How is this for an ethical dilemma?

[Kazuaki Shimazaki]

Irrelevant.

Why? Isn't your own morality and judgment this case also important in how you would decide? For example, if my morality system is one where the baby would "win out", I will save the baby. But it will not be because a mother whose clearly not in control screamt it.

I have no idea what is meant here. But you as a third party are not in a position to judge the motivations or rationality about her decision, just to abide by her wishes.

Actually, while I don't think this situation is quite so decisive, third parties are often in a position to judge the "motivations or rationality" about other people's decisions, and not abide by them.

That's ridiculous. You can't ask every pregnant woman to sign a disclaimer outlining her position on every hypothetical.

I acknowledged that. But the least you can be is to be in control, so I can be convinced your order is authentic and is the process of reasoned thought.

YOU HAVE NO RIGHT TO JUDGE HER DECISION. It's her decision, not yours, no matter what she's feeling at the time.

So no matter whether she's sane at the time, even if she clearly is in an incompetent state, I'm supposed to look after my fucking ass and abide like a robot?

[InnerBrat]

Why? Isn't your own morality and judgment this case also important in how you would decide? For example, if my morality system is one where the baby would "win out", I will save the baby. But it will not be because a mother whose clearly not in control screamt it.

No, your own morality is only relevent if the mother is telling you to kill someone else who is not willing to die. In a case of abortion at any stage, least of all during birth, you have no right to enforce it on anyone.

Actually, while I don't think this situation is quite so decisive, third parties are often in a position to judge the "motivations or rationality" about other people's decisions, and not abide by them.

Only when the decision violates someone else's rights.

I acknowledged that. But the least you can be is to be in control, so I can be convinced your order is authentic and is the process of reasoned thought.

Tough. You don't get that luxury in a life or death situation.

So no matter whether she's sane at the time, even if she clearly is in an incompetent state, I'm supposed to look after my fucking ass and abide like a robot?

How many times? EMOTION IS NOT INSANITY!
Just because she's upset, just because she's just been told she has to choose between her life at that of her child, does not been she's incompetant. Are you so devoid of sentiment yourself that you can't see this?

[Kazuaki Shimazaki]

EMOTION IS NOT INSANITY!
Just because she's upset, just because she's just been told she has to choose between her life at that of her child, does not been she's incompetant. Are you so devoid of sentiment yourself that you can't see this?

And how many times do I have to tell you that emotion on the scales we will be talking about degrades sanity, long-range planning and rationality?

It is obvious this is upsetting. But there is a difference between competent decisions in the face of adversity and incompetent ones (and by the way, let me tell you again my assessment of her competence to make decisions has nothing to do with her decision. Remember, my intent is that I execute a decision she would not regret, not that I execute my own decision A even if it is clear B is what she really wants. Do you understand this?)

[InnerBrat]

And how many times do I have to tell you that emotion on the scales we will be talking about degrades sanity, long-range planning and rationality?

Back this shit up.

It is obvious this is upsetting. But there is a difference between competent decisions in the face of adversity and incompetent ones

I know. But it's not your place to decide.

(and by the way, let me tell you again my assessment of her competence to make decisions has nothing to do with her decision. Remember, my intent is that I execute a decision she would not regret, not that I execute my own decision A even if it is clear B is what she really wants. Do you understand this?)

That is clearly not your intent, because she won't regret giving her life for her baby, you moron.
Your intent is to act according to your own subjective morality regardless of anyone else's feelings. You are imposing your decision where you have no right to impose it because you have decided getting bad news has made a woman incompetant.
She wants to give her life for her child. You have absolutely no reason to think that she wouldn't want to do so in other circumstances, and have absolutely no right to stop her from doing so.

[Kazuaki Shimazaki]

Back this shit up.

If you don't realize how emotion and pain can degrade thinking skills, you obviously never had a major emotional or physical pain before.

That is clearly not your intent,

I'm sure I still know my intent better than someone whose getting all heated I'm not slavishly obeying irrationally given invalid commands.

because she won't regret giving her life for her baby, you moron.

I'm admit at that particular nanosecond, thanks to all those maternal instincts swarming up, that might be the case. But that is different from whether this will be her long-term decision. Maybe it will be, maybe it won't. If she's holding herself together, or it is a decision pre-reached, it is far more likely for it to be her long-term decision than if she's clearly a mess.

Another personal anecdote: Once, my leg hurt. I'm not even sure what I twisted (the examination came up empty), but it hurt. A lot. I'm sure there are worse agonies in life but it already feels like the voltage on my nerves can't go any higher. I definitely wasn't thinking much or rationally. If I blurted out something like "I want to die," it might well be the truth at the moment because the pain is basically filling my mind. But is that the same as my long-term decision?

What about the countless every year who commit suicide, fail, and eventually repent? You know, at the moment they slit wrists or whatever, the will to escape it all did override survival instincts. But it turns out that it was not the same as their long-term intention. Of course, there are those who figure they really want to escape it all, and commit suicide again!

Your intent is to act according to your own subjective morality regardless of anyone else's feelings.

Oh, so despite the fact I claimed it will work under utilitarian (the most easily objective of the major ethics systems), you choose not to try to prove the baby's value to be higher, but rather to just denounce my idea as subjective?

Where can you not see I will go along under certain circumstances? Simple ones, in fact.

You are imposing your decision where you have no right to impose it because you have decided getting bad news has made a woman incompetant.

No, it is the observation of an incompetent state. What part of this is so hard to understand?

She wants to give her life for her child. You have absolutely no reason to think that she wouldn't want to do so in other circumstances,

And considering her circumstances, no particular reason to think her current decision is the one she'd make in a calmer environment.

and have absolutely no right to stop her from doing so.

I have no intention of stepping onto her rights if she's doing this sanely. Got it?

[Ghost Rider]

Kaz...show how she's being irrational under the pretense of a parent wanting to sacrifice her life for her baby.

This has been the crux of your argument and the constant using of this by implying she must be irrational to do this...is your personal viewpoint and it's really getting tiresome to hear you broken record this.

Show that this woman is being irrational and would make a different choice in what you call a sane enviroment.

[Kazuaki Shimazaki]

Kaz...show how she's being irrational under the pretense of a parent wanting to sacrifice her life for her baby.

This has been the crux of your argument and the constant using of this by implying she must be irrational to do this...is your personal viewpoint and it's really getting tiresome to hear you broken record this.

Show that this woman is being irrational and would make a different choice in what you call a sane enviroment.

1) The stuff about how I feel that under Utilitarianism (the morality system I currently find myself tending towards and the most easily objective AFAIK), under this circumstance, the mother is more valuable than the baby is discussed last page, but for a recap, it is very simple (if admittedly unemotional). If the mother gives up this one, she can have many more kids and care for them. If the mother is "great" and gives herself up, yeah this baby makes it on the planet, but that's also the end of it. She won't be able to do any of the duties as a mother and wife because she's dead. Consider the sub-possibility (a variant on a scenario that's based on information not given) that she has kids before this particular kid - now she kind of just elevated this last kid above them also. Thus IMHO, I have a strong case for saying objectively that my move does better for the greater good.

(They disagree, and remind me of this fact occasionally, but I hadn't seen counterarguments to this base calculation for awhile. They are mostly saying my moralities are irrevelant, and thus according to my opponents, what you think is the crux is irrevelant.)

2) The 2nd crux of the issue is IMO, whether this disagreement is great enough to be worth stepping on the rights of the mother. And so I answered that if she had clearly thought this through, I'd sigh and go ahead with it despite my misgivings.

3) However, since this is clearly a very emotional and painful (she's in labor to top it all off, so there's severe physical and not just emotional pain here) event, with strong ingrained instincts being implicated, there is a high chance that the decision is not based on what she'd really want in the long term, but on Heat of the Moment impulses. Emotions and instincts do this to people.

4) Which brings us to our current real crux that 99% of our space is going to. Is a woman clearly under these influences still to be considered competent?

Because if she's not competent, under currently accepted morals, such a patient will go into either Implied Consent or perhaps Proxy Consent (which means her husband, and we already know what he said on this matter). Under implied consent, the doctor uses his own judgment (which would include his own morality), under the presumption that had the patient been conscious, she'd agree to the treatment.

5) SO they'd basically listen to a distressed and not fully clear-thinking patient's mumblings and execute the words blindly in the hopes that it is really what they will want. Me, I'm not so sure. Everyone agrees that if this is a clear-thinking choice, we'd override our moralities and go with it. The only difference is what's "clear-thinking".

[Ghost Rider]

Thus in short of all that...you are saying objectively it would be better to keep the mother alive, because as a breeder she would be able to produce more babies.

The point they are making is that completely ignores the mother and is essentially placing you above her wishes, but then adding that you are obviously in a more coherent state that you can make the what you see the more clear and logical choice even though you are only in the role of an relayer of wishes.

Their reasoning is just as simple.

The mother made a request. Your job, everything except your own personal motivation hinges on you carrying out those wishes. Thus all this has been basically you going "Well, if it was solely up to me I would..."

But that's the point, the position you are put in, would mean that if you would disregard her wishes, you lose everything in a real world scenario.

And you don't think that illogical?

[InnerBrat]

If you don't realize how emotion and pain can degrade thinking skills, you obviously never had a major emotional or physical pain before.

I've never given birth, if that's what you mean. Have you?

If you want to play "OMFG! I've suffered more thn U!", then we can. I guarantee you I have a better idea of what it's like to be in her position than you do. However, I don't think that's necessary, do you?

I'm sure I still know my intent better than someone whose getting all heated I'm not slavishly obeying irrationally given invalid commands.

Commands which do not affect you in the slightest, but are her wish to save her baby.

I'm admit at that particular nanosecond, thanks to all those maternal instincts swarming up, that might be the case. But that is different from whether this will be her long-term decision. Maybe it will be, maybe it won't.

You are in no position to decide whether or not it is, so you're going to have to take it on faith that it is.

If she's holding herself together, or it is a decision pre-reached, it is far more likely for it to be her long-term decision than if she's clearly a mess.

Unofrotunately, we don't get that luxury. So you go with her decision.

Another personal anecdote: Once, my leg hurt. I'm not even sure what I twisted (the examination came up empty), but it hurt. A lot. I'm sure there are worse agonies in life but it already feels like the voltage on my nerves can't go any higher. I definitely wasn't thinking much or rationally. If I blurted out something like "I want to die," it might well be the truth at the moment because the pain is basically filling my mind. But is that the same as my long-term decision?

False analogy. Your leg has nothing to do with saving the life of a baby.

What about the countless every year who commit suicide, fail, and eventually repent? You know, at the moment they slit wrists or whatever, the will to escape it all did override survival instincts. But it turns out that it was not the same as their long-term intention. Of course, there are those who figure they really want to escape it all, and commit suicide again!

What are you going to do? Make suicdie illegal?
False dilemma. This has nothing to do with saving the life of a baby.

Oh, so despite the fact I claimed it will work under utilitarian (the most easily objective of the major ethics systems), you choose not to try to prove the baby's value to be higher, but rather to just denounce my idea as subjective?

All morality is subjective, idiot.
I'm not trying to prove the baby's value to anyone. The only person whose opinion matters is that of the mother who has decided she wants to give her life to save her baby.

Where can you not see I will go along under certain circumstances? Simple ones, in fact.

These circumstances being ridiculous hypotheticals.

The scenario was simple:
Baby dies or mother dies. Mother wants you to save the baby's life.
Then you turned round and claimed the mother has no right to choose because she's emotional.

No, it is the observation of an incompetent state. What part of this is so hard to understand?

The part where being emotional must equal incompetence. You have declared that this woman cannot make a decision to be trusted, wihtout providing a shred of evidence towards this, nor explaining why you as an outsider have any right to force your decision on her.

And considering her circumstances, no particular reason to think her current decision is the one she'd make in a calmer environment.

So the default is you go with her decision. You do not enforce your own decision on her.

I have no intention of stepping onto her rights if she's doing this sanely. Got it?

You have to prove she's insane before you take her rights away.

[Kazuaki Shimazaki]

We'd never get to discussing my position rather than pushing away all the misunderstandings of it...

Thus in short of all that...you are saying objectively it would be better to keep the mother alive, because as a breeder she would be able to produce more babies.

You got it.

The point they are making is that completely ignores the mother and is essentially placing you above her wishes, but then adding that you are obviously in a more coherent state that you can make the what you see the more clear and logical choice even though you are only in the role of an relayer of wishes.

Actually, I'm the Executor of her Wishes. Which is why I want to execute her real wishes.

The mother made a request. Your job, everything except your own personal motivation hinges on you carrying out those wishes. Thus all this has been basically you going "Well, if it was solely up to me I would..."

It is not my personal motivation. What personal motivation? What do I get from this? Rightly or wrongly, I'm trying to do what's right, and had this been a real scenario, I'm trying to do what's right at great risk to my career. Do you think I get orgies from killing nearly "ready" babies or stepping on people's rights?

Unless you happen to agree with my one of my older definitions for selfish, in which virtually everything you do can be expressed as something of self-interest, and thus everyone is selfish. In this case, my only personal motivation would be that feeling that I did the best possible, which will be quite counterbalanced by the guilt that always comes when you've made a choice in these circumstances - so it isn't even like overall I'd want that "did the best possible" feeling.

But that's the point, the position you are put in, would mean that if you would disregard her wishes, you lose everything in a real world scenario.

And you don't think that illogical?

Which is why I agreed in a real life scenario, where the woman would sue me, I probably won't. IMO, however, this is an ethical debate. Ethics is not law nor about engineering feasibilities. When I discuss ethics of Eugenics, I tend not to lay aside realistic problems like the potential "hidden costs" of genetic engineering and imperfections in our current technique. So when I discuss this, I lay aside my legal issue.

Besides, if I didn't do something merely because I'm afraid of being sued, it just means I was a selfish funk rather than trying to do the moral thing, right?
-----------------------

If you want to play "OMFG! I've suffered more thn U!", then we can. I guarantee you I have a better idea of what it's like to be in her position than you do. However, I don't think that's necessary, do you?

I have no intention of playing that game. Just that it is one thing to say that you feel that a highly emotional state is not serious enough in your eyes to rate a grade of incompetence. It is quite another to assert that emotions won't degrade your ability to think at all.

You are in no position to decide whether or not it is, so you're going to have to take it on faith that it is.

So even though someone is obviously in a state of putty and quite clearly not playing with a full deck, you will just assume they are.

False analogy. Your leg has nothing to do with saving the life of a baby

and

What are you going to do? Make suicdie illegal?
False dilemma. This has nothing to do with saving the life of a baby.

The point of this kind of thing is to demonstrate times when short-term beliefs fueled by emotions do not turn out to jive with longer-term thinking.

By the way, this decision by the mother, while considered noble, is technically also a suicide. Suicide basically means intentionally ending your own life, for which this of course qualifies.

The part where being emotional must equal incompetence.

No, you made that up to straw. I'm saying that overwhelming emotions are a strong cause for incompetence. If the woman is clearly holding that thing back, her order would be valid. So don't straw.

You have declared that this woman cannot make a decision to be trusted, wihtout providing a shred of evidence towards this,

If you think someone in emotional distress is in prime shape to make decisions that will affect her life, I'd like to see your evidence.

nor explaining why you as an outsider have any right to force your decision on her.

The entire, generally accepted concept of "implied consent" is an outsider "forcing his decision" (to provide treatment, and where more than one treatment option exists to choose the one he feels best) onto a temporarily incompetent person. So once it is agreed that the person is currently incompetent, that's the default position of society, and should require no further defense by me.

You have to prove she's insane before you take her rights away

So despite the fact that she's clearly putty (crying out of control, words barely coherent...), you'd still assume she's sane? Really, there are times when a person is clearly out of it.

[Ghost Rider]

So you push her breeding ahead of her wishes, thus saying that in this case it would be better in a morality play that you know her wishes better then she does.

That's all I have to say because you said it yourself, however you want to put it. You ion your arrogance have placed yourself above her but colored it so that it appears that you are carrying out her true wishes under the guise that she's thinking irrationally.

End of discussion because at this point, showing you that you are saying you can read true intentions is an illogical excersise.

[Kazuaki Shimazaki]

So you push her breeding ahead of her wishes, thus saying that in this case it would be better in a morality play that you know her wishes better then she does.

I don't know whether it is because of my poor expression skills or what, but why does everyone turn "I will not execute wishes that are uttered in a state of clear incompetence" into "I will not execute any of her wishes."

Honestly, it is quite pointless to continue when people keep distorting your positions.

[InnerBrat]

Thus in short of all that...you are saying objectively it would be better to keep the mother alive, because as a breeder she would be able to produce more babies.

You got it.

Right, because having as many babies as possible is the most important thing in the world

Actually, I'm the Executor of her Wishes. Which is why I want to execute her real wishes.

Except you're making up what you feel her real wishes should be.

It is not my personal motivation. What personal motivation?

Your conviction that you know exactly what is right to do in every scenario, and your bloodymindedness to the extent where you are imposing your morality where it doesn't belong.

What do I get from this? Rightly or wrongly, I'm trying to do what's right, and had this been a real scenario, I'm trying to do what's right at great risk to my career.

What's right by whom?

So when I discuss this, I lay aside my legal issue.

And by doing so, you are stating that you think there's something wrong with a law that prevents doctors from enforcing their decisions on unwilling patients.

I have no intention of playing that game.

Good, so don't accuse me of not knowing what it's like to be an emotional woman, kthx.

Just that it is one thing to say that you feel that a highly emotional state is not serious enough in your eyes to rate a grade of incompetence. It is quite another to assert that emotions won't degrade your ability to think at all.

You are claiming that emotions do make one incompetant.

So even though someone is obviously in a state of putty and quite clearly not playing with a full deck, you will just assume they are.

The scenario says fuck all about her being "clearly not playing with a full deck".

The point of this kind of thing is to demonstrate times when short-term beliefs fueled by emotions do not turn out to jive with longer-term thinking.

If you genuinely wanted to die because your leg hurt, then there's something wrong with you. It is not comparable to losing your baby.

By the way, this decision by the mother, while considered noble, is technically also a suicide. Suicide basically means intentionally ending your own life, for which this of course qualifies.

I know what suicide is, thank you very much. I also think that's a matter of personal choice.

The part where being emotional must equal incompetence.

No, you made that up to straw. I'm saying that overwhelming emotions are a strong cause for incompetence.[/quote]
And I'm saying that's bullshit and you have no right to go against a patients wishes just because she's emotional.

If the woman is clearly holding that thing back, her order would be valid. So don't straw.

What "thing"?

If you think someone in emotional distress is in prime shape to make decisions that will affect her life, I'd like to see your evidence.

Burden of proof is on your claim for insanity, I'm afraid.

The entire, generally accepted concept of "implied consent" is an outsider "forcing his decision" (to provide treatment, and where more than one treatment option exists to choose the one he feels best) onto a temporarily incompetent person. So once it is agreed that the person is currently incompetent, that's the default position of society, and should require no further defense by me.

It is in no way generally accepted that an emotional woman is incompetant, so appeal to popualr opinion is not going to help you here.

So despite the fact that she's clearly putty (crying out of control, words barely coherent...), you'd still assume she's sane? Really, there are times when a person is clearly out of it.

Bullshit. The scenario does not mention in the slightest that she's crying and incoherent. You're now inventing a situation to justify your position.

[Ghost Rider]

So you push her breeding ahead of her wishes, thus saying that in this case it would be better in a morality play that you know her wishes better then she does.

I don't know whether it is because of my poor expression skills or what, but why does everyone turn "I will not execute wishes that are uttered in a state of clear incompetence" into "I will not execute any of her wishes."

Honestly, it is quite pointless to continue when people keep distorting your positions.

Indeed...especially when it's pointed out that you have stated you would know better because she's being irrational.

And that if she wasn't irrational she would make a different choice.

Your words.

So...please demonstrate how that if she was rational her choice would be different?

[Kazuaki Shimazaki]

Right, because having as many babies as possible is the most important thing in the world

You dispute the result of my ethic calc but you cannot provide a reasonable, logical calculation as to how morally speaking, it is decisively better for the mother (a full life as of itself) to abandon everything from her future babies to everyone depending on her in the present just to protect one life.

Except you're making up what you feel her real wishes should be.

If I'm doing that, I won't have a clause saying that if her real wishes were clear, they would be obeyed.

Your conviction that you know exactly what is right to do in every scenario, and your bloodymindedness to the extent where you are imposing your morality where it doesn't belong.

Oh, so it is basically that selfishness like I said. Every time someone to his own conscience, he can be said to be doing that too, you know.

What's right by whom?

The important thing here is the attempt. By most definitions, a person that's true-heartedly trying to do good is not exactly what most call "self-serving".

And by doing so, you are stating that you think there's something wrong with a law that prevents doctors from enforcing their decisions on unwilling patients.

Laws are things created for most situations.

The scenario says fuck all about her being "clearly not playing with a full deck".

It does not say she is either. It is an empty spot in the scenario. So your decision may vary based on what you see in that spot, just as your answer to Stofsk's question 2 might vary depending on what kind of disease are you imagining for the hypothetical baby.

If you genuinely wanted to die because your leg hurt, then there's something wrong with you. It is not comparable to losing your baby.

Why? It is hurting really badly. I'm sure all my nerves were maxed out in their voltages. Trying to escape this pain isn't natural?

What "thing"?

The emotions. I'm not saying she must be smiling. But let's have some control here.

Burden of proof is on your claim for insanity, I'm afraid.

I'd observe it, got it? I'd make my observation and make a decision. As a doctor, I'd think I'd have at least basic training as to determining a person's current mental state.

It is in no way generally accepted that an emotional woman is incompetant, so appeal to popualr opinion is not going to help you here.

Not the point of this paragraph. Are you tacitily conceding if someone is incompetent for any reason, implied consent can apply?

Bullshit. The scenario does not mention in the slightest that she's crying and incoherent. You're now inventing a situation to justify your position.

Actually, the scenario does not mention either way, and to imagine the situation mandates that you subconciously insert something like this. If you want to insert extra assumptions like I can observe she's reasonably calm and coherent, I'd give her all of the little time I think she has left to confirm whatever decision she made (hell, I might even play Devil's Advocate if she wants to self-preserve) and proceed. Does that reassure you a bit that I have no intention of going against a patient's legitimate wishes, and I'm not assessing legitimacy based on whether it is in line with what I'd have chosen in the same situation?