Thursday, February 7, 2008

Ethical Dilemma?

Ethical Dilemma?
I was looking for ethical dilemmas. I recalled a serious one concerning the use of medical data derived during the Holocaust. I discovered a long article that I think is very interesting from a philosophical point of view. As in Dawkins' trolley there is an issue of one life for many, but also many other issues. There are historical implications as to how the victims will be remembered. There are implications with respect to glorifying the work of nazi butchers. I think you will find this site thought provoking and a true dilemma. With respect -Joel


Ira Glickstein said...

I read through the entire (long) paper you linked to. This is a very difficult issue: Is it ethical to utilize experimental data to benefit our fellow citizens even if that data was obtained by the most unethical, cruel, and shameful means?

The linked paper makes many philosophical and religious and legal arguments on both sides. However, I come down to the question of what my personal choice would be if this data could possibly benefit a loved one.

Say (God forbid) one of my daughters or grandchildren fell through the ice and almost froze to death. She has been rescued and is now being thawed out.

I rush to the hospital and her surgeon tells me he is warming her slowly, relying on the buildup of her own body heat.

Another surgeon tells me he recommended rapid warming by immersing in hot water but the first surgeon would not use this method because the only controlled, experimental data supporting it comes from Nazi experiments at Dachau.

"The Nazis immersed their subjects into vats of ice water at sub-zero temperatures, or left them out to freeze in the winter cold. As the prisoners excreted mucus, fainted and slipped into unconsciousness, the Nazis meticulously recorded the changes in their body temperature, heart rate, muscle response, and urine." (These horrible experiments were conducted to aid in the rescue of German pilots shot down in the North Sea.)

It is obviously terribly cruel and unethical to freeze experimental subjects. For this reason, such experiments have never been done on humans - except for the concentration camp victims at Dachau.

According to the linked paper, the Director of the Hypothermia Laboratory at the University of Minnesota attempted to publish a paper in the New England Journal of Medicine citing the Nazi data, along with the more limited experimental data from his own laboratory, but the editor of the Journal vetoed his plan.

In addition to saving our loved ones in the hypothetical case cited, that Nazi data could also have use in design of cold water survival suits and so on.

If it was your loved one, what would you decide?

The answer is clear: USE THE DATA.

Quoting Joel's linked paper: "When the value of the Nazi data is of great value to humanity, then the morally appropriate policy would be to utilize the data, while explicitly condemning the atrocities."

In publishing such data, I would censor the names of the Nazi doctors who conducted the experiments and collected the data and substitute the names of some of the victims, if their names were known. (If not, pick a holocaust victim's name at random.) That, at least would deny the memory of the rogue doctors any professional recognition for their medical atrocities.

Ira Glickstein

joel said...

Ira said:

If it was your loved one, what would you decide?

The answer is clear: USE THE DATA.

Joel responds:

It seems that we have several formulas for making moral decisions; the Golden Rule, Kant's Rule and now Ira's Loved One Rule. This rule appears to imagine that a near relative in mortal danger whenever making any moral decision. The outcome is predictably that one does whatever it takes to save the loved one. I'm a little skeptical of this tool, although it certainly might be part of one's thinking. Suppose I said, "Is it moral for me to swindle a rich old widow?" Ira's Rule would require that we imagine that my grandchild is in the hands of kidnappers demanding a ransom I couldn't afford and that swindling the old lady was my only option. Presumably I would do it. Result: It is morally justifiable to swindle old widows. There seems to be something wrong with this extrapolation from imaginary specific to real general. Besides, what happens if we place the loved one on the opposite side of the issue?

I can't say that I have a set opinion about this dilemma. I'm ambivalent. I guess that why we call it a dilemma. I would suggest that there be a fixed system in place for making such decisions. Suppose there's a poll (unbiased of course) taken on the moral dilemma after negotiating down to the best compromise. If 60% decide A, do A. If 60% decide "not A," do "not A." If 60% is not achieved by either side, place the issue in the hands of the gods. Flip a coin. Think of all the national strife that could be avoided. With respect -Joel

Ira Glickstein said...

Joel brings up an interesting objection to my "save your loved one" guideline. By that rule, he says, "It is morally justifiable to swindle old widows" if that is the only way to pay a ransom to rescue your granddaughter!

I think there is a big difference between using data that was cruely and unethically obtained by Nazis sixty years ago to save my granddaughter and my swindling an old widow today to accomplish the same goal.

If medical researchers publish and use the Nazi data, which is the only data that will ever be available for controlled freezing experiments on humans, they will be saving loved ones now, with no overt harm to anyone living now. The Nazi victims are dead and gone and we cannot "unring the bell" that tolled at their horrible deaths. So long as we do not glorify the names of the doctors who unethically gathered the data, we are, IMHO, acting ethically.

If we swindle the widow now to save my loved one, we are acting unethically, harming (at least financially) a person now.

Here is another example, surgeons learn a great deal when treating civilian victims of gunshot wounds. That data would not be available absent the unethical actions of criminal shooters. Should we ban the use of this valuable data to help save future victims?

Your "old widow" scenario does raise yet another ethical dilemma. How much money should society spend keeping old people alive?

The available resources are always limited. Money spent on medical care comes either from an insurance pool or taxes that is paid into mostly by young working people. Every dollar we spend on an old widow's medicine is, in effect, a dollar less to spend on preventive medical care for some poor child. Given that care, the child will grow up to be a productive member of society while the old widow will always be a drain on common resources.

About half of all medical care dollars is spent on people who will not live another year! We continue to spend tens and hundreds of thousands of dollars doing "heroic" operations on old people to extend their miserable lives.

I think it would be ethical to limit the level of medical spending out of the common insurance and tax pool if the likely result will not raise the recipient to some minimum standard of "quality of life". Give only pallitative care to those who will most likely never have that quality of life.

Ira Glickstein