Friday, December 08, 2006

Random Analogy I

The patient presents at the emergency department with severe, sharp abdominal pain, lower-right quadrant, and fever. The attending diagnoses acute appendicitis and orders immediate surgery to prevent the appendix from bursting and causing sepsis.

The family of the patient insists on watching the surgery from the upper gallery. As the surgeon cuts into the skin and abdominal wall, the blood starts to flow, and the family becomes hysterical. "What are you doing? His skin isn't the problem? Look at all that blood! He wasn't bleeding before we brought him in! You are hurting him! Whatever happened to 'first, do no harm'?"

While the patient is in recovery, the family freaks out over the wound. It most certainly wasn't there before. In the meantime, the patient contracts MRSA, the antibiotic-resistant "hospital infection."

"If we hadn't come to the hospital for this surgery, our loved one wouldn't have been cut open and contracted that awful infection," they rage, and conclude that doctors are malicious and hospitals are death traps. They cart the patient back home and refuse all further treatment.

The patient dies.

On whom should we blame this death? On the appendectomy or on the discontinuation of treatment?

Corrolary:

The family of the patient already believes that doctors are malicious and that hospitals are death traps, and holds as an Absolute Moral Value that it is always wrong to cut into someone. So when their loved one comes down with the acute appendicitis attack, they stay home and hope it is just bad gastritis.

The patient dies of sepsis after the appendix bursts.

Was the family correct to uphold that Absolute Moral Value ?
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