't conclusively been proven to be safe is harm then cutting someone open certainly is. Someone may die from an unproven drug. Someone may also die from complications from surgery or anesthesia. But surgery will certainly leave a hole in their body.
  - TeMPOraL 11y ago
    It is when you look at it in aggregate. It's an insight that I think most of the general population misses - that when you start to deal with interests of thousands or millions of people, things start to get much more mathematical. Consider the more zoomed-out equivalent of the train analogy: your hospital has 6 dying patients; one of them requires a serious procedure, the others need less complicated care. You don't have enough resources to help all of them - you can either spend everything on the single complicated procedure and save one patient, or distribute it to save the other 5. Which do you chose? Now scale that up to the country-level.
  - richmarr 11y ago
    > Medicine is never that cut and dried. This feels like an incomplete argument to me. > "First, do no harm" is a sound moral position in the later case. But it's a black and white moral position that doctors in the real world can't cling to on anything more than a casual basis. All treatment comes with risks, from mild side-effects all the way to death. Surgery is inherently risky, and people die all the time. Cosmetic surgeons perform surgery all the time without being struck off. Then there's abortion, euthanasia, and refusal to treat people without medical insurance.
  - Confusion 11y ago
spacehome 11y ago
> Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. That idea, with perhaps taking QALYs or something similar into account, seems like a pretty intuitive goal to me from an ethical standpoint. What do you suggest we should be optimizing for instead?
- ohyes 11y ago
  Well, there are certainly other ethical considerations than "most warm bodes". You also have to preserve human rights, for example. You could argue that trialing a potentially deadly drug took away a basic one from these people.
- brazzledazzle 11y ago
  A collection of people is not a column in a spreadsheet or inventory. The most valuable thing in the world is a human life regardless of callous examples of how cheaply they can be had or taken. Just because you can measure two different systems using a blind metric like "most living people at the end" doesn't make it ethical. Ethics apply to individuals as much, if not more so, as groups.
  - philh 11y ago
    That doesn't help us choose what to do. A collection of people is important, and another collection of people is important, and one of these collections of people is going to die and we have to choose which one. Platitudes about the domain of ethics don't help us to choose.
    - brazzledazzle 11y ago
      That isn't the situation at all. One group of people was going to die regardless. Or was going to suffer a life-long disease. The debate is whether or not killing people that weren't going to die is worth it if your body count is lower at the end. We're not debating whether or not flipping the switch on a train track is ethical.
  - 11y ago
irremediable 11y ago
> Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. This is a fundamental problem in ethics -- and like many such problems, there is no "right" answer. There is no reason it shouldn't be that way, and no reason it should.
- deleted 11y ago
  [deleted]
marcoperaza 11y ago
Let's not beat around the bush here. The issue is whether people have the right to take these risks for themselves. No one makes you sign up for a medical trial.
- abruzzi 11y ago
  But most people who sign up for medical trials are not terribly well informed of how dangerous the drug is. They are also usually from the poorest part of society (except terminally sick people hoping the latest trial may bring a cure.)
- clort 11y ago
  Actually, I don't much like this attitude. The company offers between 100 and 4500 euro to participate in trials (max earnings 4500 per year), though I don't know what they offered for this particular trial. We can wonder why people sign up for this when the only recompense offered is [a small amount of] money but its likely due to a desire for money, caused by a lack of it -- we can only suppose that if these folk had enough money already then they wouldn't have signed up to this. It would be interesting to see the demographics of the participants of drug trials like these and I'm guessing that excess wealth and ennui aren't significant features there. Its always worth keeping in mind that choices which may seem to be unpalatable to you are likely to be much less so to other people for reasons they don't necessarily have any control over.
  - marcoperaza 11y ago
    So because they're poor, they shouldn't be allowed to make their own decisions? Honestly, the philosophy would be more equitable if we just extended this thinking to the whole population, right? Let's ban drinking, ice-climbing, skydiving, smoking, sweet cars, and burgers, just to get started. Because we know better than them. The risks are understood for medical trials. Maybe they're not acceptable to me, but they are to someone else. Who am I to tell another man what risks he can take with his own life?
    - ceejayoz 11y ago
tremon 11y ago
Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct Ultimately, this is an issue of individualism vs totalitarianism. Once you let go of the (western) idealist view that every individual should have full freedom of choice on how to direct their own life, a whole host of different approaches to life and state are available to you. I like the link you made between the judicial presumption of innocence and the Hippocratic oath. It's given me a new perspective to entertain.
- deleted 11y ago
  [deleted]

by curun1r 11y ago

logingone 11y ago

There's a train on the tracks, heading for a group of people, and on a fork on the tracks one person.... etc. (trolley problem).

kens 11y ago
I recommend this amusing parody of the trolley problem: http://www.mindspring.com/~mfpatton/Tissues.htm http://www.mindspring.com/~mfpatton/Tissues.htm
eanzenberg 11y ago
False analogy. These were healthy individuals who opted into a drug study.

RHSeeger 11y ago

> Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. To be fair, while that is generally considered the "right thing", it is reasonable to debate it. The question of "at what point does the welfare of the many outweigh the welfare of the few" is a rather complex one. One question that I think highlights this well is... > There's a train headed for a group of 5 people that it will kill. You can flick a switch and make it take another track. However, doing so will make it run over 1 (different) person. Do you flick the switch? Edit: To be clear, I'm not saying I believe that the needs of the many always outweigh the needs of the few. I'm only saying it's not as cut and dry as some people seem to say it is. It's something that should sometimes be discussed based on the situation.

ams6110 11y ago
I don't like the train analogy in this case. You are faced with two choices: Kill five people or kill one. Medicine is never that cut and dried. "First, do no harm" is a sound moral position in the later case.
- Symmetry 11y ago
  If we really followed the prescription to "First, do no harm" then really we would have to stop doing surgery completely. If giving someone a drug which hasn't conclusively been proven to be safe is harm then cutting someone open certainly is. Someone may die from an unproven drug. Someone may also die from complications from surgery or anesthesia. But surgery will certainly leave a hole in their body.
- TeMPOraL 11y ago
  It is when you look at it in aggregate. It's an insight that I think most of the general population misses - that when you start to deal with interests of thousands or millions of people, things start to get much more mathematical. Consider the more zoomed-out equivalent of the train analogy: your hospital has 6 dying patients; one of them requires a serious procedure, the others need less complicated care. You don't have enough resources to help all of them - you can either spend everything on the single complicated procedure and save one patient, or distribute it to save the other 5. Which do you chose? Now scale that up to the country-level.
- richmarr 11y ago
  > Medicine is never that cut and dried. This feels like an incomplete argument to me. > "First, do no harm" is a sound moral position in the later case. But it's a black and white moral position that doctors in the real world can't cling to on anything more than a casual basis. All treatment comes with risks, from mild side-effects all the way to death. Surgery is inherently risky, and people die all the time. Cosmetic surgeons perform surgery all the time without being struck off. Then there's abortion, euthanasia, and refusal to treat people without medical insurance.
- Confusion 11y ago

spacehome 11y ago

> Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. That idea, with perhaps taking QALYs or something similar into account, seems like a pretty intuitive goal to me from an ethical standpoint. What do you suggest we should be optimizing for instead?

ohyes 11y ago
Well, there are certainly other ethical considerations than "most warm bodes". You also have to preserve human rights, for example. You could argue that trialing a potentially deadly drug took away a basic one from these people.
brazzledazzle 11y ago
A collection of people is not a column in a spreadsheet or inventory. The most valuable thing in the world is a human life regardless of callous examples of how cheaply they can be had or taken. Just because you can measure two different systems using a blind metric like "most living people at the end" doesn't make it ethical. Ethics apply to individuals as much, if not more so, as groups.
- philh 11y ago
  That doesn't help us choose what to do. A collection of people is important, and another collection of people is important, and one of these collections of people is going to die and we have to choose which one. Platitudes about the domain of ethics don't help us to choose.
  - brazzledazzle 11y ago
    That isn't the situation at all. One group of people was going to die regardless. Or was going to suffer a life-long disease. The debate is whether or not killing people that weren't going to die is worth it if your body count is lower at the end. We're not debating whether or not flipping the switch on a train track is ethical.
- 11y ago

irremediable 11y ago

> Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct. This is a fundamental problem in ethics -- and like many such problems, there is no "right" answer. There is no reason it shouldn't be that way, and no reason it should.

deleted 11y ago
[deleted]

marcoperaza 11y ago

Let's not beat around the bush here. The issue is whether people have the right to take these risks for themselves. No one makes you sign up for a medical trial.

abruzzi 11y ago
But most people who sign up for medical trials are not terribly well informed of how dangerous the drug is. They are also usually from the poorest part of society (except terminally sick people hoping the latest trial may bring a cure.)
clort 11y ago
Actually, I don't much like this attitude. The company offers between 100 and 4500 euro to participate in trials (max earnings 4500 per year), though I don't know what they offered for this particular trial. We can wonder why people sign up for this when the only recompense offered is [a small amount of] money but its likely due to a desire for money, caused by a lack of it -- we can only suppose that if these folk had enough money already then they wouldn't have signed up to this. It would be interesting to see the demographics of the participants of drug trials like these and I'm guessing that excess wealth and ennui aren't significant features there. Its always worth keeping in mind that choices which may seem to be unpalatable to you are likely to be much less so to other people for reasons they don't necessarily have any control over.
- marcoperaza 11y ago
  So because they're poor, they shouldn't be allowed to make their own decisions? Honestly, the philosophy would be more equitable if we just extended this thinking to the whole population, right? Let's ban drinking, ice-climbing, skydiving, smoking, sweet cars, and burgers, just to get started. Because we know better than them. The risks are understood for medical trials. Maybe they're not acceptable to me, but they are to someone else. Who am I to tell another man what risks he can take with his own life?
  - ceejayoz 11y ago

tremon 11y ago

Treating lives as some fungible resource where the ends justify the means and whatever process results in the most living people at the end shouldn't be correct Ultimately, this is an issue of individualism vs totalitarianism. Once you let go of the (western) idealist view that every individual should have full freedom of choice on how to direct their own life, a whole host of different approaches to life and state are available to you. I like the link you made between the judicial presumption of innocence and the Hippocratic oath. It's given me a new perspective to entertain.

deleted 11y ago
[deleted]