9 ms·
'It Was the First Time I Cried in the Operating Room'
- tomrod 9y agoThis a fascinating and heartbreaking story. Medical science can produce miracles, and I'm grateful for the consideration given to the ethics of action.
- keiferski 9y agoEssentially, it was a real-life Trolley Problem [1] - do you actively kill one patient in order to save another? Or do you do nothing and “allow” them both to die? I don’t blame the doctors on either side for their decision to participate or not participate - it is an incredibly complex ethical decision. [1]https://en.m.wikipedia.org/wiki/Trolley_problem https://en.m.wikipedia.org/wiki/Trolley_problem
- jrs95 9y agoMaybe I’m oversimplifying here, but is it really that complex of an issue in this case? The two of them together faced almost certain death. In most versions of the trolley problem, the potential victim of action isn’t going to die either way. To me, the more interesting moral aspect of this is that a surgeon who hadn’t done this before accepted the case because it would be interesting and challenging. I’m only paraphrasing a little; that was basically his description of it in the article.
- jacquesm 9y agoYou are technically correct, but that still did not make any of it any easier, the doctor must have been fully conscious that severing the artery between the girls would lead to an end of the weaker one, especially after testing it by temporarily restricting the artery and seeing how fast the weaker girl went down.
- trhway 9y ago(IANAD of course, just too much of Grey's Anatomy and House) i wonder why they didn't place her on bypass before the cut and didn't try to correct her heart or find a heart transplant for her.
- pedro_hab 9y agoYeah, the doctors I've talked to tend to say the same. A neurosurgeon seeing a MRI or CT scan of my wife's brain said it would be amusing to see her brain's tissues, but fortunately it was not needed. I had a surgery in my hips which the doctor said the same, he wanted to do the surgery to improve his research and even asked me to use my files, anonymously obviously, in his presentations and research. I think we all are interested in our work, and he said that every case is different, I'm not sure if experience would help much.
- gmueckl 9y agoMy first reaction was the same, but further down he mentions a team of 50 people involved in the procedure itself, including a couple of other doctors. This implies that the whole thing was a huge team effort, and not just a one man show for the thrill. I do wonder how much effort it took in total to prepare this procedure. CT, MRT, research, rapid prototyping of bones and other structures for analysis and practice runs... it seems they used all the tools they could.
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- golemotron 9y agoI don't think it's complex. It's heartbreaking and sad. The Trolley Problem is a test of character more than an ethical problem. It separates people who are willing to take on responsibility from those who aren't.
- cornholio 9y agoNot really a trolley problem since the weaker twin is going to die no mater what you do, so the ethical responsibility is much diminished to hastening that death with a few weeks or months in order to save another life. A real trolley problem would involve three conjoined twins, of which one has a good chance to outlive his siblings, yet an intervention exists that can save both of them by depriving him of critical organs.
- invalidOrTaken 9y agoOh, well that's not an impossibly heartbreaking story at all, no sir!
- michaelsbradley 9y agoIt's a good example of the principle of double effect. https://en.wikipedia.org/wiki/Principle_of_double_effect https://en.wikipedia.org/wiki/Principle_of_double_effect http://www.catholicculture.org/culture/library/dictionary/index.cfm?id=33215 http://www.catholicculture.org/culture/library/dictionary/in...
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- jacquesm 9y agoI'm so happy when I read this that my work does not include decisions as grave as these. The medical profession is not short of heroes, but you'll hardly ever know about any of this, this article is a great example of that. I know one woman who works in a hospital that tends to children with cancer, I can pretty much read how her charges are doing by looking at her. And nobody will ever read about her in a newspaper.
- stochastic_monk 9y agoI used to work with a physicist turned MD turned clinical geneticist who now primarily works with pediatric oncology. I’m amazed not only by how bright and dedicated he is (he gave me his personal cell while I was working with his data), but by the enthusiasm and optimism he displays while working with children with horribly aggressive cancers. These people are true heroes.
- jacquesm 9y agoIt's interesting that in just about every country there are statues and monuments to the heros of war, but I've yet to see a statue for a nurse or a surgeon who - instead of taking life - give life.
- dragonwriter 9y agohttps://en.m.wikipedia.org/wiki/Statue_of_Florence_Nightingale,_London https://en.m.wikipedia.org/wiki/Statue_of_Florence_Nightinga...
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- icebraining 9y agoIn Lisbon we have a statue of a doctor who fought against the tuberculosis epidemic: https://en.wikipedia.org/wiki/José_Tomás_de_Sousa_Martins#Legacy_and_cult https://en.wikipedia.org/wiki/José_Tomás_de_Sousa_Martins#Le...
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- lolsal 9y agoI would have loved to to hear about the discussions and arguments around the ethics of their decision. I personally believe they made the ethically correct choice. It could be argued that by not operating they were violating some sort of 'do no harm' principal. By not operating they may have caused two girls to suffer (especially in the case that they both survived into adulthood). Very interesting and puts my work into perspective. Very humbling.
- konschubert 9y agoThe way I understood it, it was very likely that the girls would die before adulthood if not separated.
- logfromblammo 9y agoThis situation was recently dramatized by the television show The Good Doctor. The ethical anguish there was compounded by making the patients old enough to tell the surgeons that they would rather sacrifice their own life to save their sister, than to be the sole survivor--who would then live only because her sister and lifelong constant companion is dead. The scriptwriters also stirred the pot by putting one in a coma to remove the possibility of explicit consent. At the time, it stretched my suspension of disbelief.
- harrisjt 9y agoI could never do this work, insanity. Props to all the nurses and people behind the surgery technology.
- nicodjimenez 9y agoThis man is a hero.
- Izmaki 9y agoIn another life I want to be a surgeon.
- baumbart 9y agoImagine an artificial intelligence (surgery robot) making this decision.
- Rexxar 9y agoThere is no need to let robot take such decision. Robot are useful when there is a lot of fast decisions to take.