General Trek Questions and Observations
- Thread starter The Old Mixer
- Start date
I never understood Crusher's resistance to a treatment the patient explicitly wanted and knew the risks of
A patient in Worf's situation is desperate and not informed enough to know if their Doctor is bullshitting them. Consent can be coaxed. Russell absolutely played on Worf's desperation to test her theory. That is NOT something a Doctor should be doing. We're seeing enough of that crap with folk guzzling horse de-worming paste RIGHT NOW.
Crusher didn't always have those big moments but "Ethics" is definitely one that I always appreciated.
I disagree. Crusher was willing to put Worf under restraint to keep him from killing himself indefinitely. That's worse than anything Doctor whatshername wanted to do. At least she never tried to force her treatment on Worf. That puts her above Crusher, IMO. The will of the patient is the determining factor in medicine, something Crusher seemed to forget. Plus she (whatshername) never hid her facts from Worf. I am sure that he knew going in that his chances were not too good.
Plus Crusher was willing to hide the very existence of that treatment from Worf. If she has had her way, Worf would have eventually killed himself. That's some ethics, huh?
I never understood Crusher's resistance to a treatment the patient explicitly wanted and knew the risks of
The answer is in the quotes I've given. A physician must not harm his or her patient. Worf was alive and in no danger of dying from his paralysis. Had the surgery failed, he would have died as a direct result of it. Ergo, the surgery was not good medicine, and Picard admitted this.
For a doctor bound by good medical ethics (which Beverly was and the other doc was not), knowingly harming a patient is unthinkable. Just as much as slapping your mother or abandoning your child would be for you. The fact that Beverly was willing to risk doing so shows that despite her failings, she did respect Worf's cultural issues.
Even if it's legal, that doesn't mean a given doctor will do it. Consider the following:
"I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a [substance] to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone but I will give place to such as are craftsmen therein.
Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets."
- From the Hippocratic Oath
A physician, in light of that, may refuse to assist a patient in killing themself, or to perform an abortion. Even if 21st, or 24th, century law permits these things.
"I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a [substance] to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone but I will give place to such as are craftsmen therein.
Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets."
- From the Hippocratic Oath
A physician, in light of that, may refuse to assist a patient in killing themself, or to perform an abortion. Even if 21st, or 24th, century law permits these things.
True. Even if the treatment has only one in ten chances of succeeding it still beats the certainty of killing yourself. That's why I think Crusher is the one whose ethics are questionable in that episode. Plus some so-called doctors (IRL) are real assholes. A friend of mine never knew from his (former) doctor that a treatment was available for what he had (an infection, that was resistant to antibiotics) anyway, his doctor never told him that phage* therapy was a possibility. You see a phage is a virus that only affects bacteria and not multicellular organisms (like us) and it can cure certain antibiotic-resistant infections. My friend learned that on his own and then went to a place specialized in these treatments. Bottom line is, he was cured!! Needless to say that he wasn't too happy about the way his former doctor kept him in the dark.
* Mislabeling things seems to be a specialty of the Voyager writing team., isn't it?
Unfortunately, medical ethics is not determined by your opinion, but by the strictures laid down by Hippocrates, 2400 years ago.
Not really. Contrary to legend ethics evolve and are different from one country to another. In certain countries a doctor is obligated to presenting a patient with EVERY treatment available whether they approve of them or not., otherwise they're liable to lawsuits.
Cool factoid. Star Trek Reddit shut itself down in protest of a anti-vaccination reddit that was spreading misinformation. Surprisingly, it seems to have worked and its back within a day.
A nice bit of civil protest.
A nice bit of civil protest.
Well, personally I think Crusher is an ass, and more often than not she's the cause of problems rather than their solution.
I won't go to a doctor who'll let me suffer or even die because a treatment doesn't meet his "ethics". There are also doctors who don't do their hoùework and don't propose treatments because they are too ignorant of the latest discoveries. There are more of these than you'd think.
Take a hard look at the alternatives Beverly was facing.
1. Provide a safe, proven treatment to her patient that would restore 60-70% of his mobility, with no chance whatsoever of his dying.
2. Go with an unproven, untested treatment that worked less than 40% of the time in an idealized environment, proposed by a doctor who had just KILLED A PATIENT you could have saved, in the name of research.
No, Beverly's decision was the right one, from a physician's perspective. She only went the other way when she realized that it was inevitable that Worf would kill himself otherwise. As seen here:
PICARD: "Beverly, he can't make the journey you're asking of him. You want him to go from contemplating suicide to accepting his condition and living with the disability, but it's too far. The road between covers a lifetime of values, beliefs. He can't do it, Beverly. But perhaps he can come part of the way. Maybe he can be persuaded to forgo the ritual in order to take the chance at regaining the kind of life he needs. A Klingon may not be good at accepting defeat, but he knows all about taking risks."
CRUSHER: "The first tenet of good medicine is never make the patient any worse. Right now, Worf is alive and functioning. If he goes into that operation, he could come out a corpse."
PICARD: "This may not be good medicine, but for Worf, it may be his only choice."
From "Ethics"
1. Provide a safe, proven treatment to her patient that would restore 60-70% of his mobility, with no chance whatsoever of his dying.
2. Go with an unproven, untested treatment that worked less than 40% of the time in an idealized environment, proposed by a doctor who had just KILLED A PATIENT you could have saved, in the name of research.
No, Beverly's decision was the right one, from a physician's perspective. She only went the other way when she realized that it was inevitable that Worf would kill himself otherwise. As seen here:
PICARD: "Beverly, he can't make the journey you're asking of him. You want him to go from contemplating suicide to accepting his condition and living with the disability, but it's too far. The road between covers a lifetime of values, beliefs. He can't do it, Beverly. But perhaps he can come part of the way. Maybe he can be persuaded to forgo the ritual in order to take the chance at regaining the kind of life he needs. A Klingon may not be good at accepting defeat, but he knows all about taking risks."
CRUSHER: "The first tenet of good medicine is never make the patient any worse. Right now, Worf is alive and functioning. If he goes into that operation, he could come out a corpse."
PICARD: "This may not be good medicine, but for Worf, it may be his only choice."
From "Ethics"
Provide a treatment that Worf had already rejected as unacceptable and that would have eventually led to his suicide.
"Turn death into a fighting chance to live" to quote McCoy in TSFS.
I stand by my assessment of Beverly. As a doctor, she's more trouble than she's worth. Don't forget that she managed to turn a minor gene problem that Barcley had into a shipwide catastrophe that turned the whole crew into a bunch of atavistic monsters that were eating each other! That's a hell of a screw-up, don't you think?
No more so than running with shields down after encountering another vessel. Or forgetting that Vulcans have an inner eyelid. Or that you could reason with anthropoids. Or thinking that maybe the Nazis had the right idea if only a few minor changes were made to the program.
Keeping the shields down may be at the same level.... almost. The Nazi remark was just downright stupid, Spock must have had something on his mind that kept him from being rational...
But think about this. A patient (Barclay) comes with a minor problem, barely worth mentioning according to Beverly herself and she managed to turn that into an indescribable horror. If not for Data who was immune and capable of a quick analysis of the situation the ship's crew would have eventually consumed itself to extinction. Contaminating any rescuers, foolhardy enough to beam in without some sort of hazard suit on. Perhaps they would have eventually blown up the Enterprise to stop the pandemia, perhaps a whole fleet of ships even. All of which because of Crusher.
As much as I'm firmly on Beverly's side in Ethics, Genesis did her no favours. We know at least one person died, but in a ship with over 1,000 people, including children living in quarters with their families, that lovecraftian horror almost certainly led to, if not more fatalities, at least serious injuries and horrible trauma...but apparently not too much of either for Beverly and Deanna to joke about Troi clearing her schedule to talk to Barclay as Beverly checks him. It practically ends on a freeze frame.
Oddly, this reminds me a bit of the controversy over Kurn's treatment on "Sons of Mogh" where some of the Tor commentators argued that Kurn needed therapy versus indulging his suicidal desires. I pointed out that I felt that Kurn wasn't mentally ill like many people with suicidal tendencies or depression. He was someone who was acting on a cultural taboo and the fact that he didn't want to live because ritual suicide was part of his people's reaction to dishonor. Which is different and not necessarily treatable (a patient has to want to get better and medication won't help Kurn).
Starfleet might view ANY desire to die as a mental illness, though.
Starfleet might view ANY desire to die as a mental illness, though.
Similar threads
- Locked
