Life or death – whose decision is it anyway?

The courses of actions that were taken shall be justified through the use of Immanuel Kant’s categorical imperative. The categorical imperative provides that one ought to, “[a]ct only on that maxim through which you can at the same time will that it should become a universal law.” There are however two formulations of the categorical imperative. The above-mentioned is the first one and the second is “[a]ct in such a way that you always treat humanity, whether in your own person or in the person of any another, never simply as a means but always at the same time as an end.”

Scenario 1

The primary issue at hand is whether or not it was ethical for the doctors in George Washington Hospital to insist that her baby be allowed to live despite Angela’s, her physicians’ and her family’s objections; especially when it was found that in the end, the surgery was a contributing cause to Angela’s death. Thus, the primary issue here is whether or not abortion would have been ethical given the situation. What is the best course of action to take given the situation?

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But even before proceeding, what exactly is the situation? The situation is the fact that Angela is faced with cancer and she has only a few days to live. Her physicians and her family wanted to preserve her life as much as they could. In addition, the surgery (cesarean section), which while gives the baby 50 to 60% chance to survive, endangers Angela’s life and withers the last few days that she has left, not to mention the fact that .  Furthermore, they estimated that there was a less than 20 percent chance that the child would be disabled.  The physicians also testified that the surgery would increase the chances of Angela Carter’s death.

The best course of action taken was the course taken by the doctors in George Washington Hospital to insist that her baby be allowed to live despite Angela’s, her physicians’ and her family’s objections.. Thus, given the situation it would not have been ethical to abort the baby. This decision can be justified using Immanuel Kant’s categorical imperative.

The categorical imperative can be explained simply through the discussion on duties. Basically if a course of action or decision is one’s duty, then it can be willed to become a universal law. If on the other hand, a course of action is not part of one’s duty then it cannot be said to become a universal law.

Given the situation above, it is the duty of Angela’s doctors to uphold the value of life. In fact as doctors, it is part of their Hippocratic Oath “[t]o practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them” and “[n]ever to do deliberate harm to anyone for anyone else’s interest.” However, it becomes complicated as they, in a way have to choose between Angela’s and her baby’s life. As it is their duty to protect their patients’ lives, they are now confronted with a scenario that they have to inevitably choose one of their patients’ lives. Thus, the question is can the doctors continue performing their duties without aborting the baby? Are there alternatives?

Subjected to the first formulation of the categorical imperative, the action not to abort and keep the child may be regarded as a universal law and may be imposed upon any other individual who finds himself/ herself in such a situation.

They may do without abortion as the same is in compliance with their duty to preserve life because there are other means by which they may still comply with their duty to Angela to protect and safeguard her life. One of these is by making sure that she is given the best possible attention during the surgery. It must be noted that Angela’s is bound to live for only a few days, no matter what the doctors do.

The course of action is further affirmed and clarified as it is subjected to the second formulation. From such maxim arises the duty that human life must be protected and safeguarded because it must not be treated just as a means but always at the same time as an end.

Ideally, the best course of action is to try all means possible and necessary to safeguard both Angela and her baby’s life. However, it must be noted that Angela’s life is already on the losing end and no matter what the doctors do, she was bound to die sooner rather than later. Thus, aborting the baby is but a means to making sure that Angela will live albeit for a few a days; with this fact, such course of action does not pass the second formulation of the categorical imperative. The life of the baby must be treated not just as a means but also as an end.

Thus, in this case the doctors of George Washington Hospital undertook to perform the best course of action given the situation as at the end of the day, life or death is not a decision that any person can make. For that matter, no one person can ever make that decision for someone else.

Scenario 4

The primary issue in this scenario was whether or not it would be ethical for the Dr. Wendy Smith to inform Jack’s father that he will die unless he gets a liver transplant.

The issue arises from the fact that Jack believes that his father’s situation will worsen once the gravity of his predicament is made known to him. On the other hand, Dr. Wendy Smith believes by his sworn duty to inform the patient of what he is up against.

In this situation there is a clash of duties between the duty of Jack to his father, as a son and the duty of the doctor to Jack’s father as his doctor. It is the duty of Jack to do everything in his power to make sure that the best interests of his father is upheld and taken care of. On the other hand, in addition to the above-mentioned duties of a doctor “[t]o practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them” and “[n]ever to do deliberate harm to anyone for anyone else’s interest,” it is also their duty “[t]o keep the good of the patient as the highest priority.”

We shall now find out the resolve of the conflicting duties by subjecting them to the two formulations of the categorical imperative.

With respect to Jack’s duty, it is true that the upholding the best interests of one’s parent can be willed that it should become a universal law. In addition, by upholding the best interests of one’s parent, one acts in such a way that he/she treats humanity, whether in your own person or in the person of any another, never simply as a means but always at the same time as an end.

With respect to Dr. Wendy Smith’s duties “[t]o practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them,” “[n]ever to do deliberate harm to anyone for anyone else’s interest,” and “[t]o keep the good of the patient as the highest priority.” The same can be willed that they can become universal laws and the same are also means by which humanity is treated not just as a means but also as an end.

Thus, as both were subjected to the categorical imperative and both passed the formulations, what then? It can be noted that Jack’s duty is to make sure that the best interests of his father are upheld, but how does Jack know what his best interests are? Is concealing the truth to him of his best interest? Thus, we subject this to the categorical imperative.

Concealing the truth cannot be willed to become a universal law. If the same were to be allowed to become universal law then all concealments of truth in all situations not related to the situation at hand will be justified. The same is inconsistent to upholding the virtue of truth. At the same time, concealing the truth is actually a method by which one is treated as a means and not as end. This is so as concealment provides a myopic view – it is a mere means for the people around Jack’s father to avoid the issue of his impending demise for themselves rather than making sure that Jack’s father is apprised of his situation and is prepared for the worst possible ending of his situation.

Thus, the best course of action to take is the action backed up by Dr. Wendy Smith’s duty as a doctor to inform the patient of his predicament no matter how grave said situation is.

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