6 ms·

If you choose to have your hand cut off because you think it would be awesome, I'd hope your doctor would refuse to do it.

harryh 9y ago
It's interesting to think about decisions that involve an action vs decisions that involve stopping an action. Doctor: undergo my recommended treatment or you will die Patient: no Patient: Doctor, please chop off one of my hands for no good reason Doctor: no In the former we respect the rights of the patient, in the latter we do not. Kind of weird isn't it?
- elicash 9y ago
  "First, do no harm." https://en.wikipedia.org/wiki/Primum_non_nocere https://en.wikipedia.org/wiki/Primum_non_nocere
- lolsal 9y ago
  in the first example the doctor is compelling the patient to do something and the patient exercises her right to refuse. In the second example the patient is compelling to the doctor to do something and the doctor exercises her right to refuse. You never have a 'right' to compel another person to do anything. You may have legal, ethical or moral reasons to compel someone to do something, but you never have a right to.
  - harryh 9y ago
    I think this is mostly right but it is worth noting that in some cases doctors are obligated to act. If I run into the ER with a serious issue and a doctor says "sorry, I can't treat you right now, it's my coffee break" that can be malpractice.
    - lolsal 9y ago
      Understood - but that is a legal or ethical obligation, not one of your rights.
  - ABCLAW 9y ago
    >You never have a 'right' to compel another person to do anything. There are plenty of instances where you have the right to compel another person to do things.
    - passivepinetree 9y ago
      I'm not disagreeing with you, but your case would be stronger if you could provide some examples.
      - ABCLAW 9y ago
        You walk into my house. I have the right to compel you to leave. You try to stab me. I have the right to compel you to stop with reasonable force. You arbitrarily try to deny my passport application because you don't like my face. I get a Writ of Mandamus issued against you and compel you to do your job. We enter into an agreement which you breach. I obtain an order mandating specific performance and compel you to personally do what we agreed upon. You're wanted for arrest and I'm a peace officer. I compel you to come down to the station. I can go on all day. The poster above you does not understand what a 'right' is and is trying to make a point about positive vs negative rights, but doesn't actually understand the distinction.
        lolsal 9y ago
        You just listed a bunch of examples where people are legally compelled to do something, which I mentioned. > The poster above you does not understand what a 'right' is and is trying to make a point about positive vs negative rights, but doesn't actually understand the distinction. Ok. Nice talking with you. Have a good day.
        ABCLAW 9y ago
        I know you mentioned it - you just weren't correct. Hope the clarification was helpful. Here's some additional reading if you're interested: https://en.wikipedia.org/wiki/Negative_and_positive_rights https://en.wikipedia.org/wiki/Negative_and_positive_rights
- croon 9y ago
  I think this is contained within "do no harm". There is an inherent risk in all treatment, even if it's 0.01% or 99%. We can't force that risk on the patient, even if the odds and upsides are objectively great. In the latter there's no clear upside other than "for fun", and definite harm. The line is drawn between "do no harm" and "force good".
- deleted 9y ago
  [deleted]
- emodendroket 9y ago
  It's not that weird. We also generally draw a legal/moral distinction between killing someone and allowing them to die.
- drewmol 9y ago
  I think it's fitting. In the US, we tend to side with supporting the rights of either party to choose not to preform an action. Patient has the right to not undergo treatment. Doctor has the right to not preform treatment. It stems from respecting a persons right to liberty, and when trying to respect some other rights of one party involves the forced action of another party, it often may incroach on right to liberty of the latter party. The idea of when it's acceptable to encroach on someones liberty using some type of forced complience is a complicated dance, as it should be. Personally, I usually lean on the side of respecting liberty above others. This necessarily involves respecting everyone's right to excercise their liberty in order to be an asshole, idiot, bigot, etc.
jhasse 9y ago
What if my doctor wants to cut my hand off by I refuse it?
- mcny 9y ago
  So the original premise was scenario 1: > Doctor: undergo my recommended treatment or you will die > Patient: no scenario2: > Patient: Doctor, please chop off one of my hands for no good reason > Doctor: no lets add a scenario 3: > Doctor: I need to chop off your hand within the next hour or you will die > Patient: no What do you think the doctor should do?
  - jhasse 9y ago
    scenario 4: > Doctor: I need to chop off your hand for no good reason > Patient: no
  - emodendroket 9y ago
    The doctor should not cut off the hand, in your scenario. A more realistic scenario is probably DNR orders, which doctors do honor.
    - testvox 9y ago
      Doctors often do not honor DNR orders because there is no penalty for disobeying them while they can face severe penalties for failing to save someone's life if their DNR order is invalid for some reason.
      - emodendroket 9y ago
        According to an article I found [0], a doctor may at least theoretically be subject to legal penalties for disregarding a DNR. > Wrongful life. Theoretically, if a patient is resuscitated in the OR against the patient's wishes, a “wrongful, life” lawsuit could be filed. Under this suit, a patient could request compensation for ensuing expenses for continued life, negligence, and battery. An Ohio appellate court reviewed a case in which a patient was resuscitated after a DNR order was documented on his chart.12 Although the court in this particular case rejected the wrongful life theory, it did uphold the possibility that battery and negligence had occurred. This case has made it certain that the advance directive is an important component of a patient's chart. [0] Evelyn Eckberg RN: The Continuing Ethical Dilemma of the Do-Not-Resuscitate Order http://onlinelibrary.wiley.com/doi/10.1016/S0001-2092(06)62642-2/full http://onlinelibrary.wiley.com/doi/10.1016/S0001-2092(06)626...
north_east_dev 9y ago
But what about trans-abled people and their rights?
- EGreg 9y ago
  I think the doctor should always have the right to refuse an elective surgery. It's up to the patient to find a willing doctor.
  - lr4444lr 9y ago
    The argument proffered through is that it is necessary for their mental health. Which then begs the question, what about people who compulsively get plastic surgery? Which is exactly why the DSM carefully says that "gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition". Body dysmorphic disorder on the other hand is itself pathological, so continued surgeries do not rank as humane treatment.
    - EGreg 9y ago
      Surgery is not the only possible answer to psychological distress, if it is one at all. Some people have body dysphoria and surgeons aren't required to weigh their distress about having an arm above everything else.
- lmkg 9y ago
  Key phrase: > for no good reason For some individuals, there is substantial therapeutic benefit to reassignment surgery.
  - north_east_dev 9y ago
    > If you choose to have your hand cut off because you think it would be awesome, Does that cut mustard? Why not?
    - deleted 9y ago
deleted 9y ago
[deleted]
da_chicken 9y ago
There are cases of body integrity identity disorder (https://en.wikipedia.org/wiki/Body_integrity_identity_disorder https://en.wikipedia.org/wiki/Body_integrity_identity_disord...) being treated by amputation. It's a rare condition, but the discussion about the ethics of voluntary amputation as treatment is quite extensive: https://www.ncbi.nlm.nih.gov/pubmed/15948330 https://www.ncbi.nlm.nih.gov/pubmed/15948330 https://www.ncbi.nlm.nih.gov/pubmed/19132621 https://www.ncbi.nlm.nih.gov/pubmed/19132621 https://www.ncbi.nlm.nih.gov/pubmed/17115518 https://www.ncbi.nlm.nih.gov/pubmed/17115518
DanielBMarkham 9y ago
I think you've hit on the nub of the problem: what "causes no harm" to the client in the lawyer-client relationship, and are lawyers supposed to act like doctors? It's in the interests of the judicial system that each client is entitled to a vigorous defense on a level playing field. That's the only thing that keeps the system working (as broken as it is). It's in the interests of the clients to do various things. Those things do not necessarily involve a vigorous defense or the best possible outcome for them. If I signed a paper absolving my lawyer from damages, then asked him to punch me in the nose, should he? I don't see why not. If I did the same thing with my doctor, should he? Absolutely not. This is the study of ethics, that is, the types of behaviors that professionals expect of one another as part of their profession. Ethically, I think the lawyer felt he should enter and defend the guilty plea. Whether or not that is the correct ethical decision -- and whether or not that decision is in the best interests of the judicial system -- is the interesting part.
- s73ver_ 9y ago
  Remember, this lawyer's action was part of a vigorous defense: He was trying to save the client from the death penalty.
  - DanielBMarkham 9y ago
    There's a gap here that the lawyer (and the expert quoted) is talking about. At some point, you are menally impaired enough that the state should treat you differently. You are incapable of knowing right from wrong. But just before that point, there are a ton of folks who are severely impaired who might either wish self-harm or take actions that consistently harm themselves. How should we treat those folks?
    - emodendroket 9y ago
      He was judged competent to stand trial, though. If he wasn't, it seems like the problem is with the way that determination is reached, not in his not taking his lawyer's advice.

harryh 9y ago

It's interesting to think about decisions that involve an action vs decisions that involve stopping an action. Doctor: undergo my recommended treatment or you will die Patient: no Patient: Doctor, please chop off one of my hands for no good reason Doctor: no In the former we respect the rights of the patient, in the latter we do not. Kind of weird isn't it?

elicash 9y ago
"First, do no harm." https://en.wikipedia.org/wiki/Primum_non_nocere https://en.wikipedia.org/wiki/Primum_non_nocere
lolsal 9y ago
in the first example the doctor is compelling the patient to do something and the patient exercises her right to refuse. In the second example the patient is compelling to the doctor to do something and the doctor exercises her right to refuse. You never have a 'right' to compel another person to do anything. You may have legal, ethical or moral reasons to compel someone to do something, but you never have a right to.
- harryh 9y ago
  I think this is mostly right but it is worth noting that in some cases doctors are obligated to act. If I run into the ER with a serious issue and a doctor says "sorry, I can't treat you right now, it's my coffee break" that can be malpractice.
  - lolsal 9y ago
    Understood - but that is a legal or ethical obligation, not one of your rights.
- ABCLAW 9y ago
  >You never have a 'right' to compel another person to do anything. There are plenty of instances where you have the right to compel another person to do things.
  - passivepinetree 9y ago
    I'm not disagreeing with you, but your case would be stronger if you could provide some examples.
    - ABCLAW 9y ago
      You walk into my house. I have the right to compel you to leave. You try to stab me. I have the right to compel you to stop with reasonable force. You arbitrarily try to deny my passport application because you don't like my face. I get a Writ of Mandamus issued against you and compel you to do your job. We enter into an agreement which you breach. I obtain an order mandating specific performance and compel you to personally do what we agreed upon. You're wanted for arrest and I'm a peace officer. I compel you to come down to the station. I can go on all day. The poster above you does not understand what a 'right' is and is trying to make a point about positive vs negative rights, but doesn't actually understand the distinction.
      - lolsal 9y ago
        You just listed a bunch of examples where people are legally compelled to do something, which I mentioned. > The poster above you does not understand what a 'right' is and is trying to make a point about positive vs negative rights, but doesn't actually understand the distinction. Ok. Nice talking with you. Have a good day.
        ABCLAW 9y ago
        I know you mentioned it - you just weren't correct. Hope the clarification was helpful. Here's some additional reading if you're interested: https://en.wikipedia.org/wiki/Negative_and_positive_rights https://en.wikipedia.org/wiki/Negative_and_positive_rights
croon 9y ago
I think this is contained within "do no harm". There is an inherent risk in all treatment, even if it's 0.01% or 99%. We can't force that risk on the patient, even if the odds and upsides are objectively great. In the latter there's no clear upside other than "for fun", and definite harm. The line is drawn between "do no harm" and "force good".
deleted 9y ago
[deleted]
emodendroket 9y ago
It's not that weird. We also generally draw a legal/moral distinction between killing someone and allowing them to die.
drewmol 9y ago
I think it's fitting. In the US, we tend to side with supporting the rights of either party to choose not to preform an action. Patient has the right to not undergo treatment. Doctor has the right to not preform treatment. It stems from respecting a persons right to liberty, and when trying to respect some other rights of one party involves the forced action of another party, it often may incroach on right to liberty of the latter party. The idea of when it's acceptable to encroach on someones liberty using some type of forced complience is a complicated dance, as it should be. Personally, I usually lean on the side of respecting liberty above others. This necessarily involves respecting everyone's right to excercise their liberty in order to be an asshole, idiot, bigot, etc.

jhasse 9y ago

What if my doctor wants to cut my hand off by I refuse it?

mcny 9y ago
So the original premise was scenario 1: > Doctor: undergo my recommended treatment or you will die > Patient: no scenario2: > Patient: Doctor, please chop off one of my hands for no good reason > Doctor: no lets add a scenario 3: > Doctor: I need to chop off your hand within the next hour or you will die > Patient: no What do you think the doctor should do?
- jhasse 9y ago
  scenario 4: > Doctor: I need to chop off your hand for no good reason > Patient: no
- emodendroket 9y ago
  The doctor should not cut off the hand, in your scenario. A more realistic scenario is probably DNR orders, which doctors do honor.
  - testvox 9y ago
    Doctors often do not honor DNR orders because there is no penalty for disobeying them while they can face severe penalties for failing to save someone's life if their DNR order is invalid for some reason.
    - emodendroket 9y ago
      According to an article I found [0], a doctor may at least theoretically be subject to legal penalties for disregarding a DNR. > Wrongful life. Theoretically, if a patient is resuscitated in the OR against the patient's wishes, a “wrongful, life” lawsuit could be filed. Under this suit, a patient could request compensation for ensuing expenses for continued life, negligence, and battery. An Ohio appellate court reviewed a case in which a patient was resuscitated after a DNR order was documented on his chart.12 Although the court in this particular case rejected the wrongful life theory, it did uphold the possibility that battery and negligence had occurred. This case has made it certain that the advance directive is an important component of a patient's chart. [0] Evelyn Eckberg RN: The Continuing Ethical Dilemma of the Do-Not-Resuscitate Order http://onlinelibrary.wiley.com/doi/10.1016/S0001-2092(06)62642-2/full http://onlinelibrary.wiley.com/doi/10.1016/S0001-2092(06)626...

north_east_dev 9y ago

But what about trans-abled people and their rights?

EGreg 9y ago
I think the doctor should always have the right to refuse an elective surgery. It's up to the patient to find a willing doctor.
- lr4444lr 9y ago
  The argument proffered through is that it is necessary for their mental health. Which then begs the question, what about people who compulsively get plastic surgery? Which is exactly why the DSM carefully says that "gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition". Body dysmorphic disorder on the other hand is itself pathological, so continued surgeries do not rank as humane treatment.
  - EGreg 9y ago
    Surgery is not the only possible answer to psychological distress, if it is one at all. Some people have body dysphoria and surgeons aren't required to weigh their distress about having an arm above everything else.
lmkg 9y ago
Key phrase: > for no good reason For some individuals, there is substantial therapeutic benefit to reassignment surgery.
- north_east_dev 9y ago
  > If you choose to have your hand cut off because you think it would be awesome, Does that cut mustard? Why not?
  - deleted 9y ago

deleted 9y ago

[deleted]

da_chicken 9y ago

There are cases of body integrity identity disorder (https://en.wikipedia.org/wiki/Body_integrity_identity_disorder https://en.wikipedia.org/wiki/Body_integrity_identity_disord...) being treated by amputation. It's a rare condition, but the discussion about the ethics of voluntary amputation as treatment is quite extensive: https://www.ncbi.nlm.nih.gov/pubmed/15948330 https://www.ncbi.nlm.nih.gov/pubmed/15948330 https://www.ncbi.nlm.nih.gov/pubmed/19132621 https://www.ncbi.nlm.nih.gov/pubmed/19132621 https://www.ncbi.nlm.nih.gov/pubmed/17115518 https://www.ncbi.nlm.nih.gov/pubmed/17115518

DanielBMarkham 9y ago

I think you've hit on the nub of the problem: what "causes no harm" to the client in the lawyer-client relationship, and are lawyers supposed to act like doctors? It's in the interests of the judicial system that each client is entitled to a vigorous defense on a level playing field. That's the only thing that keeps the system working (as broken as it is). It's in the interests of the clients to do various things. Those things do not necessarily involve a vigorous defense or the best possible outcome for them. If I signed a paper absolving my lawyer from damages, then asked him to punch me in the nose, should he? I don't see why not. If I did the same thing with my doctor, should he? Absolutely not. This is the study of ethics, that is, the types of behaviors that professionals expect of one another as part of their profession. Ethically, I think the lawyer felt he should enter and defend the guilty plea. Whether or not that is the correct ethical decision -- and whether or not that decision is in the best interests of the judicial system -- is the interesting part.

s73ver_ 9y ago
Remember, this lawyer's action was part of a vigorous defense: He was trying to save the client from the death penalty.
- DanielBMarkham 9y ago
  There's a gap here that the lawyer (and the expert quoted) is talking about. At some point, you are menally impaired enough that the state should treat you differently. You are incapable of knowing right from wrong. But just before that point, there are a ton of folks who are severely impaired who might either wish self-harm or take actions that consistently harm themselves. How should we treat those folks?
  - emodendroket 9y ago
    He was judged competent to stand trial, though. If he wasn't, it seems like the problem is with the way that determination is reached, not in his not taking his lawyer's advice.