Titan: And the issue of Abortion (Destiny Spoilers)

[HIj'Qa]

Re: Titan: Over a Torrent Sea (SPOILERS)

Did I miss something?
The whole Riker/Troi having difficulties having a baby thing, is that unique to them in some way?

Deanna and Kestra seemed to come along with no trouble, Deanna popped out babies for Worf in another timeline, there are other human/Betazoids like Devinoni Ral and his mother.

Maybe it just went on too long, but it seemed contrived for DRAMA to me.

 

[Sci]

Re: Titan: Over a Torrent Sea

strongly implies that one gives up a certain amount of control over your own body and health when you choose to join Starfleet.

A certain amount of control - but not every control.

You're talking about a military organization that has the legal right to order people into battle or to die to save their ship. I don't know how that can reasonably not be referred to as having damn near every control.

Remember, the time the situation came up, there was no reason at all to force Deanna to do anything. Titan wasn't in any crisis,

Sure there was -- the fact that the ship could, at any moment, face an unfolding crisis (in particular that they could face Borg attack, during that trilogy). To have an officer in such profound emotional turmoil and pain that she'd willingly allow herself to die is a potentially dangerous situation that should simply not be tolerated. What if she had been forced to take command of the ship in a crisis, for instance? Would she have, at that point, been in the proper frame of mind to be able to order someone to their death (as TNG's Bridge Officer Test indicated one must be capable of doing?) Troi, at the very least, should have been relieved of duty for the duration of her medical crisis -- and, frankly, I question Riker's ability to function as an effective captain when he's undergoing such profound pain, too.

I'm not military, and I never plan to be - but I highly doubt that, just because you join a military organization, that organization can tell/order you what to do with your own body *any time*.

You'd be surprised. I mean, hell, if you're a member of the United States Armed Forces, you don't even get to decide who you have sex with. I don't agree with that particular military law, but it does demonstrate just how profound the individual's loss of authority over their own lives and bodies is when they choose to join the military.

William Leisner already pointed out quite a few canon examples where the patient definitely overruled the doctor...

Which I refuted.

And I think it's interesting that the examples you, Sci, refer to all happen in TrekLit.

1. This is a TrekLit forum, so those examples are as valid as any other.

2. I also cited canonical data.

And sorry, but, Sci, your opinion about Troi's dereliction of duty sounds quite a bit farfetched to me. Up to the point of the landing party's departure, was Troi incapable of carrying out her duties? Did she endanger anyone?

No, but she carried the potential to do so if her mental condition left her incapable of exercising sound -- or even pragmatic -- judgment in a crisis. And a crisis can unfold at any moment without warning. This doesn't mean that officers should be in a perpetual state of planning for an imminent crisis -- but it does mean that they need to have "their heads on" straight enough that they can function well.

And Ree definitely didn't understand the psychological effects of a mammal pregnancy, and the attachment of a pregnant woman to the fetus... perhaps you should read the pertinent pages again?!?

I did read it. As I read it, Ree understood the psychological effects of mammalian pregnancy intellectually, but not necessarily on an intuitive level. He clearly felt terrible for Troi -- his musing that the psychological effects of Pahkwa-thanh reproduction and customs would have made things easier for her was one born of compassion; he felt that his species' mode of reproduction would have caused her significantly less emotional pain (and he's probably right about that). However, he felt that preserving Troi's life was the paramount issue and outweighed the importance of respecting her feelings.

And, frankly, I agree with him. That doesn't mean I don't understand the effects of pregnancy -- it means that, in my view, if you're a part of an organization like Starfleet, you have a moral obligation to yourself and to your crewmates to put your personal life, even a pregnancy, second to your professional life in order to help ensure that everyone is safe. Maybe that's a harsh view -- but to me, it's a consequence of choosing to join Starfleet, and if you're unwilling to accept that consequence, you shouldn't have joined in the first place.

(Of course, I don't think children belong on a starship and view the decision to bear and raise a child aboard one as being profoundly irresponsible, but that's an entirely separate discussion.)

Did I miss something?
The whole Riker/Troi having difficulties having a baby thing, is that unique to them in some way?

You missed something pretty major from Gods of Night, I'd say. It was firmly established that the reason Troi and Riker were having so much trouble reproducing was that Troi had suffered heretofore undetected genetic damage during her pregnancy with Ian Andrew in TNG Season Two's "The Child."

Deanna popped out babies for Worf in another timeline,

Given what GoN establishes, the only pertinent example you cited is this, and that is easily explainable as resulting from her having never carried Ian in that timeline.

Maybe it just went on too long, but it seemed contrived for DRAMA to me.

I mean, if that's "contrived for DRAMA," then so is every plot ever in the whole history of Star Trek. I thought it was a perfectly realistic and reasonable dilemma for the characters to face, and one that nicely supported the over-reaching themes of the Destiny trilogy.

 

[Baerbel Haddrell]

Re: Titan: Over a Torrent Sea (SPOILERS)

I hesitated before I entered this discussion again. It didn`t go well the last time and I don`t expect it to be any better this time. I will probably regret it but I just can`t continue reading this thread without saying something!

If the baby was considered to be doomed anyway, if the baby was endangering Deanna`s life doesn`t change the fact that we were not talking about removing a dead baby in order to save the mother. The baby was alive. It was badly mutated but it was alive and what Dr. Ree wanted to do is removing that living baby. That is an abortion. I am surprised that there are still arguments if it would have been one or not.

Another fact is that it was made clear that Starfleet has the legal right to order Deanna to have such an abortion. That means at the very least if the life of the mother is in danger and the baby is considered to be doomed, the doctors can order a woman to have this procedure. What I think was missing in “Destiny” is a clear discussion what that actually means. I would have liked to have read very clearly that Deanna was given the option to accept or to resign. I would have liked to see that Riker would have resigned too. It would also have been better to show more clearly what this order actually means: Would anybody really be willing to stun Deanna or drag her to sickbay against her will so that this abortion can be performed?

What is legal is not necessarily what is right. I still find it sickening that Starfleet has the legal right to give such an order. I repeat my point that it is now finally illegal to order a Vulcan to do a mind meld against his will. What happened to Deanna must not be allowed to happen to any other woman!

That Starfleet has the right to order medical treatment against the will of the patient is bad enough. Although I don`t think “canon” Trek is that consistent. There was a Voyager episode in which B`Elanna refused treatment because the means of this cure was obtained by methods Mengele used in Nazi Germany. If I remember correctly, that research was removed from Voyager`s database as well. There was another one when Picard didn`t want to order Worf to give a blood sample for saving a Romulan. Maybe both captains in question could have insisted on the letter of the law and insist but in these cases they didn`t.

David Mack was walking a very fine line here and he reacted quite strongly when I got some of the facts not quite right also because I was at the end too emotionally involved in the discussion, more than I should have been. I am trying not to fall into the same trap but at the same time I don`t remember every single detail of Destiny any more.

What happened is that Deanna was traumatized, she was stubborn and, yes, she was irrational. How do you approach such a patient? You are not talking about a person who has yet reached the state that she can be seen as mentally unfit. Sci, Deanna was not an irresponsible officer who ought to be charged with dereliction of duty. People with mental health problems (and the trauma Deanna went through can easily be classified as such) need help and treatment, not condemnation. Also the character who was suffering from trauma because of the friendly fire incident, would you put her on trial if Dax had been unsuccessful to get her to return to duty?

What Deanna needed was guidance by a counsellor. She needed the chance to get a second opinion. She needed time to think, time to consider all the options available. Dr. Ree didn`t give her this chance. He literally chased her mentally into a corner and adding that it would be a good idea to remove her womb at the same time – I am not surprised at all that it had a dreadful impact on Deanna.

I am actually glad that what happened in Destiny has not simply been dropped in Titan and I am saying this based on what I have read in the review thread. I haven`t reached that part of the book yet and I will definitely say more when I do.

 

[Claudia]

Re: Titan: Over a Torrent Sea

Sure there was -- the fact that the ship could, at any moment, face an unfolding crisis (in particular that they could face Borg attack, during that trilogy).

Honestly, then you would have to remove every single being with even the slightest problems "because something *could* happen". I'd say that's the risks of going on such deep space exploration missions where anything could happen. And on Titan they didn't know about or rather weren't affected directly by the immediate Borg crisis, they were just following those strange phenomena to the new Caeliar homeworld.

That doesn't justify at all taking premature measures, monitoring her would have sufficed - we're not talking about monitoring such as "if something hurts, come back", but as in "if her vital signs just drop a tiny bit, initiate an emergency transport to sickbay". On that notion, just at the risk of a burst appendix, do get humans their appendices removed or at all monitored? (And I know what I'm talking about, how fast this can turn *very* serious.)

[About Sci's examples for when the rights of the individual are severely diminished being almost exclusively from Treklit]

1. This is a TrekLit forum, so those examples are as valid as any other.

That wasn't meant as a criticism, rather as a curious notion why it's felt to take such a harsh stand on such a sensitive topic, especially such a military-related topic when ST is supposed to be about exploration and the ships we're reading about certainly aren't meant to be warships...

(And that's also where the comparison with modern military is lacking IMO - because those organizations are meant and trained for conflict and not exploration. I'd be willing to say the same might be true for the security division on ships... but the others? I think it would be quite interesting to see that explored a bit further. I mean, does an ordinary science crewman actually feel himself as "being military"? Or where in the chain of command do the lines blur?)

I did read it. As I read it, Ree understood the psychological effects of mammalian pregnancy intellectually, but not necessarily on an intuitive level. He clearly felt terrible for Troi -- his musing that the psychological effects of Pahkwa-thanh reproduction and customs would have made things easier for her was one born of compassion; he felt that his species' mode of reproduction would have caused her significantly less emotional pain (and he's probably right about that). However, he felt that preserving Troi's life was the paramount issue and outweighed the importance of respecting her feelings.

And that's, frankly, where he was wrong. He denied her emotional pain - granted, perhaps he'd have saved her from the immediate crisis, but what about the ramifications? In his mind, the problem would have been solved - but that wouldn't have been the case at all. And letting such emotional wounds fester might have proven more devastating (because they would have festered in secret and no one would have been aware that a problem might suddenly arise at some inopportune moment) in the longterm.

And, frankly, I agree with him. That doesn't mean I don't understand the effects of pregnancy -- it means that, in my view, if you're a part of an organization like Starfleet, you have a moral obligation to yourself and to your crewmates to put your personal life, even a pregnancy, second to your professional life in order to help ensure that everyone is safe. Maybe that's a harsh view -- but to me, it's a consequence of choosing to join Starfleet, and if you're unwilling to accept that consequence, you shouldn't have joined in the first place.

Honestly, I was quite surprised right at the beginning of Titan by the fact that the pregnant shuttle pilot was still allowed to perform her duty. Even with an intact pregnancy there comes a point when it gets unreasonable not to restrict duties... and in... was it "Red King"?... that point had easily come and gone...

OTOH, I think the decision to put your personal life aside comes easier on temporal assignments - but Starfleet isn't apparently built on temporary commissions, but rather on the fact that once you join, you join for life. And then it gets rather difficult to really ask people to devote their whole lives just to duty and nothing else.

(Of course, I don't think children belong on a starship and view the decision to bear and raise a child aboard one as being profoundly irresponsible, but that's an entirely separate discussion.)

That's a topic for another discussion - and to a certain extent I agree with your sentiments. And in comes the above mentioned lack in division between military and exploration...

 

[William Leisner]

Re: Titan: Over a Torrent Sea

William Leisner already pointed out quite a few canon examples where the patient definitely overruled the doctor...

Which I refuted.

My, we are quite enamoured of our own rhetorical skills, aren't we?

Sorry to say, I'm less so.

 

[Sci]

Re: Titan: Over a Torrent Sea

If the baby was considered to be doomed anyway, if the baby was endangering Deanna`s life doesn`t change the fact that we were not talking about removing a dead baby in order to save the mother. The baby was alive.

Well, that depends on how you define when a fetus gains personhood. It's a bit like asking when scruff becomes a beard -- it's hard to figure out where the line is between "collection of cells" and "baby."

What is legal is not necessarily what is right. I still find it sickening that Starfleet has the legal right to give such an order.

I find it sickening that anyone would refuse such an order and still be an active-duty officer. Someone in Deanna's state of mind at that time is simply incapable of performing his or her duties competently, and for her to not resign her commission or at least request leave while she worked through the issue was grossly negligent.

Let's make it clear: Starfleet does not have the right to forcibly perform abortions all willy-nilly on its officers, but it does have the right to compel them to undergo life-saving medical treatments if those individuals are currently commissioned officers and refuse to undergo such treatments.

I repeat my point that it is now finally illegal to order a Vulcan to do a mind meld against his will.

One hopes that there are exceptions when that Vulcan officer requires a mind meld to survive but is refusing it. Otherwise, we would have stumbled upon a profound inequality under the Starfleet Code of Military Justice. But from what we know from Gods of Night, the SCMJ seems to require CMOs to "not allow, either by action or omission of action, personnel under their medical charge to bring themselves to harm or death."

What happened to Deanna must not be allowed to happen to any other woman!

What happened to Deanna is the consequence of joining a military organization and surrendering certain rights unto that organization. It is not a violation of Deanna's rights to force her to undergo a life-saving medical procedure, because she consented to the loss of those rights by choosing to join the Federation Starfleet and to submit herself to the Starfleet Code of Military Justice.

That Starfleet has the right to order medical treatment against the will of the patient is bad enough. Although I don`t think “canon” Trek is that consistent. There was a Voyager episode in which B`Elanna refused treatment because the means of this cure was obtained by methods Mengele used in Nazi Germany.

Voyager wasn't exactly being run according to the SCMJ. Amongst other things, if they were, B'Elanna would have been subject to a court-martial for treason for having joined the Maquis long beforehand. Ergo, the choices that Captain Janeway made aboard Voyager are not evidence of binding legal precedent.

You are not talking about a person who has yet reached the state that she can be seen as mentally unfit. Sci,

I'm not saying that Commander Troi should have been found mentally incompetent to make any choices for herself by civilian standards. But by the standards of Starfleet, she was clearly incapable of competently executing the duties of her uniform, and ergo should have requested a leave of absence. That she did not -- and that Captain Riker did not relieve her of duty -- was dereliction of duty. It endangered the ship -- and, furthermore, Captain Riker's refusal to issue such an order illustrates perfectly how his having his wife under his command constitutes a conflict of interests that severely interferes with his willingness to execute his duties properly.

Deanna was not an irresponsible officer who ought to be charged with dereliction of duty. People with mental health problems (and the trauma Deanna went through can easily be classified as such) need help and treatment, not condemnation.

I agree completely. Commander Troi should have requested a leave of absence and then undergone the sort of mental health treatments necessary to restore a more balanced and mentally competent frame of mind, and upon her return to duty, her time off and her treatment should in no way have been held against her or used to undermine her judgment. But the fact that she didn't request to be relieved of her duties was the mistake -- this was the choice that deserves condemnation, not the actual fact that she was undergoing a mental health crisis.

Also the character who was suffering from trauma because of the friendly fire incident, would you put her on trial if Dax had been unsuccessful to get her to return to duty?

No, because in that instance, Lieutenant Kedair acted responsibly: She evaluated herself as being mentally unfit to perform her duties and requested that she be relieved of her duties. Upon being evaluated by a mental health expert (Captain Dax), this expert deemed her not to be mentally incompetent to perform her duties, and she was returned to duty. Everyone involved behaved responsibly: Lieutenant Kedair made the responsible choice to make sure that her mental health issues would not lead her to improperly or incompetently discharge her duties, and Captain Dax determined that this choice was unnecessary because her fears of an inability to function were inaccurate.

If Commander Troi had requested that she be relieved of duties for the duration of the mental health and pregnancy crises, I would have considered this a completely responsible choice and would not argue that she deserves to be brought up on charges of dereliction of duty.

Mind you, that is a separate issue from whether or not she had the legal right to refuse life-saving medical treatment. Even upon being relieved of duty, had she continued to refuse medical treatment, she should then have been brought up on charges of disobeying an order from her chief medical officer and endangering herself. If she wanted to avoid this, she should have resigned her commission -- remember, even in the midst of all this, she retained ultimate control over her own body via that option. But if she wanted to stay in Starfleet, she had no right to refuse life-saving medical treatment.

Sure there was -- the fact that the ship could, at any moment, face an unfolding crisis (in particular that they could face Borg attack, during that trilogy).

Honestly, then you would have to remove every single being with even the slightest problems "because something *could* happen".

No, only people who are clearly so embroiled in mental crises that they are obviously incapable of competently discharging their duties -- which Commander Troi clearly was. No one undergoing such an extreme mental health crisis can reasonably be expected to deal with issues of life and death in an emergency; to do so would be unfair both to Commander Troi and to her shipmates.

1. This is a TrekLit forum, so those examples are as valid as any other.

That wasn't meant as a criticism, rather as a curious notion why it's felt to take such a harsh stand on such a sensitive topic, especially such a military-related topic when ST is supposed to be about exploration and the ships we're reading about certainly aren't meant to be warships...

(And that's also where the comparison with modern military is lacking IMO - because those organizations are meant and trained for conflict and not exploration.

We've had this debate before, and that's a weak argument that proceeds from false premises. Militaries are not institutions that do not practice exploration -- historically, that, along with diplomacy, was considered to be one of the primary functions of a military -- and in point of fact, the military today still performs missions of scientific research.

That Starfleet is not militaristic does not mean that it is not a military -- as evidenced by its courts-martial, by numerous references to it being a military, and by the Starfleet Code of Military Justice established in Gods of Night.

I'd be willing to say the same might be true for the security division on ships... but the others? I think it would be quite interesting to see that explored a bit further. I mean, does an ordinary science crewman actually feel himself as "being military"? Or where in the chain of command do the lines blur?)

Nowhere. They're all Starfleet officers, they are all charged with the defense of the Federation in times of war, they all make up the Federation's armed forces. That this is an armed force that performs non-combat-related functions as well as combat functions does not mean that they are not all equally military officers.

And that's, frankly, where he was wrong. He denied her emotional pain - granted, perhaps he'd have saved her from the immediate crisis, but what about the ramifications? In his mind, the problem would have been solved - but that wouldn't have been the case at all.

You're jumping to conclusions. More than likely, Ree would have been well aware that after forcing her to undergo an abortion, Commander Troi would be in a profound mental health crisis and would subsequently require mental health treatment before returning to duty. He's a doctor, not a monster. His whole point was saving his patient, and doing so in accordance with the dictates of the SCMJ, which explicitly forbade him from allowing her to kill herself.

And, frankly, I agree with him. That doesn't mean I don't understand the effects of pregnancy -- it means that, in my view, if you're a part of an organization like Starfleet, you have a moral obligation to yourself and to your crewmates to put your personal life, even a pregnancy, second to your professional life in order to help ensure that everyone is safe. Maybe that's a harsh view -- but to me, it's a consequence of choosing to join Starfleet, and if you're unwilling to accept that consequence, you shouldn't have joined in the first place.

Honestly, I was quite surprised right at the beginning of Titan by the fact that the pregnant shuttle pilot was still allowed to perform her duty.

I was downright pissed off. It's a fundamentally irrational choice that's incredibly dangerous. And sure enough, what happened? She went into labor in the middle of a mission.

OTOH, I think the decision to put your personal life aside comes easier on temporal assignments - but Starfleet isn't apparently built on temporary commissions, but rather on the fact that once you join, you join for life.

Not really. Numerous episodes have made it clear that an officer can choose to resign his or her commission at any point. Had Commander Troi decided to, she could have resigned her commission and thereby prevented Dr. Ree from subjecting her to treatment as a civilian. Basically, she had a choice: Stay in Starfleet and submit to medical treatment, or become a civilian and retain control over her health.

William Leisner already pointed out quite a few canon examples where the patient definitely overruled the doctor...

Which I refuted.

My, we are quite enamoured of our own rhetorical skills, aren't we?

Sorry to say, I'm less so.

Because this is getting heated, I want to make one thing very clear:

Nothing in the argument is personal in any way. I have nothing but respect for the individuals I am debating with, and in particular, A Less Perfect Union is one of my absolute favorite Star Trek stories ever.

Having said that, we have a very profound disagreement over what the canonical evidence indicates -- and in any event, Gods of Night firmly establishes via the SCMJ that a CMO can order an officer to undergo treatment.

 

[rfmcdpei]

Re: Titan: Over a Torrent Sea (SPOILERS)

Then I found out Deanna had already lost a baby, that she really, really wanted one, and Riker did, and that if she lost this one, she couldn't conceive again. So her desperation to hang on to the baby made a bit more sense emotionally.

That's not quite accurate. Before her treatment by the Caeliar, Deanna's ova were incapable of producing a viable fetus at all, full stop, and that future attempts at conception would be nearly guaranteed to produce non-viable fetuses. It wouldn't be worthwhile, anyway, since the Eichner-related damage to her reproductive system had created serious potential for health problems including cancer.

I felt Troi's behaviour throughout to be quite believable, from her anguish and rage at the news of her second fetus' non-viability to her grief on learning the cause of what happened to her subsequent denial. It was touching.

 

[JoeZhang]

I think a phaser on high will perform an abortion and this applies to all star trek fiction and not just Titan.

 

[black_dranzer]

Re: Titan: Over a Torrent Sea

If the baby was considered to be doomed anyway, if the baby was endangering Deanna`s life doesn`t change the fact that we were not talking about removing a dead baby in order to save the mother. The baby was alive.

Well, that depends on how you define when a fetus gains personhood. It's a bit like asking when scruff becomes a beard -- it's hard to figure out where the line is between "collection of cells" and "baby."

What is legal is not necessarily what is right. I still find it sickening that Starfleet has the legal right to give such an order.

I find it sickening that anyone would refuse such an order and still be an active-duty officer. Someone in Deanna's state of mind at that time is simply incapable of performing his or her duties competently, and for her to not resign her commission or at least request leave while she worked through the issue was grossly negligent.

Let's make it clear: Starfleet does not have the right to forcibly perform abortions all willy-nilly on its officers, but it does have the right to compel them to undergo life-saving medical treatments if those individuals are currently commissioned officers and refuse to undergo such treatments.



One hopes that there are exceptions when that Vulcan officer requires a mind meld to survive but is refusing it. Otherwise, we would have stumbled upon a profound inequality under the Starfleet Code of Military Justice. But from what we know from Gods of Night, the SCMJ seems to require CMOs to "not allow, either by action or omission of action, personnel under their medical charge to bring themselves to harm or death."



What happened to Deanna is the consequence of joining a military organization and surrendering certain rights unto that organization. It is not a violation of Deanna's rights to force her to undergo a life-saving medical procedure, because she consented to the loss of those rights by choosing to join the Federation Starfleet and to submit herself to the Starfleet Code of Military Justice.



Voyager wasn't exactly being run according to the SCMJ. Amongst other things, if they were, B'Elanna would have been subject to a court-martial for treason for having joined the Maquis long beforehand. Ergo, the choices that Captain Janeway made aboard Voyager are not evidence of binding legal precedent.



I'm not saying that Commander Troi should have been found mentally incompetent to make any choices for herself by civilian standards. But by the standards of Starfleet, she was clearly incapable of competently executing the duties of her uniform, and ergo should have requested a leave of absence. That she did not -- and that Captain Riker did not relieve her of duty -- was dereliction of duty. It endangered the ship -- and, furthermore, Captain Riker's refusal to issue such an order illustrates perfectly how his having his wife under his command constitutes a conflict of interests that severely interferes with his willingness to execute his duties properly.



I agree completely. Commander Troi should have requested a leave of absence and then undergone the sort of mental health treatments necessary to restore a more balanced and mentally competent frame of mind, and upon her return to duty, her time off and her treatment should in no way have been held against her or used to undermine her judgment. But the fact that she didn't request to be relieved of her duties was the mistake -- this was the choice that deserves condemnation, not the actual fact that she was undergoing a mental health crisis.



No, because in that instance, Lieutenant Kedair acted responsibly: She evaluated herself as being mentally unfit to perform her duties and requested that she be relieved of her duties. Upon being evaluated by a mental health expert (Captain Dax), this expert deemed her not to be mentally incompetent to perform her duties, and she was returned to duty. Everyone involved behaved responsibly: Lieutenant Kedair made the responsible choice to make sure that her mental health issues would not lead her to improperly or incompetently discharge her duties, and Captain Dax determined that this choice was unnecessary because her fears of an inability to function were inaccurate.

If Commander Troi had requested that she be relieved of duties for the duration of the mental health and pregnancy crises, I would have considered this a completely responsible choice and would not argue that she deserves to be brought up on charges of dereliction of duty.

Mind you, that is a separate issue from whether or not she had the legal right to refuse life-saving medical treatment. Even upon being relieved of duty, had she continued to refuse medical treatment, she should then have been brought up on charges of disobeying an order from her chief medical officer and endangering herself. If she wanted to avoid this, she should have resigned her commission -- remember, even in the midst of all this, she retained ultimate control over her own body via that option. But if she wanted to stay in Starfleet, she had no right to refuse life-saving medical treatment.



No, only people who are clearly so embroiled in mental crises that they are obviously incapable of competently discharging their duties -- which Commander Troi clearly was. No one undergoing such an extreme mental health crisis can reasonably be expected to deal with issues of life and death in an emergency; to do so would be unfair both to Commander Troi and to her shipmates.



We've had this debate before, and that's a weak argument that proceeds from false premises. Militaries are not institutions that do not practice exploration -- historically, that, along with diplomacy, was considered to be one of the primary functions of a military -- and in point of fact, the military today still performs missions of scientific research.

That Starfleet is not militaristic does not mean that it is not a military -- as evidenced by its courts-martial, by numerous references to it being a military, and by the Starfleet Code of Military Justice established in Gods of Night.



Nowhere. They're all Starfleet officers, they are all charged with the defense of the Federation in times of war, they all make up the Federation's armed forces. That this is an armed force that performs non-combat-related functions as well as combat functions does not mean that they are not all equally military officers.



You're jumping to conclusions. More than likely, Ree would have been well aware that after forcing her to undergo an abortion, Commander Troi would be in a profound mental health crisis and would subsequently require mental health treatment before returning to duty. He's a doctor, not a monster. His whole point was saving his patient, and doing so in accordance with the dictates of the SCMJ, which explicitly forbade him from allowing her to kill herself.



I was downright pissed off. It's a fundamentally irrational choice that's incredibly dangerous. And sure enough, what happened? She went into labor in the middle of a mission.



Not really. Numerous episodes have made it clear that an officer can choose to resign his or her commission at any point. Had Commander Troi decided to, she could have resigned her commission and thereby prevented Dr. Ree from subjecting her to treatment as a civilian. Basically, she had a choice: Stay in Starfleet and submit to medical treatment, or become a civilian and retain control over her health.

Which I refuted.

My, we are quite enamoured of our own rhetorical skills, aren't we?

Sorry to say, I'm less so.

Because this is getting heated, I want to make one thing very clear:

Nothing in the argument is personal in any way. I have nothing but respect for the individuals I am debating with, and in particular, A Less Perfect Union is one of my absolute favorite Star Trek stories ever.

Having said that, we have a very profound disagreement over what the canonical evidence indicates -- and in any event, Gods of Night firmly establishes via the SCMJ that a CMO can order an officer to undergo treatment.

In the DS9 episode 'Rapture', Admiral Whatley orders Bashir to perform life-saving surgery on Sisko, however Bashir replies that he's unable to comply without the permission of Sisko's next-of-kin. Of course, on Titan the issue would be less complicated since Riker would be Troi's next-of-kin, but still canon clearly shows that even Starfleet officers have the right to refuse treatment and not even an Admiral can order the doctors to operate

 

[Sci]

Re: Titan: Over a Torrent Sea

In the DS9 episode 'Rapture', Admiral Whatley orders Bashir to perform life-saving surgery on Sisko, however Bashir replies that he's unable to comply without the permission of Sisko's next-of-kin. Of course, on Titan the issue would be less complicated since Riker would be Troi's next-of-kin, but still canon clearly shows that even Starfleet officers have the right to refuse treatment and not even an Admiral can order the doctors to operate

Then the canon's contradicting itself, considering that previous episodes made it very clear that CMOs have a lot of authority over their patients, including the authority to issue treatment and to force them to submit to medical examination.

And that's in clear contradiction to what Gods of Night establishes. Normally, you'd go with the canon when there's an apparent contradiction -- but the thing to remember is that that Doctor Bashir was actually a Changeling infiltrator, so his understanding and application of Starfleet medical law is suspect.

 

[Claudia]

Re: Titan: Over a Torrent Sea

Just curious, but it only happens quoting Sci's posts that all the things he/she quotes from previous posts are removed which is kind of annoying... Does anyone have any idea why that happens?

You're jumping to conclusions. More than likely, Ree would have been well aware that after forcing her to undergo an abortion, Commander Troi would be in a profound mental health crisis and would subsequently require mental health treatment before returning to duty. He's a doctor, not a monster. His whole point was saving his patient, and doing so in accordance with the dictates of the SCMJ, which explicitly forbade him from allowing her to kill herself.

But see, that's where the whole problem/discussion lies. He didn't *act* like he understood the situation. He didn't *act* sympathetically at all. He didn't show compassion. He didn't try to communicate with Troi, the whole crisis could have been avoided if he had just listened for a second.

A doctor's duty is to heal, of course, whenever possible - but also not to cause further pain - and Ree failed in that because he caused Troi further pain, not just in *what* he told her, but *how* and how he absolutely showed no sympathy whatsoever. He (and you BTW) thought, let's deal with the current crisis and then take care of the rest - but in handling the situation differently from the beginning, further problems could perhaps have been avoided entirely.

And let's not forget that Troi's mental health wouldn't have been Ree's problem but one of the counselors'... Ree wouldn't really have had to face the ramifications here.

About SF being militaristic:

I don't deny that the roots of Starfleet are the planets' own defense units, so the organization is quite similar. But I never had the impression that SF still *is* in its whole structure a militaristic organization. I'm sorry if I offend anyone here because that's not my intention, but when I hear military I think of those bootcamps that are often portrayed in films where young people are kind of indoctrinated, humiliated and more or less "brainwashed" into team work and super soldiers. And that has nothing to do with Starfleet. And sorry, you can't tell me that soldiers of today are trained to be explorers, we are not talking about the medieval ages and the crusades here after all.

I still don't see a reason for turning Starfleet into a real militaristic organization again - some sort of back to the roots thing, going on in TrekLit?

And I really don't get that "forbidding people to risk their lives"-thing - where was that established? The way I remember from canon Trek, a doctor could relieve the captain/commanding officer from duty if he sees him unfit for duty. That was it - and that made sense. But this approach, I'd say, does nothing at all for patients to actually put their trust in their CMO. I wonder why there are still discussions about medical procedures at all - the CMO knows best and that's what happens. Sorry, but that makes no sense at all to me.

Not really. Numerous episodes have made it clear that an officer can choose to resign his or her commission at any point. Had Commander Troi decided to, she could have resigned her commission and thereby prevented Dr. Ree from subjecting her to treatment as a civilian. Basically, she had a choice: Stay in Starfleet and submit to medical treatment, or become a civilian and retain control over her health.

Actually, I don't think that's true. First of all, could she have stayed on Titan as civilian, would she have been relegated to being just Riker's wife? I didn't get the impression (apart from the first 2 or so books) that Titan was a family ship like the Enterprise D where it was possible for civilians to actually work on and contribute to the small community.

Secondly, I think it's a bit hypocritical of an organization to force people to resign in times of conflict of opinions, but otherwise make life on family ships etc. possible. That's a contradiction, because, honestly, having your partner/children on board the same ship will always lead to a certain conflict of interests whenever a crisis comes up. I wonder why that SCMJ was established so strongly, but rules of fraternization or about families etc. on board a Starfleet ship haven't come up yet (except for that slap on the wrist in "Change of Heart" or Picard's issues in "Lessons"). Because IMO they simply contradict each other. You can't be expected to lead a personal life when there's the slightest risk that in case of a problem the CMO could just overrule you and make you undergo a procedure you don't want.

(And still, removing Troi's uterus?????????? That went way beyond just solving the immediate crisis - and therefore IMO wasn't covered by that obscure SCMJ.... Where's the Starfleet JAG officer when you need one. *g*)

 

[rfmcdpei]

Re: Titan: Over a Torrent Sea

A doctor's duty is to heal, of course, whenever possible - but also not to cause further pain - and Ree failed in that because he caused Troi further pain, not just in *what* he told her, but *how* and how he absolutely showed no sympathy whatsoever. He (and you BTW) thought, let's deal with the current crisis and then take care of the rest - but in handling the situation differently from the beginning, further problems could perhaps have been avoided entirely.

I find it difficult to imagine how he could have delivered it in such a way as to help Troi significantly.

"You remember the child you gave birth to, one of the most significant experiences of your life? It turns out that it contaminated your reproductive system irretrievably--not only are you incapable of successfully conceiving and carrying to term a fetus, but your reproductive oprgans are so damaged that they may become a significant health risk--cancer, say--and need to be removed. So sorry."

It's not at all unexpected that Troi would be devastated by this news to the point of being parasuicidal. How that can be sugarcoated is beyond me.

(And still, removing Troi's uterus?????????? That went way beyond just solving the immediate crisis - and therefore IMO wasn't covered by that obscure SCMJ.... Where's the Starfleet JAG officer when you need one. *g*)

As Ree said, the damage from the Eichner radiation was such that she risked serious complications, including cancer, and that the best way to ensure her continued health would be to perform a hysterectomy. It's no different a principle from the preemptive removal by women with a genetic susceptibility to breast cancer of those organs.

 

[Baerbel Haddrell]

This is not about a failure of Ree to sugarcoat the bad news. That was not required and trying to do that would have been an insult anyway.

What Dr. Ree should have done is giving Deanna options. At that time her life was not in immediate danger. There was a need for strong supervision but no need to drag her immediately into sickbay for an operation.

This is where Ree failed. He should have offered her, for example, the option of getting a second opinion from a specialist. He should have discussed her what options she has of having a baby even if there is no way to repair her genetic damage.

There was certainly no immediate need to remove that option from Deanna by taking away her womb. He could have told her that because of the risk of cancer (I am not sure, was it mentioned somewhere that there is a cure for cancer now anyway?) or other risks she has to be under observation. He should have told her that Deanna should have the children she wants and then a hysterectomy could have been considered.

Even today in the real world there are options for women like egg donations.

 

[rfmcdpei]

There was certainly no immediate need to remove that option from Deanna by taking away her womb. He could have told her that because of the risk of cancer (I am not sure, was it mentioned somewhere that there is a cure for cancer now anyway?) or other risks she has to be under observation. He should have told her that Deanna should have the children she wants and then a hysterectomy could have been considered.

Ree's point was that Deanna couldn't have children, that not only were her ova so corrupted by the Eichner radiation as to be unable to produce viable fetuses, but that her entire reproductive system had suffered irreparable damage at the genetic level. Even egg donation might be out of the question: Could the damaged uterus support it?

24th century cancer treatments can probably work quite effectively against patches of cancer, but if entire organs are made up of pre-cancerous cells could there be any treatment apart from these organs' removal from the body? Ree likely thought that Troi's reproductive system was a ticking time bomb insofar as the cancer risk was concerned and favoured its immediate removal in order to save her life.

 

[Marie1]

I think Doctor Ree had in mind what he thought was a good, and mostly convenient option.

Doctors in the future certainly are not going to be allowed to force any medical treatment on anyone, to say otherwise means patient rights in the future are going backwards. Especially if they've made their choices clear- so even if they're unconscious, there is no consent. Being in SF doesn't change that, it's still a matter of ethics. Actually, it comes up in Mack's Warpath as well, now that I think of it. And that case sprang to mind when I read the Troi/Ree parts of Destiny.

The away mission aside, the danger was that the child- when it died, and the miscarriage actually occurred, could cause severe bleeding. The book showed the depth of her agony, and like Picard, the breakdown of someone supposed to be strong. Even tho Ree didn't like it because he couldn't prevent the problem immediately, I loved the fact they were willing to monitor it to give Troi time. She needed it for her mental health, not just the plot line. I thought in the end, once everyone calmed down, a good discussion and compromise/viable solution came of it. I'm always happy to see options- as medicine is pretty well never black and white.

I think part of Troi's problem is the mix between her emotions and Riker's, and their difficulties figuring whose are whose. I hadn't thought of that til it was mentioned in Destiny. That would be really complicated... and Lwaxana said a Betazoid (tho Troi is only half) can sense their babies, so given Troi's affection for the child, it'd be that much harder.

 

[Strider]

Lwaxana said a Betazoid (tho Troi is only half) can sense their babies

I don't mean to force my politics, but can you imagine what such a thing would do to the abortion rate?

 

[Baerbel Haddrell]

There was certainly no immediate need to remove that option from Deanna by taking away her womb. He could have told her that because of the risk of cancer (I am not sure, was it mentioned somewhere that there is a cure for cancer now anyway?) or other risks she has to be under observation. He should have told her that Deanna should have the children she wants and then a hysterectomy could have been considered.

Ree's point was that Deanna couldn't have children, that not only were her ova so corrupted by the Eichner radiation as to be unable to produce viable fetuses, but that her entire reproductive system had suffered irreparable damage at the genetic level. Even egg donation might be out of the question: Could the damaged uterus support it?

24th century cancer treatments can probably work quite effectively against patches of cancer, but if entire organs are made up of pre-cancerous cells could there be any treatment apart from these organs' removal from the body? Ree likely thought that Troi's reproductive system was a ticking time bomb insofar as the cancer risk was concerned and favoured its immediate removal in order to save her life.

From what I remember her ova was damaged, meaning her eggs. I wasn`t left with the impression that the rest of her organs suffered damage as well.

Otherwise, I think Destiny should have pointed that out more clearly.

 

[Claudia]

I find it difficult to imagine how he could have delivered it in such a way as to help Troi significantly.

"You remember the child you gave birth to, one of the most significant experiences of your life? It turns out that it contaminated your reproductive system irretrievably--not only are you incapable of successfully conceiving and carrying to term a fetus, but your reproductive oprgans are so damaged that they may become a significant health risk--cancer, say--and need to be removed. So sorry."

Sugarcoating isn't the same as working *with* the patient, and not exerting your authority over her.

This is a very sensitive topic for me, both as a doctor and the daughter of someone who was told he had terminal cancer absolutely unsympathetically without any preparation at all. There are just very different ways to tell the truth. And Ree took one of the worst available to him.

As Ree said, the damage from the Eichner radiation was such that she risked serious complications, including cancer, and that the best way to ensure her continued health would be to perform a hysterectomy. It's no different a principle from the preemptive removal by women with a genetic susceptibility to breast cancer of those organs.

Yes, but Ree wanted to jump ahead and force that hysterectomy on Troi when an abortion would have sufficed for the immediate crisis. And that's the difference here.

And sorry, but somehow I find it a bit incredible that 370 years from now there's no cure for cancer - a bit of gene manipulation on the malign cells and everything's alright again... and if they have to remove an organ - why not grow it back, they did it with Worf's spinal cord after all...

Ree's point was that Deanna couldn't have children, that not only were her ova so corrupted by the Eichner radiation as to be unable to produce viable fetuses, but that her entire reproductive system had suffered irreparable damage at the genetic level. Even egg donation might be out of the question: Could the damaged uterus support it?

There was no hint that her uterus itself was damaged by the radiation, just her eggs. But her uterus would only be in danger due to miscarriage. The only curious thing was (and I was never given an explanation here if that's part of Betazoid physiology - but Deanna's half Betazoid...) that she apparently doesn't have ovaries because Inyx said he "repaired the remaining eggs in her womb"... Which would put a different spin on the whole matter of the hysterectomy (but, mind you, still not make it right to force Deanna to undergo such a procedure immediately).

 

[Marie1]

Lwaxana said a Betazoid (tho Troi is only half) can sense their babies

I don't mean to force my politics, but can you imagine what such a thing would do to the abortion rate?

Lower it, I'm guessing? If they're mentally tied- can feel their contentment to be in there, as Lwaxana described it, then it would be hard to end that life. Especially later on- how long is a Betazoid's pregnancy? Human brainwaves are detectable at 6 weeks, 10 weeks they have facial expressions like frowning, so they're probably expressing emotions.

I'd say, since human babies have a nervous system at around 11 weeks, and can definitely feel pain with it at 12 weeks, you'd rarely see abortions after that comparable time for Betazoids, unless modern abortions are painless and immediate. Otherwise, due to the empathic nature of Betazoids, even if the mother's lives were in danger, the mental issues of the mother wouldn't go away due to the abortion. Deanna had that connection to the baby that gave her the radiation in the first place- she refused to terminate it then too- I got the impression that was due in part to her empathic connection with it.

As Ree said, the damage from the Eichner radiation was such that she risked serious complications, including cancer, and that the best way to ensure her continued health would be to perform a hysterectomy. It's no different a principle from the preemptive removal by women with a genetic susceptibility to breast cancer of those organs.

And sorry, but somehow I find it a bit incredible that 370 years from now there's no cure for cancer - a bit of gene manipulation on the malign cells and everything's alright again... and if they have to remove an organ - why not grow it back, they did it with Worf's spinal cord after all...

A lot of these stories are based on what recent medical information the authors can find. We can or are close to targeting and destroying individual cancer cells and preserving the rest of the body- so will their be better cancer treatment? Of course.

What puzzles me is the Echiner/cancer thing- after all those years it couldn't possibly still be confined to her womb, especially if it hadn't shown up yet. So would removing her reproductive organs help that much? You'd think blood could have carried some of those cells all over...

 

[Sci]

Re: Titan: Over a Torrent Sea

Just curious, but it only happens quoting Sci's posts that all the things he/she quotes from previous posts are removed which is kind of annoying... Does anyone have any idea why that happens?

No clue. It happens to me all the time, too, and it never used to. Oh well. I tend to just open another box and copy and paste another quote into my posts when I think they're necessary.

You're jumping to conclusions. More than likely, Ree would have been well aware that after forcing her to undergo an abortion, Commander Troi would be in a profound mental health crisis and would subsequently require mental health treatment before returning to duty. He's a doctor, not a monster. His whole point was saving his patient, and doing so in accordance with the dictates of the SCMJ, which explicitly forbade him from allowing her to kill herself.

But see, that's where the whole problem/discussion lies. He didn't *act* like he understood the situation. He didn't *act* sympathetically at all. He didn't show compassion. He didn't try to communicate with Troi, the whole crisis could have been avoided if he had just listened for a second.

A doctor's duty is to heal, of course, whenever possible - but also not to cause further pain - and Ree failed in that because he caused Troi further pain, not just in *what* he told her, but *how* and how he absolutely showed no sympathy whatsoever. He (and you BTW) thought, let's deal with the current crisis and then take care of the rest - but in handling the situation differently from the beginning, further problems could perhaps have been avoided entirely.

See, when I read Gods of Night, the impression I got was that we as the audience had arrived in the middle of this conflict between Ree and Troi. I got the sense that Ree had been kind and sympathetic at first, that he had tried to work with her, and that she had rebuffed him and consistently behaved uncooperatively and self-destructively. Thus, the impression I got was that Ree was, by the time of Gods of Night, being far more authoritarian about the situation than he would normally be, because he felt that sympathy had not worked and that authoritarian-ness was now necessary to save a self-destructive patient and officer.

About SF being militaristic:

I don't deny that the roots of Starfleet are the planets' own defense units, so the organization is quite similar. But I never had the impression that SF still *is* in its whole structure a militaristic organization.

We need to go back and define "military" and "militaristic." They're not the same thing, and "militaristic" is not an adjective form of "military." (The word "military" is usually used as its own adjective form, but the word "martial" is also an adjective for "Military.")

A military is simply the armed forces of a state. That's it. If a state creates an organization and charges that organization with the use of force in defense of the state against hostile foreign powers, then that organization is a military. It's a legal term, not a value judgment. That military might be given other tasks, too, and militaries historically have been given in real life. But so long as it is the organization legally tasked with the defense of the state, then that organization is also a military. That's why the United States Coast Guard, for instance, even though most of its functions are maritime law enforcement-related and search-and-rescue-related, and even though it isn't part of the Department of Defense unless it's transferred there, is still considered a military organization.

"Militaristic," on the other hand, is an adjective used to describe someone who is often belligerent and hostile, who believes the use of violence by a military force is the best and most effective means of problem-solving. It contains strong negative connotations, including a disregard for human life. A military need not be particularly militaristic -- the Canadian Forces consider one of their most important missions to be the delivery of humanitarian aid, for instance -- and someone can be pretty militaristic without being part of the military.

Starfleet is not a militaristic organization. It is not an organization that believes that violence is a preferable way to solve conflicts, and its operational ethos is to avoid violence except as a last resort or unless ordered to do violence by the Federation government. Nonetheless, Starfleet is still a military: It is the legal institution created by the Federation and charged with the Federation's defense in times of conflict with foreign powers. It possesses one of the distinguishing features of a military, the use of force in the enforcement of an internal legal code upon its officers, in the form of its courts-martial. It is also the institution that the Federation can call upon to enforce martial law upon the civilian populace, as established in DS9's "Homefront." Heck, "Paradise Lost," the second part of that two-parter, even has Starfleet officers referring to the Federation President as their commander-in-chief.

I'm sorry if I offend anyone here because that's not my intention, but when I hear military I think of those bootcamps that are often portrayed in films where young people are kind of indoctrinated, humiliated and more or less "brainwashed" into team work and super soldiers.

I'm not offended, but you're confusing the current practices of a military with its inherent definition. There's nothing inherent to a military that requires it to engage in the kinds of behavioral conditioning that many militaries engage in today. It is, again, simply a legal term. If the Parliament of the Federated States of Freedonia passes a bill purchasing a few fishing boats and putting two guns on them, and then hires 15 guys to work part-time on those boats every other weekend, and designates that these 15 guys and two boats shall be legally charged with defending Freedonia in times of crisis, then that's the Freedonian Navy.

Starfleet obviously doesn't engage in the kinds of extreme conditioning that many militaries engage in today, but it is still the organization the Federation government relies upon to defend the Federation. Ergo, it is a military.

And sorry, you can't tell me that soldiers of today are trained to be explorers, we are not talking about the medieval ages and the crusades here after all.

I was thinking more of the period between approximately 1500 and 1900, actually; European states often relied upon their navies to serve as explorers. That we do not do so today is more a function of the fact that, well, the world's been charted and there are no more unknown lands.

And I really don't get that "forbidding people to risk their lives"-thing - where was that established? The way I remember from canon Trek, a doctor could relieve the captain/commanding officer from duty if he sees him unfit for duty. That was it - and that made sense. But this approach, I'd say, does nothing at all for patients to actually put their trust in their CMO. I wonder why there are still discussions about medical procedures at all - the CMO knows best and that's what happens. Sorry, but that makes no sense at all to me.

It's a matter of, space is an inherently dangerous environment. Everyone needs to be able to trust that everyone else is capable of being relied upon to do their jobs, and the CMO is one of the people who has to judge that. If the CMO says they're not, then they can't be relied upon. Everyone gives up some of their freedom when they join a military -- even a non-militaristic, benign one like Starfleet.

Not really. Numerous episodes have made it clear that an officer can choose to resign his or her commission at any point. Had Commander Troi decided to, she could have resigned her commission and thereby prevented Dr. Ree from subjecting her to treatment as a civilian. Basically, she had a choice: Stay in Starfleet and submit to medical treatment, or become a civilian and retain control over her health.

Actually, I don't think that's true.

Well, we've seen several examples of it happening, so I don't know how you can reasonably claim that a Starfleet officer does not have the option of resigning his/her commission.

First of all, could she have stayed on Titan as civilian, would she have been relegated to being just Riker's wife? I didn't get the impression (apart from the first 2 or so books) that Titan was a family ship like the Enterprise D where it was possible for civilians to actually work on and contribute to the small community.

The Titan does have several civilians and families on it, so that certainly would have been an option for a theoretical Citizen Troi.

Secondly, I think it's a bit hypocritical of an organization to force people to resign in times of conflict of opinions, but otherwise make life on family ships etc. possible. That's a contradiction, because, honestly, having your partner/children on board the same ship will always lead to a certain conflict of interests whenever a crisis comes up. I wonder why that SCMJ was established so strongly, but rules of fraternization or about families etc. on board a Starfleet ship haven't come up yet (except for that slap on the wrist in "Change of Heart" or Picard's issues in "Lessons"). Because IMO they simply contradict each other. You can't be expected to lead a personal life when there's the slightest risk that in case of a problem the CMO could just overrule you and make you undergo a procedure you don't want.

I'm not sure I see how there's a contradiction between a CMO being able to force you to undergo treatment and the capacity to have a personal life.