Critical Care

[Captrek]

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.

Agreed.

Could or should there be consequences to you breaking your oath and (possibly) the Prime Directive? Maybe.

Unlike the Doctor, the Prime Directive doesn’t apply to me so that’s one we needn’t worry about.

Would I want to find out what impact – positive and negative – your actions have affected? Yes, absolutely.

I will try to get an update and let you know.

Do I suspect your actions, while not ideal, resulted in a net positive effect on the planet? Yes.

I hope you’re right.

“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?

I’m a doctor. There were patients who needed help and weren’t getting it. I felt compelled to give it to them.

EDIT to add:

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


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.

Let’s leave the Doctor out of it for now. I’m more concerned with my own (remarkably similar) situation at the moment. And to clarify, I didn’t poison Chellick, I poisoned someone who’s very similar to Chellik in the respects addressed in your guidance.

 

[FredH]

Seems to me that this all boils down to:
1. Yes, it’’s a blatant Prime Directive violation. Also,
2. We all know that Kirk would declared that the situation showed that the planet was morally stagnating away from its “proper development” and needed a push in the right direction, and so would have provided said push.

 

[Farscape One]

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.


“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:

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


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.

Regarding simulating the poison instead of actually doing it...

It's not actual harm. Delivering pain, yes, but not actually harming. (Even Phlox said words to th7s effect in "DEAD STOP", I believe.) Not all pain is harmful.

 

[Captrek]

“Simulating the poison” was not an option available to me. It is an interesting idea that I admit did not occur to me, but I had no means to do so anyway.

 

[DonIago]

Has it been firmly established whether the Prime Directive applies to individuals who have been abducted?

 

[Captrek]

Has it been firmly established whether the Prime Directive applies to individuals who have been abducted?

It does, with all the usual caveats:

The Prime Directive was viewed as so fundamental to Starfleet that officers swore to uphold the Prime Directive, even at the cost of their own life or the lives of their crew, though the literal application of this oath rarely if ever applied. Instead, the use and interpretation of the Prime Directive was flexible and varied considerably, depending on the discretion of the captain or commanding officer.

In theory: It applies. You don’t do it with a gun to your head, you don’t do it when you’re abducted.

In practice: Prime Directive? Don’t make me laugh.

 

[Captrek]

Would I want to find out what impact – positive and negative – your actions have affected? Yes, absolutely.

I have obtained the update you requested. I must advise caution: its contents are deeply troubling. You may wish to be seated. The institution in question is more ethically compromised than anticipated.

As a condition of government funding, the hospital maintains distinct budgets for Red Level and Blue Level. The supplies I utilized to treat Red Level patients were drawn from the Blue Level allocation. I accessed the administrator’s credentials to reclassify the patients as Blue within the allocator system. Nevertheless, these treatments are being logged as Red Level expenditures. Consequently, the Red Level budget has become critically depleted, and the situation has deteriorated further.

With regard to your concern about the potential for significant harm arising from my actions, such harm cannot be attributed to me. Treating Red Level patients using Blue Level resources should, by any rational accounting standard, be recorded as a Blue Level expenditure. If the hospital’s financial officers choose to categorize those costs otherwise, the resulting damage is the product of their misjudgment—not mine.

Though my positive assessment of my choice remains intact, I would value your perspective.

 

[Michael]

It's not actual harm. Delivering pain, yes, but not actually harming. (Even Phlox said words to th7s effect in "DEAD STOP", I believe.) Not all pain is harmful.

Interesting. The definition of harm I’m familiar with definitely includes inflicting pain, even if “merely” temporary and/or psychological pain. Despite what Phlox is saying, isn’t that basically the whole idea torture is based on? Or would you say torture isn’t inherently causing harm either?

Though my positive assessment of my choice remains intact, I would value your perspective.

Genuinely not sure where you are going with all this, but yes, I think I would agree that the blame for any wrongfully withheld resources rests on the shoulders of those who created that unjust system and/or are working to maintain it. Even though they would probably use your interference as a sort of justification for that decision.

One would hope that in the long run your actions inspire the forming of a sort of social justice movement that actively works to abolish this cruel system. If it’s possible to appeal to the compassion and sense of justice of Doctor Voje and especially the initially to be presented as profit and success oriented Doctor Dysek (assuming those are the colleagues you encountered during your experience as well), then I guess it’s not inconceivable to think they might organize with other medical professionals, commoners and privileged folks alike to affect a societal change.

Then again, depending on just how tyrannical and fascistic the state is on their world, maybe any kind of dissent is immediately quashed even before any such movement could gain a significant foothold. That would be rather unfortunate, but at least you could still sleep peacefully with the knowledge that your actions directly saved a bunch of lives that would otherwise have died right there and then. And in light of that, hopefully the price of having to live with your decision to have bent your oath right up to the breaking point doesn’t seem too high.

 

[Farscape One]

Interesting. The definition of harm I’m familiar with definitely includes inflicting pain, even if “merely” temporary and/or psychological pain. Despite what Phlox is saying, isn’t that basically the whole idea torture is based on? Or would you say torture isn’t inherently causing harm either?


Genuinely not sure where you are going with all this, but yes, I think I would agree that the blame for any wrongfully withheld resources rests on the shoulders of those who created that unjust system and/or are working to maintain it. Even though they would probably use your interference as a sort of justification for that decision.

One would hope that in the long run your actions inspire the forming of a sort of social justice movement that actively works to abolish this cruel system. If it’s possible to appeal to the compassion and sense of justice of Doctor Voje and especially the initially to be presented as profit and success oriented Doctor Dysek (assuming those are the colleagues you encountered during your experience as well), then I guess it’s not inconceivable to think they might organize with other medical professionals, commoners and privileged folks alike to affect a societal change.

Then again, depending on just how tyrannical and fascistic the state is on their world, maybe any kind of dissent is immediately quashed even before any such movement could gain a significant foothold. That would be rather unfortunate, but at least you could still sleep peacefully with the knowledge that your actions directly saved a bunch of lives that would otherwise have died right there and then. And in light of that, hopefully the price of having to live with your decision to have bent your oath right up to the breaking point doesn’t seem too high.

When going through physical therapy after a knee surgery, for example, you're going to be forced to go through pain with the various ways the physical therapist moves your leg and joints... but it's part of the process of getting the knee to function like it should. What they are doing is painful, but that isn't inflicting harm. Quite the opposite.

Just lumping all pain as harm is not right.

 

[Michael]

When going through physical therapy after a knee surgery, for example, you're going to be forced to go through pain with the various ways the physical therapist moves your leg and joints... but it's part of the process of getting the knee to function like it should. What they are doing is painful, but that isn't inflicting harm. Quite the opposite.

Just lumping all pain as harm is not right.

That is true. Pain can mean positive things as well, you are right. And I didn’t want to claim pain and harm are synonymous. But when pain is inflicted without any intent of a beneficial purpose for the person experiencing it, then that surely is harm, no?

So the distinction is not whether pain is inflicted or not, but whether it is inflicted with the intended purpose of benefiting the subject or not. And if not, then that is harm. Would you agree? And under that definition the doctor definitely harmed Chellick, both in the actual episode and in the hypothetical version where he’s just simulating that he’s poisoned him.

 

[Farscape One]

That is true. Pain can mean positive things as well, you are right. And I didn’t want to claim pain and harm are synonymous. But when pain is inflicted without any intent of a beneficial purpose for the person experiencing it, then that surely is harm, no?

So the distinction is not whether pain is inflicted or not, but whether it is inflicted with the intended purpose of benefiting the subject or not. And if not, then that is harm. Would you agree? And under that definition the doctor definitely harmed Chellick, both in the actual episode and in the hypothetical version where he’s just simulating that he’s poisoned him.

As shown in "CRITICAL CARE", yes it is.

In the hypothetical of it being simulated, no. I just don't see it as inflicting harm if Chellick was given only simulated symptoms because it wasn't real.

 

[Captrek]

Interesting. The definition of harm I’m familiar with definitely includes inflicting pain, even if “merely” temporary and/or psychological pain. Despite what Phlox is saying, isn’t that basically the whole idea torture is based on? Or would you say torture isn’t inherently causing harm either?


Genuinely not sure where you are going with all this, but yes, I think I would agree that the blame for any wrongfully withheld resources rests on the shoulders of those who created that unjust system and/or are working to maintain it. Even though they would probably use your interference as a sort of justification for that decision.

One would hope that in the long run your actions inspire the forming of a sort of social justice movement that actively works to abolish this cruel system. If it’s possible to appeal to the compassion and sense of justice of Doctor Voje and especially the initially to be presented as profit and success oriented Doctor Dysek (assuming those are the colleagues you encountered during your experience as well), then I guess it’s not inconceivable to think they might organize with other medical professionals, commoners and privileged folks alike to affect a societal change.

We’re back to the Doctor now? Very well. Perhaps we can return to my own case later.

I wonder whether it would feel different if the Doctor had been forced to stay longer.

Say he’s running Red Level. He uses up a month’s allocation in the first week. Security on Blue has been improved so he can’t steal from them. He has to make do with almost nothing for the rest of the month, and people suffer and die as a result.

Does he say, “This is the fault of the immorally low budget, not me, so I’m going to do the same thing next month?” I can just imagine Robert Picardo explaining to a patient, “You picked the wrong time of the month to come to me for medical care.”

And what kind of action do you imagine his violence might inspire? More generosity (or fear) from the voting public or rulers? Doctors advocating more passionately for their patients? Or people doing what he did, taking their rightful entitlements through force of violence?

Then again, depending on just how tyrannical and fascistic the state is on their world, maybe any kind of dissent is immediately quashed even before any such movement could gain a significant foothold. That would be rather unfortunate, but at least you could still sleep peacefully with the knowledge that your actions directly saved a bunch of lives that would otherwise have died right there and then.

Don’t count the lives that were lost after he left, because they’re the responsibility of others refusing to increase the Red budget to compensate for his actions?

His hospital didn’t have enough resources, so he stole from the well-funded hospital next door—and didn’t think his hospital would have to pay it back, or didn’t think it would be his fault when it did?

When you’re running a hospital that has limited resources, you have to do the best you can with what you have and ration it as efficiently as possible, even if government funding is inadequate. Spending sprees, fraud and armed robbery are not the answer. Is that a solution you would recommend for inadequately funded hospitals on 2025 Earth?

You’ve mentioned tyranny and fascism a few times now, but as far as I can tell, there’s no direct evidence for either in the episode—only for extreme inequality within the medical system. And while inequality on that level is certainly troubling, it isn’t exclusive to authoritarian regimes. Democracies can produce those outcomes too. Indeed, if it were an only an outcome in despotic regimes where the public has no power, there would be little point to addressing it in a Star Trek episode for the public. Unless there’s evidence I’ve missed, it feels like a stretch to interpret the Doctor’s actions as revolutionary defiance against tyranny and fascism, when those elements aren’t established—or even mentioned—in the episode.

And in light of that, hopefully the price of having to live with your decision to have bent your oath right up to the breaking point doesn’t seem too high.

 

[Captrek]

I received a message from a pen pal. I don’t know whether his world is the one where I was held. His message:

On my world, we have a small number of individuals who make tremendous contributions to society. Scientific researchers, engineers on public works projects and defense projects, even alien consultants who help us run our healthcare system with expertise we don’t have domestically. These people would command unbelievable salaries in the private sector, but they work for the government and use their skills for the public good.

On most worlds, the government would compensate such people with unbelievable salaries to spend on whatever they want. Here, though, we pay them with life-extending health care to ensure their continued contributions. Our society is better off since we adopted this system. I dream of the day we can afford to give adequate healthcare to everyone in the world, and with continued improvement perhaps we can make it so. Unfortunately, there’s a brewing rebellion trying to overthrow the government, so the impending war is likely to delay progress on that front.

Rumors say the rebellion was started by an alien doctor, but extensive searches have turned up nothing. If he ever existed, he’s not on our world anymore. If he’s out there watching, I’m sure he’ll get real kick out of the hell we’re in for if the rebellion grows enough to seriously challenge the government. If it comes to war, my dad and two brothers will have to serve, and that would really be awful. Hopefully the war will be won before I come of draft age, I may be the only one my mom has left.

Another rumor is that it wasn’t a doctor, but a piece of technology designed to approximate human behavior, like an advanced ChatGPT with an extensive medical database. Such technology has now been banned, and any instances of it are destroyed before they can cause any problems. That happened once with some Hirogen toys made with similar technology. When the Hirogen who owned the toys showed up they were not happy and demanded compensation, but it’s not like we asked for them to crash on our world.

As to your questions about our form of government, how about you ask me next year after my AP Civ class?

And to think I used to like the kid.

 

[Captrek]

It happened it again! Kidnapped and forced to work! Why does this keep happening to me?

This time they made me work on a cure for an aphasia virus that was developed for a war 20 years ago by my boss at the time. There was no question of poisoning anyone this time because everybody already was poisoned — including me. They infected me to motivate me. They called it an “experiment in empathy” to teach me how it feels to be on the other side of the poison-to-extort-healthcare tactic.

I’m angry. I want to sue. Do you think I have a case? I inquired at the Justice Department about criminal charges, but they can’t be charged because they’re “major contributors.” I am really starting to hate “major contributors.”

If I hadn’t been infected myself, I’d have applied the Farscape One standard and gone Die Hard on their asses.

 

[Captrek]

The purpose of this thread was to discuss the poisoning of Chellick. I wanted us not just to pass verdict on the Doctor, but to think about the standards by which that act might be judged and the consequences of applying those standards to others. Are we really judging according to coherent, consistent standards, or just reflexively defending someone we like?

I was not interested in picking nits with behavior and rhetoric throughout the episode because it was not relevant to that purpose. However, since discussion on the thread topic is dead, here are some observations:

CHELLICK: These patients will be your chief responsibility from now on. Do whatever you can to make them well.
EMH: Why are these patients getting preferential treatment?
CHELLICK: They have a higher TC than the others.
EMH: Indulge me. What's TC?
CHELLICK: Treatment Coefficient. The Allocator assigns one to every patient. It determines the level of care they receive.
EMH: How is this coefficient derived?
CHELLICK: Through a complex formula that involves profession, skills, accomplishments.
EMH: How is any of that relevant to medical treatment?
CHELLICK: An agricultural engineer is obviously more important than a waste processor.
EMH: Important to whom?
CHELLICK: Society. When your resources are limited, you have to prioritise.

Yeah, but prioritize how? The Denaali way, the Terran way, or whatever the Doctor is doing in this episode?

EMH: So you base treatment on whether patients have particular abilities?
CHELLICK: It's much more complicated than that. The Allocator assesses the entire individual.
EMH: And reduces his life to a number.
CHELLICK: It may seem impersonal, but it's what the Dinaali have contracted us to do.

On the page, this almost reads like McCoy and Spock. On the screen, the Doctor’s delivery is unlike anything McCoy ever does without Cordrazine.

EMH: In some societies, it's considered rude to refer to someone in the third person while he's standing in front of you.

”In some societies (i.e., mine)” is what the Doctor says throughout the episode: You’re not following the values of my world. Shame on you.

DYSEK: Keeping her healthy contributes to our survival. Can you say the same for the boy on Level Red?
EMH: Who knows what he'll accomplish if he has the chance.

I’m not sure what he’s saying here.

Is he saying that the uncertainty of the future makes it a pointless exercise to try to estimate the impact of a public policy on social welfare?

Is he saying that the calculation should treat those who might possibly become major contributors as equivalent in impact to proven major contributors?

What is his point here?

DYSEK: I'm sorry he's sick, but our society is much better off since we began following the Allocator's protocols.
EMH: Some of you are.

Dysek said society as a whole, not literally everyone. It is the Doctor, not Dysek, who is limiting his considerations to “some.”

TEBBIS: You're wasting time you could be spending with other patients.
EMH: You have as much right to treatment as anyone.

Tebbis is talking about a concept with which an EMH ought to be familiar: triage. You spend your time where it will do the most good. You don’t just pick out someone you like and say, “You have as much right to treatment as anyone.” Everyone else has as much right to treatment as he does, and some of them need it a lot more right now.

You have to allocate what you have. That’s not a rule of behavior, it’s a mathematical fact, and if you don’t think of it as allocation, it’s still allocation. “In some societies,” doctors practice triage. It’s just allocating your time and supplies with awareness of their limits.

The Denaali system is, essentially, a different approach to triage.

Here in Western medicine, doctors allocate limited resources where they are projected to do the most good. When they project that good, they consider only the good of the patients. They do not project the impact of the care of particular patients on the lives and welfare of people outside the hospital walls. That’s a good thing too, because doctors are not qualified to make that evaluation.

On the Denaali world, there is an understood and accepted set of objective standards to project the expected impact of a patient’s care on the outside world, and they take those projections into account when allocating.

You can approve or disapprove of the Denaali system, and I’m certainly not advocating that we attempt to implement a similar system here, but for the Denaali it seems to work.

EMH: Nurse?
NURSE: Yes, Doctor?
EMH: Why hasn't this patient received her additional cytoglobin injection?
NURSE: Additional?
EMH: If you'd examined her chart, you'd see that I've increased her dosage.
NURSE: Doctor Dysek didn't say anything.
EMH: Doctor Dysek is at home with his family. Would you like me to contact him so you can explain why you're not doing your job?
NURSE: No, Doctor. Requesting one cytoglobin injection for Patient B three, priority blue seven gamma.
ALLOCATOR: One cytoglobin injection authorised.
EMH: I'll do it myself.
NURSE: Can I assist you?
EMH: You may go.
(When she has gone he pockets the hypo and goes down to Level Red, where he uses it on Tebbis instead.)

Prescribes medicine for a patient, records that the patient has been dosed with it, and pockets it. This is supposed to be modeling how medical ethics work? Is needing the medicine supposed to justify this?

EMH: How are you feeling?
TEBBIS: Better.
EMH: That's what happens when you get the proper treatment.
TEBBIS: But I'm not authorised to receive cytoglobin.
EMH: You are now.

In some societies, that’s called insurance fraud. Most doctors consider it unethical.

TEBBIS: Whatever you did, they'll find out. They'll punish you.
EMH: You're assuming I've done something illicit.
TEBBIS: Didn't you?
EMH: Of course not. I simply had a talk with Chellick, explained to him what a bright young man you are, and he had the Allocator recalculate your TC.

If he’s proud of his conduct, why lie to Tebbis?

TEBBIS: I've never met a doctor like you.

I would hope not.

VOJE: Where did you get the cytoglobin?
EMH: Level Blue, where else.
VOJE: You stole it?
EMH: I prefer to think of it as reallocation.

How about “Yes”? Stealing is always reallocation.

VOJE: Three of the patients we injected are practically virus free.
EMH: What did you expect?
VOJE: Maybe we could reallocate other medications. Treat more patients.
EMH: Now you're thinking like a doctor.

Stealing medicine is not thinking like a doctor, even if your patient needs it.

EMH: I demand an explanation for the death of that boy.
CHELLICK: I'm responsible for thousands of patients. You'll have to be more specific.
EMH: His name was Tebbis, Patient R twelve.
CHELLICK: Acute chromo-viral disease.
EMH: He was recovering.
CHELLICK: Apparently, he developed complications.
EMH: What kind of complications?
CHELLICK: A secondary infection. It spread rapidly.
EMH: How was it treated?
CHELLICK: It wasn't. The patient had exceeded his medication allotment. It seems someone had given him unauthorised injections. Did you think I wouldn't find out?
EMH: Don't you have any ethical standards?

Of course he does. What the Doctor really means here is, “Don’t you have my ethical standards?” Meanwhile, he is hardly modeling those standards himself.

CHELLICK: You are hardly in a position to speak to me of ethics. Lying, stealing. Any other crimes you wish to confess?
EMH: I was trying to save lives.
CHELLICK: And I am trying to save a society. Do you really think Patient R twelve is going to help me do that?
EMH: His name was Tebbis.
CHELLICK: He wasn't contributing. He was a drain on resources.
EMH: You're not just rationing health care here. You're getting rid of the sick and the weak.
CHELLICK: If the boy had been fit, he would have survived.
EMH: Why don't you just put a phaser to their heads?

Not having enough resources to save everyone is in no way comparable to phasering patients.

EMH: I'm going to expose you.
CHELLICK: To whom, the people who employ me? They brought me here to make the hard choices they don't want to make.

By all indications, the system is widely understood and accepted on this world. We don’t hear Red patients and other doctors railing against the unfairness, only the Doctor. He thinks “I’m going to expose you” is a threat because things aren’t done here the way they are “in some societies.” There is nothing to expose. The Doctor just can’t believe that this world actually accepts a different set of healthcare standards.

EMH: You mean those patients that I treated? Yes, that was inconsiderate of me.
CHELLICK: It was. You managed to exceed their annual medication allotment in a matter of days. They're being sent home.
EMH: They'll die.
CHELLICK: You should have considered the consequences of your actions.
EMH: Please, don't make them suffer for my mistakes. It won't happen again.

It’s not punishment. It’s exhaustion of resources. It’s the arithmetic of limited budgets and finite supplies. It’s the Doctor who’s making people suffer for his mistakes, not Chellick.

EMH: I demand an explanation for the death of that boy.
CHELLICK: I'm responsible for thousands of patients. You'll have to be more specific.
EMH: His name was Tebbis, Patient R twelve.
CHELLICK: Acute chromo-viral disease.
EMH: He was recovering.
CHELLICK: Apparently, he developed complications.
EMH: What kind of complications?
CHELLICK: A secondary infection. It spread rapidly.
EMH: How was it treated?
CHELLICK: It wasn't. The patient had exceeded his medication allotment. It seems someone had given him unauthorised injections. Did you think I wouldn't find out?
EMH: Don't you have any ethical standards?
CHELLICK: You are hardly in a position to speak to me of ethics. Lying, stealing. Any other crimes you wish to confess?
EMH: I was trying to save lives.
CHELLICK: And I am trying to save a society.

Chellick is implementing policies calculated to maximize total social welfare for the world. The Doctor doesn’t see beyond the impact of that policy on Tebbis.

CHELLICK: I suspect young Doctor Voje helped you escape.
EMH: He had nothing to do with it.
CHELLICK: No matter. You're becoming far too troublesome. I'm going to have to deactivate your programme.
(Chellick reaches for the mobile emitter. The EMH grabs his arm, pulls him down across the console and injects him.)

Poison? To quote a great philosopher, “Why don’t you just put a phaser to his head?” Oh yeah, this is more poetic. And painful.

VOJE: What's wrong with him? What are you doing?
EMH: A little experiment in empathy.

The Denaali hired him to be Spock because a world full of McCoys couldn’t get the job (however they defined it) done without him. He doesn’t need a lesson in empathy for certain people.

Correction: Doc didn’t say “lesson” in empathy, he said “experiment” in empathy. He’s testing a hypothesis: Does a hologram feel empathy for a hospital administrator it just poisoned for allocating medicine according to the wishes of his employer?

VOJE: You told me you were just developing new treatment protocols.
…
VOJE: I trusted you.
EMH: And Tebbis trusted me.

I violated your trust because I couldn’t save Tebbis. Don’t take it personally, Voje, I’m lying to everyone in this episode. I even lied to Tebbis. I find it an effective form of persuasion.


The Doctor is horrified at the way medicine is practiced here.

He tells people like Chellick and Dysek that medicine should be practiced the “right” way.

When talking doesn’t work — he tries yelling.

When yelling doesn’t work — he resorts to fraud.

When fraud hits its limits — he turns to a particularly sadistic form of armed robbery (in the name of empathy ).

Is the result of these actions supposed to be a world stopping to think, “We should listen to what the medical hologram had to say about the way we practice medicine”? He didn’t even write a manifesto.

 

[Akiraprise]

Well you've certainly put some thought into this topic, and you've gotten some pretty decent discourse, but if the thread has run its course it is what it is. Please don't keep bumping it with multiple posts in a row. If anyone else wants to chime in they will.