One of the main principles of medical Ethics is to keep the faith and save lives. Direct ethical work is what every medical worker should do. However, what is ethical actually? If a person is going to die soon and there is no hope for recovery, should doctors “keep trying” and make a person suffer, especially, if he/she is tired and wants to die? It is a dilemma that is in the spotlight nowadays. Every case is individual, and one cannot judge if he/she wasn’t in the same situation. However, there is a principle that can be applied to every situation: “The ends justify the means”. In this essay, we are going to discuss the moral theory of consequentialism and its application to medical practice through the analysis of the story “The Cruel Clarity of It All” from the book by Richard M Zaner Conversation on the Edge.
First, a few words about the book and its author should be said. Richard Zaner is a philosopher and medical ethics. His works deal with the patients’ reactions to different illnesses. One of his most famous books is Conversations on the Edge: Narratives of Ethics and Illness. It is a collection of six stories written from the author’s experience when he was working with families of dying people. In this book, the author tries to understand and describe feelings and emotions experienced by patients, as well as their families.
One of the stories is the author’s personal experience about the death of his mother. “The Cruel Clarity of It All” is a very thought-provoking story, as its central subject is the question of ethical scrutiny. The author tells about the period of his mother’s last days and the time she spends in the nursing home. Another concern of the story is the problem of ethical actions (work). Was he right when helped his mother fill out the form? Did she want to be heeded? He encouraged his mother to live her last days in the nursing home. That is how he tells about it:
“I, for I can and will speak only for myself, lived in a kind of careful ignorance of what had happened to her, or where she was living out her final days and in what miserable conditions” (Zaner 137).
Zaner shows a painful reality. On the one hand, the author did a virtue while helping his mother, as he believed that it would be better for her to be cared for by medical personal and she would live longer. On the other hand, he asked himself a question: did he do right? Maybe he added suffering to his mother’s last days. Thus, he hesitates whether she had a stroke accidentally, or she remover the oxygen mask by herself attempting to die?
The theory of consequentialism can be expressed in such aphorism: “The ends justify the means”. It actually casts some light on the story. The ultimate aim of the author was to save his mother’s life as long as he could, and he did everything possible. He considered that thus he will make her happy. However, the accidents with the oxygen mask provided that he was wrong. So, maybe he was an egoist and did all that just to calm his conscience?
At any rate, ethics in medicine is a controversial point. “The ends justify the means” cannot be taken as an axiom because the “ends” of patients and their families can be different. Each patient is an individual case and not only medical ethics, but human feelings should be taken into consideration.
Zaner, Richard M. Conversations on the Edge: Narratives of Ethics and Illness. Washington, DC: Georgetown University Press, 2004.