Academic journal article The Hastings Center Report

Commentary

Academic journal article The Hastings Center Report

Commentary

Article excerpt

Familiar modes of ethical argumentation involve a way of reading a text that can obscure or mute morally rich and relevant features. One way of making moral sense of a story is to read it shrewdly, fleshing out ethically significant details that not only make it more intelligible but also permit ethical justification of a seemingly dubious action. Such a reading can provide the proper context for resisting the conclusion that Dr. H and the cardiologist have acted wrongly.

A crucial detail in this story is that Dr. H is not Mr. G's physician but his brother-in-law. Moreover, the two men have been intimate friends for most of their lives. They are bound closely by ties of affection, marriage, proximity (until very recently), and a long shared history--ties that bind their families as well. This detail has moral implications: people who live in loving intimacy have claims on one another that go beyond the claims of friends, casual acquaintances, or strangers. One's right to one's own money is tempered, for instance, by one's spouse's and children's claims on it. So too one's right to privacy is tempered. We would think it very odd indeed if, for example, Mrs. G were to go out of town on business but said nothing about it to her husband; we would think that their marriage was no longer intimate.

It might be objected that although intimacy is an important feature of the story, so is the fact that Dr. H is a doctor. He is bidden to obey a special set of rules, imposed by the profession for the excellent reason that they preserve trust between doctor and patient. But an analysis governed solely by rules of confidentiality fails to see that Mr. G is not Dr. H's patient, nor are they merely relatives: Mr. G called his brother-in-law, not to consult him professionally, but because Dr. H could translate into lay terms what Mr. G's illness means for him.

What does it mean? To see the illness properly we must go back four years, to the time when Mr. G had a serious heart attack. When we flesh out the details of that episode we see that for the first time in his life, perhaps, and so suddenly that it left him unprepared, he had no choice but to confront the fact of his mortality. We may also suppose that, like many men of his generation, he found it difficult to talk about his fears. So he put a smooth face on them, and when he got better he carefully avoided the subject of his health. …

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