Ethics of Death: From Patient Decisions to Seatbelts

“Alright, how about this?”

I braced myself for the impact of a tough question, which was surely dancing across my friend’s mind by the way he grinned at me.

“Let’s say you are an emergency doctor, and let’s suppose that a patient is wheeled in urgently. Now, this patient is bleeding profusely, which means you need to perform a blood transfusion ASAP. However, this patient is screaming that they can’t have a blood transfusion due to religious reasons. They say they won’t accept it, no matter what. But you know that this patient will certainly die if they don’t receive a blood transfusion soon–”

“–You mean to say, I can’t do anything else to help him? Surely, there must be a way, not just a blood transfusion!” I frowned.

“It’s a hypothetical situation,” he chuckles, “so what would you do? Save him? Let him die?”

I sat back, ruminating on the dichotomous choices that seemed to engage the subject of ethics but also frustratingly infringed on emotions. My instincts chanted to save the patient, but my mind told me that this question couldn’t have such an easy answer. Something told me that I shouldn’t save the patient, but I couldn’t bring myself to say it out loud.

“I’d save him first. I mean, if he still chooses to die, he could always do so a little after, when he has more time to think about his decision and would be calmer in doing so as well. You can’t regret dying, but you can regret not dying, right?” I was hopeful that this was an ethically sound answer.

“Nope. The right answer is that you don’t save them. You can’t give them a blood transfusion against their will, so you can’t do that. You have to let them go.” He shrugged his shoulders.

This was the first time I was exposed to the rather counter-intuitive bioethical topics. I’ve always considered the role of a physician as, literally, a life-saver, and therefore couldn’t wrap my head around the fact that the correct decision in such a scenario, though hypothetical, could very well happen to any physician, was to watch a patient die.

Ultimately, I understood that physicians are only the gatekeepers of life, and therefore cannot “play God” by determining who lives and who dies. Ultimately, the decisions are made by the patient and must be respected to the utmost degree, regardless of whether one believes it is the ‘right’ decision, which could be the one that will save the patient’s life. Not necessarily so, and this extends to the ethical controversies surrounding physician-assisted suicide. Following this argument, physician-assisted suicide should be allowed if it is the ultimate wish of the patient.

Regardless, it’s clear that the fundamentals regarding final decisions of healthcare are ultimately made by the patient. Each person is responsible for and has control of their own life.

One could carry forward this principle into the context of seatbelts. For a substantial amount of time in history, seat belts were not mandatory as they are today, and those in vehicles could decide whether or not to put them on. Of course, wearing seat belts resulted in a drastically decreased likelihood of dying in a crash, though the decision to wear them still rested with the individuals in the vehicle. Our government today has made it illegal to drive without all passengers (and driver) to wear a seatbelt as an effort to reduce fatalities.

Those of you reading this are probably confused as to how we came upon seat belts – what an arbitrary topic – but here’s the question that I hope can bridge the two subjects; couldn’t we argue that the government is actually infringing upon our rights to our own life? The decision as to whether or not one will wear a seatbelt technically should be with those in the vehicle, as it’s ultimately a decision regarding their lives. Moreover, each person’s decision will not affect the probabilities of dying for others; a seatbelt-free person sitting beside a person wearing a seatbelt will not increase nor decrease the chances of that person dying in an accident, and vice-versa. Besides, the probability of getting into a vehicle accident has little correlation to whether the driver was wearing a seatbelt or not, which means it is an individual decision that has absolutely no affect on others.

If so, it would suffice to say that the government has actually taken away our ability to make our own decisions about our lives – though it seems like it was agreeable to all. Who are they to decide if we want to increase our chances of dying?

I suppose it’s because the majority of us wish to live longer than dying an early death, which is why such a law was implemented. But this also points to a deeper ethical dilemma – when is it permissible to assume that everyone wants to live longer, and when should we question that fundamental perspective on mortality, just as we did previously?

How would you resolve this dilemma?

(Written by Judy Chen / Image Source)

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