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Ethics: One of the More Complicated Eps.

Red Ranger

Red Ranger

Admiral
In Memoriam
People,

I just rewatched Ethics, the ep where Worf is paralyzed and can only be saved by an experimental technique advocated by a less-than-perfect doctor.

It had been awhile since I watched it, and given the current wrangling over healthcare, it touches on many issues still pertinent today: Dying with dignity, respecting others' beliefs (even when one disagrees), and the risks of experimental treatments.

I was most struck by how much more effective Dr. Crusher was in this ep, which makes sense, given it was about how to treat a patient and friend.

I also thought Picard's reactions to (a) Crusher's disbelief in Worf not wishing to live with such an injury, and (b) his steadfast defense of Worf's decision to take his own life, despite Riker's hatred of the idea, were in keeping with his thoughtful persona. And, in a way, keeping with the Prime Directive, insomuch as he wanted to honor Worf's beliefs, even if he personally found them abhorrent.

Would love to hear your thoughts.

Red Ranger
 
To be honest I always had problems with this episode. It had a good idea, but the character of Toby Russel just kept giving me pause. How the hell was she still allowed to practice medicine after she experimented on the survivors of that transport ship to see if her medication would work?
 
nx1701g said:
To be honest I always had problems with this episode. It had a good idea, but the character of Toby Russel just kept giving me pause. How the hell was she still allowed to practice medicine after she experimented on the survivors of that transport ship to see if her medication would work?
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A fair question. I had always assumed that no action was taken because the treatment she had administered was a valid course of treatment, if not the best one in the situation. While it was clear from her later behavior that was was willing to experiment maybe she never took that last "step" between new treatment and outright human experimentation.

As such perhaps Dr. Crusher was unable to take any actions against her within regulations, besides banning her from working on board Enterprise.
 
I think Russel was painted in a terrible light, but Crusher was far worse.

Beverly was far too emotionally attached to Worf as a shipmate and friend, to say nothing of her emotional attachment to Federation values of preserving life at all costs.

As was stated many times throughout the episode, a Klingon is as good as dead if he can no longer stand and fight. It's their way. To a Klingon, there would be no need for medicine that would bring them back from otherwise certain death as Sto-vo-kor would be ready for them anyway.

I think that any doctor forcing an injured Klingon to live as an invalid would deserve to be gratuitiously killed by the dishonoured warrior's family as an act of justice.

I vaguely remember what Kurn said to Worf in DS9 when Odo stopped the Hegh'ba ceremony: "Why didn't you kill him when he tried to stop you?"
 
This is one of my favourite episodes.

It explores some genuinely tricky issues by good use of the SF setting. Both Crusher and Russell put themselves in some difficult ethical positions and neither really comes out smelling of roses. Plus Worf and Riker get some good work.

Yep, good ep, this one.
 
Riker and Crusher's lack of respect for the beliefs and values of other races disgusted me in that episode. They were grimly determined to enforce inalienable "human" rights upon Worf.
 
Don't come down on Riker too hard, respecting anothers cultural beliefs never means giving up your own. Couple of years ago, we had a "honor killing" near where I live, where do you draw your lines, I know where I drew mine.
 
While Riker was reluctant I do feel he ultimately would have helped Worf, if it had been his place to do so. But as he said, according to Klingon custom it wasn't his place.
 
T'Girl said:
Don't come down on Riker too hard, respecting anothers cultural beliefs never means giving up your own. Couple of years ago, we had a "honor killing" near where I live, where do you draw your lines, I know where I drew mine.
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An honor killing in the Muslim fashion should not ever be compared to assisted suicide. I believe every person has a right to take their own life if they want to. Worf wanted to die honourably. He nearly begged for it.


And in the end he chose something even better. An experimental surgery that would either see him back on his feet, ready to fight another day, or would see him reunited with K'Ehleyr in the afterlife. It was perfect in keeping with the Klingon philosophy; no guts, no glory.
 
I found it irritating that a severe spinal injury is still nearly unfixable in the 24th century.

And that Worf got taken down by freaking storage crates!
 
Well, it's a win-win situation, of a sort: Either Russell's treatment will work, or not. If it works, then obviously there's no need for Worf to take his own life - he can live to fight another day. If it doesn't work, then Worf could then have gone ahead and killed himself. I don't see why Russell's surgery shouldn't have been given the chance.
 
MeanJoePhaser said:
I found it irritating that a severe spinal injury is still nearly unfixable in the 24th century.

And that Worf got taken down by freaking storage crates!
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Klingons have different physiology that isn't as well documented as humans, I had no problem buying that. Their medicine is more or less "You can't walk? Then you're dead, no point in learning more."

And people have died from much less! Simple falls and stuff. Freak accidents are common enough, again, I buy the storage crate, NO problem at all.
 
I always thought it would have been brilliant if it had been Doctor Palowski who returned as the specialist in this episode, and then we could have seen Doctor Crusher square off against her. Heh.
 
T'Girl said:
MeanJoePhaser said:
I found it irritating that a severe spinal injury is still nearly unfixable in the 24th century.
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Yeah, I mean come on, McCoy put Spocks brain back in eighty years ago.
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Well, he had help from the Teacher, which advanced his surgical skills. And even then, he began to forget and had to allow Spock to help him! "I'm never going to live this down. This Vulcan is telling me how to operate!"

As for Riker, I think it was refreshing to see genuine scorn for the Heq'ba. He may be a product of a tolerant society, but even he had his limits. I felt just as he did.

And it was great how he reminded Worf how he really needed to conduct the ceremony, with his son at his side, giving him the knife. It was that little detail that prompted Worf to fight and risk Dr. Russel's untried treatment.

It is a bit preposterous that 24th century medicine couldn't cure Worf's ills. But remember, there wasn't much medical literature from the Klingons on such injuries -- probably because all the Klingons who experienced such injuries performed the Heq'ba.

Who knows -- maybe Worf's decision to undergo the treatment might well save the quality of life for other Klingons suffering from spinal injuries. And probably other humanoids, too.

Red Ranger
 
Great episode. Many people have suggested Pulaski as the antagonist, and it sounds like a good idea at first, but I think it would muddy the waters too much dramatically. Remember, she was getting along with Worf pretty well by the end of the second season.

And who thought cargo bays without restraints for the cargo was a good idea?
 
Hahaha... yeah, they overlooked that one.

I quite liked the episode, it kinda falls into the same category for me as the one where they had to ask Worf for a donation to help treat a Romulan and he was less than thrilled.

There were a number of questions raised about why Russel was allowed to practice medicine, but as a specialist she was the closest thing they had to saving Worf. Crusher, in my opinion, took the only call she could as a doctor, and we've seen Bashir resort to last gasp, controversial efforts too, showing that starfleet doctors are prepared to push the limits to save lives.
 
Tallis Rhul said:
Hahaha... yeah, they overlooked that one.

I quite liked the episode, it kinda falls into the same category for me as the one where they had to ask Worf for a donation to help treat a Romulan and he was less than thrilled.

There were a number of questions raised about why Russel was allowed to practice medicine, but as a specialist she was the closest thing they had to saving Worf. Crusher, in my opinion, took the only call she could as a doctor, and we've seen Bashir resort to last gasp, controversial efforts too, showing that starfleet doctors are prepared to push the limits to save lives.
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The objections to Russel were not (i've always thought) over Worf's treatment but rather over her actions during the other emergency in the episode. (transport ship I think?) Wherein she used a controversial new treatment on a patient, who would have survived if she had used the more accepted form of treatment. This is where Bashir and Russel differ, both were willing to do the extreme, but Bashir only after regular forms of treatment were exhausted.
 
^ Precisely.

From my own medical perspective, Russell was completely out of line in her actions in the earlier emergency. There was a perfectly viable (and tested) treatment available to her and she chose not to use it in favour of an experimental, unauthorised, treatment for no reason other than to see if it worked. Her actions were not based on good practice and resulted in harm and so were negligent.

However, when it came to Worf's case, it's Crusher that acts unethically - she allows her emotional attachment to Worf, her own cultural perspective, and her hatred of Russell to interfere with allowing Worf to make his own decision regarding the experimental surgery.

Now, it can be argued that Russell should be suspended from practice pending investigation following her earlier actions. In which case the following argument is invalid. But if you accept that she can remain in practice while the investigation into her earlier choice occurs, then she is quite right to offer Worf the experimental spinal procedure.

The crux of the issue is whether Worf has the legal capacity to make the decision - in other words, is his thinking sufficiently clear to be able to take on board what she is saying, retain the information and freely make a choice between the options open to him. I'd argue that while he's clearly in emotional distress, he does retain capacity and therefore can consent to the experimental procedure, which is a viable - if risky - option.

Crusher is probably wrong to deny him the option, because of the reasons she uses to justify the decision (alternative therapies, cultural perspectives, etc). If she stuck to reasons like "Russell should be suspended for her earlier actions pending investigation" or "Russell doesn't have Starfleet ethical approval for humanoid trials for this procedure because of lack of scientific data to support its use" then she's on firmer ground, though IIRC from the last time I saw this ep, Picard overrules that latter point, and so provides a proxy for Starfleet ethical approval.

The ones that emerge best from this ep are Riker (who weighs up the ethical considerations around Worf's request for assisted suicide very carefully and precisely correctly) & to a lesser extent Picard and Worf.
 
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