Paradoxes of Today

This section will explore thoughts on Capital Punishment.

Capital Punishment has a fork: ethics and law.

Medicine - therapeutic death

In the event of that a person is to be sentenced to death, doctors often assist in the execution.

Lethal injection is sole accepted method of execution.

Convicts are given 2000-2500 mg Sodium thiopental, 60-100 mg of pancuronium, and 120-240 meq of potassium.

First, the Na Thiopental causes complete cessation of brain activity before respiration and circulatory collapse occurs. Pancuronium is given to paralyze the muscles so the convict does not convulse. And Potassium speeds up the cardiac arrest.

I’d say this is far better than firing-squads, electrical chairs, or cyanide gas chambers.

So, If a person is sentenced to death, is it ethical for a doctor to assist in execution?

In order to assess the question further, it can be broken down to: is it ethical for a doctor to kill people.

This question cannot be considered on just one ground so I will first start with the metaphysical application to this subject.

If a person has a terminal illness, and is ‘humanely killed’ with a lethal dose of morphine, then is this person relieved? Answer is: no. A person who exists is defined by many including Descartes: a person who is aware of their existence - “I think therefore I am”. If this is the case, than a dead person is non-existent. Then a non-existent person is NOT relieved of pain/suffering, since to be ‘relieved’, one must be existent.

Politics - Law of Death, does it make sense?

“It is the mark of an educated mind to be able to entertain a thought without accepting it.”

- Aristotle

We as individuals give up our rights to the law, so that the law can gain power.

When we give up our rights, I mean that we follow the law. We choose to follow the law, and through this we give power to the law.

Through this power, the law over sees us.

When the law over sees us, I mean that the consequences we receive was originally powered by us, when we gave up those rights to follow them. Sources: Nichomachean Ethics/The Leviathan

In order to investigate this further, I will make a parallel with the individual soul and the United States (similar to what Plato does in The Republic).

The activities of large group of people is similar to our own activities, kind of like a blown up version of it.

If the US allows for Capital Punishment, it means that the individual people who gave up the rights to follow law, allow for this punishment to occur. In this sense, a person who receives the punishment is actually getting the punishment from themselves; almost suicidal in a sense. This may seem quite outlandish and ambiguous, so allow me to clarify.

When a group of people are in a room and must collectively complete a task, there is a power shift.

Instead of each individual doing things on their own, a person is put in charge through the rest of the people allowing for the person to make orders.

The stronger is not that person in charge, it is the equivalent between the individuals and the person put in charge. The law should therefore be for the good for the individuals. The power that we give up goes to the government which holds us down. It is a self-limitation to keep ourselves “stable”.

A person who commits a crime as bad enough to relieve capital punishment (as judged by the society) is therefore inflicting this upon himself.

Now, let us apply capital punishment to this scenario.

The core of the paradox

If a person by law is to be terminated, then it is just as unfortunate as a medical scenario. The only difference is that instead of a medical condition that terminates the patient, the law of society inflicts the patient. Therefore, should a doctor be allowed to perform the execution of a convict?

In Plato’s REPUBLIC, it says that the guardian of a city has the greatest potential to betray the city. In this same sense, the hand that heals has the potential to do the greatest harm.

The AMA (American Medical Association) states in article 2.06 that no physician should participate in such acts of execution.

Capital Punishment is wrong in the first place, because it is overall suicide on a larger scale. The people ALLOW for Capital Punishment in this society! In this society, we the individuals have hold the majority of the power! And in this society, is it wrong for a physician to aid in the death of a terminal patient? If that is wrong, then it SHOULD be wrong to aid in execution. However, this is not the case.

Running in between - my view

Physicians do not kill the patients, they comfort them through an misfortune. Is this still considered harm?

In my experience, I’ve concluded that there are certain requirements that should be met, before a person ‘executed’.

- person should have a terminal illness/inevitable death (not to be interpreted as: all people die)

- person should be genuinely willing

- person should be mentally stable

Now, it may seem that I am contradicting myself when I say suicide does not relieve. However, capital punishment and terminal illnesses are NOT suicide for the individual affected. It is a type of suicide to have capital punishment within our system. But these are misfortunes; they did not occur by choice, but through life. I may agree with you that comforting does not relieve the patient of pain, but in weighing the accumulated ethics/law, I find that although decisions I make may be wrong, at least a decision is made.

Sources : Atul Gawande, Stephen Trombley, AMA, Stephen Mile

www.deathpenaltyinfo.org/executions.php

The fork: Medical Treatment and Insurance

Simple Truth

So this is basically how the system currently works.

We enter the hospital/doc’s office.

We either have insurance or not.

If we have insurance, insurance companies find reason to reject about 30% of patients.

If we don’t have insurance, the doc asks us to pay out of our own pocket.

Usually, most doctors (because they came into med to ‘help people’) dislike taking money from the poor, so they charge the bare minimum and do not profit at all. (Unless your well-off, they probably do charge you in full)

Therefore, doctors mostly get money from insurance companies.

Jumbled Numbers

Insurance companies are a business unlike a doctor who runs both a business and patient care.

If about 15% of American are uninsured, that means of the 30% of the 85% who are insured are not actually insured. This totals to about 35.5% of American are not actually insured. Which means about 1 in 3 people who come into the hospital are not insured/ or not getting money from the insurance companies.

Ridiculous, I know.

In order for a well-run doctor office to run properly (make actual profit), they fight the insurance companies to make that 30% into about 15%. And that is precisely where doctors make money.

NOT through ordering more tests than necessary or treatments that are not needed, but through fighting the insurance companies. Yes, there may be an extreme few who do actually do what the myth says, but doctors are educated individuals with ethics. In addition, a doctor gets sued once in about 6 years - where 70% are either dropped or lost and if won, the pay out on average is over $500,000. A kind of paradoxical thing the medical law suits in the US do: protect the patients from aggressive doctors and also hurt patients who weren’t looked at properly because of the protocols, laws, and fear of getting sued. I guess in the end, it basically comes down to: the rich get better health care than the poor.

The Paradox

In 2005, the United States spent more than 2 TRILLION dollars on health care. This is by the way 1/6th of the money we have in our piggy bank. with approx. 280 million people, that breaks down to about $7000 per person. Of the 2 trillion dollars, 80% is split between insurance companies and government. The rest come out of the people’s pockets (the 35.5% who are not actually insured). Wow, we pay $7000 per year on health care (through tax) that one in three people don’t receive. That makes me feel great, I’m helping fight other people’s diseases!

Works Cited:

Atul Gawande, David Studdert, Michelle Mello, William Hsaio, William Weeks, Jack Hadley

www.cms.hhs.gov/nationalhealthexpenddata

www.reformmonitor.org

More information on cited works will be sent upon request.

Laziness (I know, academically frowned upon)

Feel Free to Leave any comments/criticisms!

The fork in this scenario is between: Devastated Families and Innocent Doctors

The Reality of the Boston Massacre - a preview of a flawed system

On the icy evening of March 5, 1770, a lone guard reinforced by eight British soldiers stood against several hundred bitter men spitting, cursing, and throwing chunks of stone. We all know what happens. Five men are shot as the soldiers open fire. Paul Revere distributes a print about the killing as a “bloody butchery” portraying the scene as a slaughter of the innocent and “The Boston Massacre” is forever embedded in the public’s eyes. The following day, John Adams is called to court to defend the soldiers. Although no one else accepted the offer, Adams takes the case in the belief “that no man in a free country should be denied the right to counsel and a fair trial” (McCullough 66). And so, Captain Preston, the captain who was accused of giving the order to fire into the crowd, was found not guilty. Adams had a much closer study on the incidence, and was convinced that the soldiers were not guilty.

“The tragedy was not brought on by the soldiers, but by the mob, and the mob, it must be understood, was the inevitable result of the flawed policy of quartering troops in a city on the pretext of keeping peace” (McCullough 67).

I bring this historic reference up for the following reason: in a flawed system, the people (mob) react to their situation, mainly, the unfair taxing system. The reaction of the people caused the innocent (refering to both the soldiers and the victims of the shooting) to suffer.

We’ve all heard about history repeating itself. Whenever there is a flawed system, the innocent suffer. In today’s medical society, we find innocent people suffer as well: innocent doctors and devastated families.

The “modern” system

The United States supposedly has one of the best governing systems in the world. And we always look at the past to see how far along we’ve come; and the way the so called “modern day America” is used makes it seem like we have it good. However the truth is: its a mess. Among the mess of things, there is the United States Malpractice System.

Medical Malpractice as defined on law.com:

“A physician’s deviation from the applicable standard of care that a similar physician would exercise under the same circumstances.”

Usually, the average doctor gets sued every six years. Depending on the risk of your practice - such as neurosurgeons and obstetricians - get sued more often. Seventy percent of the lawsuits are dropped by the plaintiff or won by the doctor. If the doctor loses, then the pay out is over half a million dollars. Average surgeon pays about 30,000 to 300,000 dollars for malpractice-insurance premiums depending the litigation climate.

The way lawyers choose clients, are through the damages done. The greater the damages, the greater the payout. Even if there are no direct connections involved, indirect ones can be used against the physician.This being said, despite people calling about suing physicians, the only ones that make it through are ones with heavy damages. Many malpractice lawyers gets ridiculous calls, however those are usually turned away.

Negligence (again, defined by law.com) is the term used to describe mistakes that could have been avoided.

“failure to exercise the care toward others which a reasonable or prudent person would do in the circumstances, or taking action which such a reasonable person would not.”

In one way, this is considered a good thing since it keeps the physician on his feet. However, this definition of negligence makes a doctors life even harder. A Physician performs thousands of delicate procedures and deals with unclear test results and to not cause a complication is just not possible. The lawyer’s perspective is more like this: you could have a perfect driving record, but if you run a red light and cause an accident, you are negligent.

The only thing that the malpractice system has done is that people can receive compensation for a devastating mistake in a civilized manner, unlike other foreign countries where hospitals deal with rioting families. Even still, many malpractice lawsuits have not successfully given families satisfactory compensation; and only leave both sides bitter. Half of the US states have enacted caps on the amount of money that can be compensated by the doctors to make sure that malpractice premiums can still be afforded by physicians.

Conclusion

If the Justice system in the United States truly does work, then it will protect the innocent and punish the violators. However, all doctors not only go through lawsuits but they also pay thousands of dollars for malpractice premiums. Families that DO suffer either get their case turned away by lawyers or lost in court.

Perhaps a day like the Boston Massacre will occur and hopefully, a person like John Adams will shed enough light on the matter so that we can all see: we need change.

Citations:

Atul Gawande, David Studdert, Michelle Mello, Troy Brennan, D. Ridgway

More Information will be sent upon request.

Feel free to leave comments!