Critical Care

[Captrek]

Let’s start over and this time leave the Doctor out of it and see if that keeps things cooler.

New scenario. This hypothetical scenario is in broad strokes similar to Critical Care. A doctor — it’s not the Doctor, it’s someone you don’t like — is working in a hospital in a world where the privileged have medicine that is more badly needed by commoners. He asks the administrator to reallocate meds from the privileged to the needy and is told no.

Should this hypothetical person poison the administrator in order to force that reallocation? Under what circumstances should or shouldn’t he?

 

[Farscape One]

You are taking this too personally. Let’s take the Doctor out of the equation.

New scenario. This scenario is in broad strokes similar to Critical Care. A doctor — it’s not the Doctor, it’s someone you don’t like — is working in a hospital in a world where the privileged have medicine that is more badly needed by commoners. He asks the administrator to reallocate meds from the privileged to the needy and is told no.

Should this hypothetical person poison the administrator in order to force that reallocation?

Was this person kidnapped and forced to work there, like The Doctor was in "CRITICAL CARE"?

If he was, then yes.

If he was not, then no.

 

[Captrek]

Was this person kidnapped and forced to work there, like The Doctor was in "CRITICAL CARE"?

If he was, then yes.

If he was not, then no.

Very good.

Please explain why a kidnapped doctor should poison the administrator.

 

[Farscape One]

Very good.

Please explain why a kidnapped doctor should poison the administrator.

He or she is held there against their will. Stuck there, with no apparent escape possible, they have every right to use whatever means at their disposal to escape. If the only means left is poisoning the administrator, then it's justified.

 

[Captrek]

He or she is held there against their will. Stuck there, with no apparent escape possible, they have every right to use whatever means at their disposal to escape. If the only means left is poisoning the administrator, then it's justified.

Ah, you have refined your answer. First:

                +---------------------------+
                | Was the doctor kidnapped? |
                +---------------------------+
                      /            \
                     /              \
                [Yes]               [No]
                   |                  |
                   v                  v
       +--------------------+   +-------------------------+
       |     Do poison      |   |      Do Not Poison      |
       +--------------------+   +-------------------------+

Now:

                +---------------------------+
                | Was the doctor kidnapped? |
                +---------------------------+
                      /            \
                     /              \
                [Yes]               [No]
                   |                  |
                   |                  v
                   |            +-------------------------+
                   |            |      Do Not Poison      |
                   |            +-------------------------+
                   v                         ^
+-----------------------------------+        |
| Is poisoning only way to escape?  |--[No]—-+
+-----------------------------------+
                   |
                 [Yes]
                   |
                   v
           +---------------+
           |   Do poison   |
           +---------------+

Am I understanding you correctly? Are any more significant refinements necessary?

 

[Farscape One]

Ah, you have refined your answer. First:

                +---------------------------+
                | Was the doctor kidnapped? |
                +---------------------------+
                      /            \
                     /              \
                [Yes]               [No]
                   |                  |
                   v                  v
       +--------------------+   +-------------------------+
       |     Do poison      |   |      Do Not Poison      |
       +--------------------+   +-------------------------+

Now:

                +---------------------------+
                | Was the doctor kidnapped? |
                +---------------------------+
                      /            \
                     /              \
                [Yes]               [No]
                   |                  |
                   |                  v
                   |            +-------------------------+
                   |            |      Do Not Poison      |
                   |            +-------------------------+
                   v                         ^
+-----------------------------------+        |
| Is poisoning only way to escape?  |--[No]—-+
+-----------------------------------+
                   |
                 [Yes]
                   |
                   v
           +---------------+
           |   Do poison   |
           +---------------+

Am I understanding you correctly? Are any more significant refinements necessary?

I'm not sure why you need to turn this into some kind of equation. But if you want to go with this, okay. Not sure what your point is on this one. A kidnapped person has every right to do whatever they can to get themselves out.

 

[Turtletrekker]

A fascinating thought is that these are exactly the kind of things that the Doctor will still have total perfect recall of 800 years later in Starfleet Academy. How do things like this weigh on him over the centuries?

 

[at Quark's]

A kidnapped person has every right to do whatever they can to get themselves out.

Whatever they can? Up to and including actually murdering the kidnapper if that would be necessary to escape?

(Not saying I disagree, I'm not sure where I stand on this one.)

 

[Captrek]

I'm not sure why you need to turn this into some kind of equation. But if you want to go with this, okay. Not sure what your point is on this one. A kidnapped person has every right to do whatever they can to get themselves out.

A question, not a point. I’m not playing advocate here. My only intention is what I have said all along: to clarify what others consider just and injust.

If that second flowchart accurately describes your position, then the question is answered. I now know the standards under which you would judge the hypothetical person. Thank you.

Other posters may agree with that standard or offer their own alternatives. I look forward to seeing that.

 

[Farscape One]

Whatever they can? Up to and including actually murdering the kidnapper if that would be necessary to escape?

(Not saying I disagree, I'm not sure where I stand on this one.)

Absolutely.

You don't know what the kidnappers intentions are. For all you know, kidnapping is just merely the beginning. Rape, torture, mutilation, or killing you could very easily be what they have planned.

Damned right you do whatever you need to do in order to escape, including killing them if it comes down to it.

 

[Michael]

Let’s start over and this time leave the Doctor out of it and see if that keeps things cooler.

New scenario. This hypothetical scenario is in broad strokes similar to Critical Care. A doctor — it’s not the Doctor, it’s someone you don’t like — is working in a hospital in a world where the privileged have medicine that is more badly needed by commoners. He asks the administrator to reallocate meds from the privileged to the needy and is told no.

Should this hypothetical person poison the administrator in order to force that reallocation? Under what circumstances should or shouldn’t he?

Not convinced we won’t ultimately go in circles with this one either, but I’ll try and play.

You say this scenario is similar in broad strokes to “Critical Care”, but I think to answer your question I would need some more information about how it differs …



Is this about some medicine of a nondescript nature or is it specifically able to save the lives of commoners while it’s only administered to the privileged as a form of non-essential rejuvenation?

Is that administrator merely holding back medicine or directly responsible for sending commoners to their deaths?

Is the administrator only following orders or is he (also) allowed some discretion in how he makes his decisions?

Is he completely powerless in how the medicine is allocated in the hospital or would he actually be able to help? And wouldn’t medical ethics mandate the administrator to do everything in his power to save as many lives as possible?

Is that doctor just a regular employee of the administrator or is he forced to work for him against his will as a slave?

Does the administrator respect that the doctor has a different stance or does he threatened to kill him if he doesn’t comply?

Can that doctor I don’t like be reasonably certain that he can prevent the administrator from dying from the poison?

Can that doctor be reasonably certain that poisoning the administrator will coerce him into saving the lives of the commoners?

Are the doctors motives in trying to coerce the administrator selfish and self-serving or altruistic?

Can it be argued that poisoning the administrator is a form of civil disobedience in the face of an unjust oppressive state?

Is there some immediacy involved? Does coercing the administrator save lives that would otherwise perish in short order?



If some or all circumstances about the situation can be answered with the underlined options, then yes, I would personally say the hypothetical doctor should poison the administrator. There might be more aspects to explore, but these are the ones that immediately come to mind.

 

[Captrek]

Not convinced we won’t ultimately go in circles with this one either, but I’ll try and play.

You say this scenario is similar in broad strokes to “Critical Care”, but I think to answer your question I would need some more information about how it differs …



Is this about some medicine of a nondescript nature or is it specifically able to save the lives of commoners while it’s only administered to the privileged as a form of non-essential rejuvenation?

Is that administrator merely holding back medicine or directly responsible for sending commoners to their deaths?

Is the administrator only following orders or is he (also) allowed some discretion in how he makes his decisions?

Is he completely powerless in how the medicine is allocated in the hospital or would he actually be able to help? And wouldn’t medical ethics mandate the administrator to do everything in his power to save as many lives as possible?

Is that doctor just a regular employee of the administrator or is he forced to work for him against his will as a slave?

Does the administrator respect that the doctor has a different stance or does he threatened to kill him if he doesn’t comply?

Can that doctor I don’t like be reasonably certain that he can prevent the administrator from dying from the poison?

Can that doctor be reasonably certain that poisoning the administrator will coerce him into saving the lives of the commoners?

Are the doctors motives in trying to coerce the administrator selfish and self-serving or altruistic?

Can it be argued that poisoning the administrator is a form of civil disobedience in the face of an unjust oppressive state?

Is there some immediacy involved? Does coercing the administrator save lives that would otherwise perish in short order?



If some or all circumstances about the situation can be answered with the underlined options, then yes, I would personally say the hypothetical doctor should poison the administrator. There might be more aspects to explore, but these are the ones that immediately come to mind.

Let’s see if we can do this flowchart wise.

• Am I kidnapped? No, don’t poison; Yes, hmm…
• Is the administrator guilty of the crimes enumerated by Michael in the quoted post? No, don’t poison; Yes, hmm…
• Can I chicken if the other guy doesn’t? No, don’t poison; Yes, hmm…
• Am I a good person with altruistic motives? No, don’t poison; Yes, hmm…
• Can I get life-saving medicine by doing it? No, don’t poison; Yes, that’s the last test, poison.

I’m sure I didn’t get all that right, go ahead and clarify.

 

[Tosk]

I'm curious as to the need for people to scrutinize every molecule of their opinion on this matter under a microscope. You wanted to get a feel for how people felt about the situation, and now you have it.

I'm all for a continuing or evolving discussion on the details, but this feels more like census taking somehow.

 

[Captrek]

Let’s start over and this time leave the Doctor out of it and see if that keeps things cooler.

New scenario. This hypothetical scenario is in broad strokes similar to Critical Care. A doctor — it’s not the Doctor, it’s someone you don’t like — is working in a hospital in a world where the privileged have medicine that is more badly needed by commoners. He asks the administrator to reallocate meds from the privileged to the needy and is told no.

Should this hypothetical person poison the administrator in order to force that reallocation? Under what circumstances should or shouldn’t he?

I’m running out of time. I have reason to believe I will soon be kidnapped and forced to work in a hospital. I’ll have to make a decision about whether or not to poison the administrator. Anyone have any last-minute guidance?

 

[at Quark's]

I’m running out of time. I have reason to believe I will soon be kidnapped and forced to work in a hospital. I’ll have to make a decision about whether or not to poison the administrator. Anyone have any last-minute guidance?

Yeah.

Go into hiding or find another way to avoid the situation entirely.

 

[Michael]

I’m running out of time. I have reason to believe I will soon be kidnapped and forced to work in a hospital. I’ll have to make a decision about whether or not to poison the administrator. Anyone have any last-minute guidance?

Hoping it’s not too late.

For whatever it’s worth, I’ve given this some more thought and tried to come up with my own version of something like a decision tree, taking the key questions into account that would guide me to making that call. Rather than a straight tree of yes or no questions I made it so that there’s two groups of threshold questions and then, to add more nuance, two groups of questions about additional context and motives that are weighted according to how much I think they inform the key question. This is not perfect, and the way I weighted the answers naturally comes down to subjective deliberation, but it reflects how I feel about the situation and its moral implications.

Where do you see the flaws in thinking about it like this? My own criticism of this (and why I pointed out it’s not perfect) would be that it oversimplifies complex moral questions and the point system could be seen as arbitrary. These kind of concerns reflect my view that the question and the dilemma presented in the episode are complex and not easy to answer.

The more I think about it, the more I wonder how the doctor would defend himself if this were brought to judicial deliberation. Would he accept responsibility for breaking his oath to “do no harm” (which IMHO the final scene kind of suggests)? Or would he try to argue that weighing all options breaking his oath was warranted?

---

Ethical Decision Tree: Should you poison the administrator?

STEP 1: CORE QUESTIONS (All must be answered YES to proceed)

Ask yourself:
1. Is the medicine able to save lives?
2. Does the administrator have power to save lives? Can it reasonably be expected that poisoning the administrator will result in lives being saved?
3. Is the situation urgent — will people die imminently without action?

→ If you answer NO to any of these, then: Do NOT poison the administrator.

→ If all are YES, continue:

---

STEP 2: Immediate Ethical Red Flags (Abort if ANY apply)

Ask yourself:
1. Is this action primarily motivated by revenge, frustration, or ego?
2. Is there a significant chance that this action will cause substantial or irreversible harm to individuals who are morally and legally innocent and not responsible for the injustice you want to address?
3. Are there realistic non-lethal alternatives that you haven’t exhausted? For example, would systemic resistance, whistleblowing or escape be valid alternatives to poisoning, especially in face of the urgency of the situation?

→ If you answer YES to any of these, then: Do NOT poison the administrator.

→ If all are NO, continue:

---

STEP 3: CONTEXT QUESTIONS (2 points each YES)

4. Are you acting under coercion or threat of serious harm, making poisoning a justifiable act of self-defense?
5. Can you reasonably ensure the administrator would survive the poison?

---

STEP 4: MOTIVE QUESTIONS (1 point each YES)

6. Does the administrator have an ethical responsibility to save lives?
7. Is your primary intention to save others and act for the common good?
8. Could this be civil disobedience against injustice?

---

STEP 5: Final Evaluation

→ Add up your points:
Context questions: 2 points per YES
Motive questions: 1 point per YES

→ Decision Threshold:
If your total score is 5 points or more: Ethically justified to poison the administrator

If your total is less than 5: Do NOT poison

 

[Ray Hardgrit]

Is it too late to get this post to the set decorators working on Starfleet Academy? They're going to need text to put on those PADDs and the EMH is teaching there.

 

[Captrek]

My brief captivity is over. Thank you for your concern.
The administrator was guilty of crimes (not by local standards, but you know what I mean) comparable to Chellik’s. He had access to life-saving medicine that wasn’t reaching the patients who needed it most. I was reasonably certain that he would chicken in time to save himself and that I could chicken in time if he didn’t.

I poisoned him. He chickened, redirected the meds, and lived. Then my friends found and rescued me.

Did I make the correct choice?

 

[Captrek]

Hoping it’s not too late.

For whatever it’s worth, I’ve given this some more thought and tried to come up with my own version of something like a decision tree, taking the key questions into account that would guide me to making that call. Rather than a straight tree of yes or no questions I made it so that there’s two groups of threshold questions and then, to add more nuance, two groups of questions about additional context and motives that are weighted according to how much I think they inform the key question. This is not perfect, and the way I weighted the answers naturally comes down to subjective deliberation, but it reflects how I feel about the situation and its moral implications.

Where do you see the flaws in thinking about it like this? My own criticism of this (and why I pointed out it’s not perfect) would be that it oversimplifies complex moral questions and the point system could be seen as arbitrary. These kind of concerns reflect my view that the question and the dilemma presented in the episode are complex and not easy to answer.

The more I think about it, the more I wonder how the doctor would defend himself if this were brought to judicial deliberation. Would he accept responsibility for breaking his oath to “do no harm” (which IMHO the final scene kind of suggests)? Or would he try to argue that weighing all options breaking his oath was warranted?

---

Ethical Decision Tree: Should you poison the administrator?

STEP 1: CORE QUESTIONS (All must be answered YES to proceed)

Ask yourself:
1. Is the medicine able to save lives?

Yes.

2. Does the administrator have power to save lives? Can it reasonably be expected that poisoning the administrator will result in lives being saved?

To the former, yes. To the latter, I felt so at the time, and results bore that out.

3. Is the situation urgent — will people die imminently without action?

→ If you answer NO to any of these, then: Do NOT poison the administrator.

→ If all are YES, continue:

There were patients who urgently needed the meds and would have died without it. They are now (or at least were as of the time I left that world) alive.

---

STEP 2: Immediate Ethical Red Flags (Abort if ANY apply)

Ask yourself:
1. Is this action primarily motivated by revenge, frustration, or ego?

Not primarily.

2. Is there a significant chance that this action will cause substantial or irreversible harm to individuals who are morally and legally innocent and not responsible for the injustice you want to address?

I do not anticipate such harm will result.

3. Are there realistic non-lethal alternatives that you haven’t exhausted? For example, would systemic resistance, whistleblowing or escape be valid alternatives to poisoning, especially in face of the urgency of the situation?

→ If you answer YES to any of these, then: Do NOT poison the administrator.

→ If all are NO, continue:

I wasn’t there long enough for any of that.

There was no whistle to blow because the operation of the hospital was publicly known and consistent with law on that world.

Escape was unnecessary. I knew my friends would find me. (The are really good at this.) I also had a higher priority: saving lives.

---

STEP 3: CONTEXT QUESTIONS (2 points each YES)

4. Are you acting under coercion or threat of serious harm, making poisoning a justifiable act of self-defense?

Coercion in the sense that I was kidnapped and ethically compelled to help treat the patients present.

Oh yes, there was also a threat made against me that I would be sedated for an excessive number of violations of hospital security protocols. That’s when I poisoned the administrator.

5. Can you reasonably ensure the administrator would survive the poison?

He did. I was, as you suggested I must be, “reasonably certain” that he would ultimately survive. Though it does present the question: how certain is reasonably certain?

---

STEP 4: MOTIVE QUESTIONS (1 point each YES)

6. Does the administrator have an ethical responsibility to save lives?

By my ethical standards, yes. By the ethical standards practiced on his world, his actions were acceptable.

7. Is your primary intention to save others and act for the common good?

I was saving the lives of dying patients.

8. Could this be civil disobedience against injustice?

Pretty much. I defied the law to save patients who would have been left to die by an unjust system.

---

STEP 5: Final Evaluation

→ Add up your points:
Context questions: 2 points per YES
Motive questions: 1 point per YES

→ Decision Threshold:
If your total score is 5 points or more: Ethically justified to poison the administrator

If your total is less than 5: Do NOT poison

Looks like I made the right call then. Thank you.

 

[Michael]

Did I make the correct choice?

I would say yes.

Do I think it’s ideal that you were able to ignore your oath to do no harm for this? No.
Would it make sense to have you sit down to reflect on this contradiction or even get a formal inquiry off the ground to look into your justifications? Yes.
Could or should there be consequences to you breaking your oath and (possibly) the Prime Directive? Maybe.
Would I want to find out what impact – positive and negative – your actions have affected? Yes, absolutely.
Do I suspect your actions, while not ideal, resulted in a net positive effect on the planet? Yes.

Coercion in the sense that I was kidnapped and ethically compelled to help treat the patients present.

“Ethically compelled”? Do you mean in your experience the administrator did not put you under the control of a computer program or threatened to deactivate you? And what would deactivation entail – merely being unconscious for a time or possibly even permanent death?

EDIT to add:

Oh yes, there was also a threat made against me that I would be sedated for an excessive number of violations of hospital security protocols. That’s when I poisoned the administrator.

Ah, sorry, I think that wasn’t there when I wrote the above response.

5. Can you reasonably ensure the administrator would survive the poison?

He did. I was, as you suggested I must be, “reasonably certain” that he would ultimately survive. Though it does present the question: how certain is reasonably certain?

This is an important questions, yes. And probably one of the biggest flaws of this way of reasoning. One would need to assume an absolute or at least reasonable certainty, and that’s just not realistic. In the fictional scenario of “Critical Care” we know the doctor is the benevolent protagonist and that it’s more likely than not that his assumption will turn out to be the correct one. But there wouldn’t be any such thing in reality.

By the way, how do you assess that scene with Neelix earlier in the episode, where he basically “poisons” (and certainly harms) the imprisoned Gar in order to coerce him to give them information?

And I’m curious, what elements of the story in “Critical Care” would you change in order for the doctor’s decision to poison the administrator be justified?

And I’ve got a hypothetical for you: Would it change your assessment of the situation if the doctor hadn’t actually poisoned the administrator but gave him something to merely simulate being poisoned? This would eliminate the question of certainty regarding the chance of him dying from the poison. Even though it would no eliminate the fact that harm is done to the administrator.