Practical problems in medical ethics: I. An unexpected finding of non-paternity

As you probably know, this site is dedicated to practical philosophy, which includes discussions of philosophies of life (Stoicism, Epicureanism, Buddhism, and the like), issues in metaphysics and philosophy of mind that have practical import (free will, anyone?), and of course ethics. Lots of ethics. After all, for the ancient Greco-Romans, “ethics” literally was the study of how to live one’s life. It hardly gets any more practical than that.

This week we are going to take a look, in three installments, to a number of problems in practical medical ethics recently posed at a departmental colloquium at the City College of New York by my colleague Jeff Blustein. Jeff provided us with a set of criteria by which to evaluate the three ethical dilemmas he posed, then presented each dilemma, and asks us the sort of questions that a medical doctor, as well as his patients, would have to face under the circumstances. I’m proposing this as an exercise in collective ethical evaluation. I was surprised to find that my own reactions were very clear in two of the three cases, as I almost immediately zoomed into one of the possible answers. I will provide my reasoning in each case, but I would love to hear what readers have to say in each instance.

First, though, a quick run down of the six criteria Jeff suggested for a good philosophical evaluation of the case studies:

1. Formulate the problem. This is not always as easy as it sounds, as there may be more than one way to formulate the problem itself, before we even begin to consider possible answers.

2. Consider the relevant information. If there are critical pieces of information that are missing, articulate why they are relevant to the ethical analysis, and what follows from the fact that they are currently missing.

3. Refer to the ethical principles involved. An ethical dilemma arises when some values dictate incompatible courses of action, and it is not immediately obvious which should take priority.

4. Review alternative courses of action. Consider the possible alternatives, compare the range of outcomes against relevant principles and values. Keep in mind that it may be necessary to accept trade-offs.