Life And Death Moral Scenario

[tinytherese]

This is a question I have to answer in my philosophy class for homework at a non-Catholic community college.

"You and a group of friends are in the woods when your friend Benny slips and falls off a cliff. Benny is badly hurt: his head is bleeding profusely and he is unconscious. Fortunately, Brad, Steve, and Tammy know how to get him into the truck without doing more damage. They are now prepared to drive Benny to the hospital. Before she takes off, however, Tammy says the following:

'We'll get Bennyn to the hospital, but those of you left here have an important decision to make. Benny has no insurance. In last week's [i]USA Today,[/i] an undercover team of investigators reported that because of costs, emergency patients without insurance often don't get the best care available. Since Steve has an insurance card, we are considering admitting Benny on it. The card doesn't have Steve's picture, so there is no way the hospital will know Benny isn't Steve before they treat him, and it is quite possible they will never know of the deception. Using the card could be the difference between Benny living and dying, but it is also insurance fraud, which is, of course, illegal. We don't know what to do, so we are going to leave the decision to you all. Talk about it with each other for about twenty minutes. Then vote on it."


Now I know that the ends do not justify the means, just as the Catechism says, but what else can I say about this? Can anyone think of any alternatives to the deception proposed?

[CatherineM]

You can pre-pay some money on a credit card. You could take him to the nearest charity hospital or medical school hospital. You can also immediately demand the hospital's patient advocate. Having someone standing there watching, and demanding they treat their friend can also go a long way.

There is more than just financial issues involved in pretending to be someone else in a hospital. For example, if Benny is allergic to penicillin, but Steve's medical records say that he isn't, they might give it to Benny without asking, and not know that it might kill him. It could also really mess up Steve in the future. What happens if Benny maxes out his yearly limit, and Steve finds out two weeks later that he has cancer and needs expensive treatment.

[jeffpugh]

You are faced with no right answer. It is choosing the lesser of evils. I believe we'd place the sacredness of life over the law of the land, no? As for citing that, I cannot.

[jeffpugh]

[quote name='CatherineM' date='14 July 2010 - 06:00 PM' timestamp='1279144841' post='2142725']
You can pre-pay some money on a credit card. You could take him to the nearest charity hospital or medical school hospital. You can also immediately demand the hospital's patient advocate. Having someone standing there watching, and demanding they treat their friend can also go a long way.

There is more than just financial issues involved in pretending to be someone else in a hospital. For example, if Benny is allergic to penicillin, but Steve's medical records say that he isn't, they might give it to Benny without asking, and not know that it might kill him. It could also really mess up Steve in the future. What happens if Benny maxes out his yearly limit, and Steve finds out two weeks later that he has cancer and needs expensive treatment.
[/quote]
D'oh. You posted before me. I like how you nitpick this question, because the situation is never so cut-and-dry. Unfortunately, I'm at a loss of how to deal with this because I have no understanding of American medical practice and payment issues.

[Sternhauser]

I don't know of any hospital in America that will turn away someone who is so badly injured. Nearly every hospital will work out a payment plan.

~Sternhauser

[Ziggamafu]

[quote name='Sternhauser' date='14 July 2010 - 08:03 PM' timestamp='1279152214' post='2142772']
I don't know of any hospital in America that will turn away someone who is so badly injured. Nearly every hospital will work out a payment plan.

~Sternhauser
[/quote]

A payment plan that is outrageous, sure. I once spent 3.5 hours waiting in an ER room for a doctor to prescribe something simple. I did get an IV. I don't think an IV and 3 minutes of time with a doctor was worth the over THREE THOUSAND DOLLARS THAT I WAS BILLED.

Medical costs bankrupt America. Every day there are people forced to choose between probable disability (or death) and bankrupting their family.

[MissScripture]

[quote name='Sternhauser' date='14 July 2010 - 08:03 PM' timestamp='1279152214' post='2142772']
I don't know of any hospital in America that will turn away someone who is so badly injured. Nearly every hospital will work out a payment plan.

~Sternhauser
[/quote]
I *think* legally they have to accept the patient and figure out how to deal with it later. It's not exactly uncommon for people not to pay what they owe when they do not have insurance (which is one reason people argue for mandatory insurance). And I know that a lot of hospitals have foundations set up to help patients pay for the care if they cannot afford it, so that they do not need to go without treatment.

Also, I know that because of insurance fraud and medical identity theft, many places now scan a driver's license with the insurance card, so that might not work out so well, anyway...

And like CatherineM said, Steve's medical file would be different than Benny's, plus this would all end up in Steve's medical file and NOT Benny's so say Benny ends up needing some sort of metal implant, and then in the future, needs an MRI, but the metal implant isn't in his file...well, that could end really badly.
And would Benny want Steve to then have access to all of his medical records from this episode of care?
And how long do the friends really think they could keep up the charade of calling Benny "Steve" before they screwed up, got caught and all ended up in major trouble? What about Benny's family? They'd need to be told about him, and told what was going on with the fraud. Would they go along with it? Just logistically, I think it would be too complicated to try to work out. It just doesn't sound like a good idea all around.

I'd say Benny's friends would be better off using their time to figure out how to organize a fundrasier to help Benny pay for these medical bills!

[CatherineM]

What happens if Benny dies? Steve would have to go through a bunch of carp to get himself "undeaded" in the eyes of the bureaucracy.

[Sternhauser]

[quote name='Ziggamafu' date='14 July 2010 - 07:13 PM' timestamp='1279152819' post='2142778']
A payment plan that is outrageous, sure. I once spent 3.5 hours waiting in an ER room for a doctor to prescribe something simple. I did get an IV. I don't think an IV and 3 minutes of time with a doctor was worth the over THREE THOUSAND DOLLARS THAT I WAS BILLED.

Medical costs bankrupt America. Every day there are people forced to choose between probable disability (or death) and bankrupting their family.
[/quote]

I wonder why veterinary care is so much cheaper, and they perform many of the same procedures. Except that I don't wonder.

~Sternhauser

[Winchester]

At it's heart, this is a question about whether it's permissible to lie to preserve human life. It is permissible, and I would do it in many circumstances.

The more complex issue is this: Your health insurance is a sort of contract. You pay for your policy. If you break that contract, then you're in the wrong. I might do it to save a friend: that wouldn't make it right.

The reality is that emergency rooms in the US don't work like that. They are legally obligated to stabilize the patient and after years of seeing them do that for people in all walks of life, I know that they go to extraordinary means regardless of ability to pay. I've seen very rich people called minutes after being brought in and very poor people taken from shock rooms to surgery.

[cmotherofpirl]

[quote name='tinytherese' date='14 July 2010 - 06:39 PM' timestamp='1279143597' post='2142718']
This is a question I have to answer in my philosophy class for homework at a non-Catholic community college.

"You and a group of friends are in the woods when your friend Benny slips and falls off a cliff. Benny is badly hurt: his head is bleeding profusely and he is unconscious. Fortunately, Brad, Steve, and Tammy know how to get him into the truck without doing more damage. They are now prepared to drive Benny to the hospital. Before she takes off, however, Tammy says the following:

'We'll get Bennyn to the hospital, but those of you left here have an important decision to make. Benny has no insurance. In last week's [i]USA Today,[/i] an undercover team of investigators reported that because of costs, emergency patients without insurance often don't get the best care available. Since Steve has an insurance card, we are considering admitting Benny on it. The card doesn't have Steve's picture, so there is no way the hospital will know Benny isn't Steve before they treat him, and it is quite possible they will never know of the deception. Using the card could be the difference between Benny living and dying, but it is also insurance fraud, which is, of course, illegal. We don't know what to do, so we are going to leave the decision to you all. Talk about it with each other for about twenty minutes. Then vote on it."


Now I know that the ends do not justify the means, just as the Catechism says, but what else can I say about this? Can anyone think of any alternatives to the deception proposed?
[/quote]The scenerio is a false one. In the US hospitals are required to stabilize a patient and cannot turn away someone badly injured. Committing this crime will make no difference to his initial treatment and may kill him for the reasons Catherine listed. It may also bar him from further medical treatment there because of the fraud.

[CatherineM]

I think what is truly telling, is that this assignment shows the ingrained thinking of many, especially in liberal bastions such as universities, about how our health care system works. The "inbetween the lines" lesson your professor is trying to teach is that we have a choice between Obamacare or death.

[tinytherese]

Thanks everyone. We're going to act this out in class today and take a vote on what to do. This will be interesting.

[jeffpugh]

[quote name='tinytherese' date='15 July 2010 - 12:28 PM' timestamp='1279211337' post='2142987']
Thanks everyone. We're going to act this out in class today and take a vote on what to do. This will be interesting.
[/quote]
Oh dear, miss. Tell us how it goes.

[Nihil Obstat]

I was just thinking of something. As Catholics, don't we consider *access to* healthcare a human right? (I don't read the word "free" into that as some people like to do, but just simple access to services.)

If access to healthcare is a right, and a law prevents access to healthcare for someone, then that law can be ignored without sin. Am I right?

[SaintOfVirtue]

They could go to the ER. In the ER they basically "shoot first ask questions about finances later"

[SaintOfVirtue]

[quote name='Nihil Obstat' date='15 July 2010 - 02:37 PM' timestamp='1279229850' post='2143109']
I was just thinking of something. As Catholics, don't we consider *access to* healthcare a human right? (I don't read the word "free" into that as some people like to do, but just simple access to services.)

If access to healthcare is a right, and a law prevents access to healthcare for someone, then that law can be ignored without sin. Am I right?
[/quote]

People can never agree on what qualifies as "healthcare" either; it is quite an ambiguous statement.

[Nihil Obstat]

[quote name='SaintOfVirtue' date='15 July 2010 - 05:41 PM' timestamp='1279233719' post='2143152']
People can never agree on what qualifies as "healthcare" either; it is quite an ambiguous statement.
[/quote]
So true.

However, emergency medicine to save someone's life should qualify across the board, right?

[Sternhauser]

[quote name='Winchester' date='15 July 2010 - 08:44 AM' timestamp='1279201495' post='2142935']
At it's heart, this is a question about whether it's permissible to lie to preserve human life. It is permissible, and I would do it in many circumstances.
[/quote]

What does "permissible" mean? Does that mean that an act that is intrinsically evil, and thus a sin, is sometimes not evil? Or is evil sometimes permissible?

~Sternhauser

Edited July 15, 2010 by Sternhauser

[Slappo]

I honestly don't think you can morally lie and put the one person on the others health insurance.

Principle of double effect includes that the evil must come at the same time as the good or be an effect of the good, not the good an effect of the evil.

This lie is not like hiding a jew from the nazi's as that is information being asked that someone does not have the right to. This is blatant lying. "Yes I have health insurance, and this is my card."

It is only [b]possible[/b] that a good effect will come from the evil lie. It could be that the hospital would have treated him with or without insurance. It could also be that although the hospital treats him he still dies. It could also be that even with insurance he has to wait for an hour and during that hour he dies or reaches a point of no return.

We have a right to health care, but we do not have a right to lie to receive that health care.