TUSHAR SHEKHAR

(GMITE09184)

Assignment
For

Ethics in Decision Making

Assignment for Ethics in Decision Making by Tushar

Shekhar/GMITE09184/tushar.shekhar@gmail.com

1 What was the dilemma

When my father suffered from a severe brain stroke and slipped into coma at a
small town government medical college, it was implied by the doctor that we take
him out of ICU in the interest of other patients.
What action to take to satisfy my sense of duties, my families concerns and the
matter of life and death was one probably the biggest dilemma of my life.

2 Brief Background and Issues

My parents were travelling on a vacation to Alleppey, a small tourist destination in
Kerala, when my father suffered a massive hemorrhage. He was rushed to the local
government medical college where a scan showed massive blood clot and put him
on life support in ICU.
When we reached the hospital, the doctors said that his situation was not going to
improve and implied that he be shifter out of ICU and that bed be given to another
patient.
We needed to decide what to do next under the circumstances.

3 Options, Dilemma and Ethical Issues

The following were the options available to us:
a) Overrule the suggestions given by the doctor and let my father continue on
life support till the time even that was not sufficient to sustain his life.
b) Allow the doctors to shift him to the General Ward and await his demise
c) Take him to another better facility or hospital at the risk of losing him during
the transit. Since the bleeding was massive, movement could significantly
endanger his life
The issue was very emotional and sensitive. The person most affected, my mother,
was not in a position to advice or analyze. Though there were other relatives
present as well, but the final decision was to be taken by me and my wife.
The dilemmas involved were:
a) Should we have any say in deciding anyones life span
b) Should we take our actions as our action or actions imposed upon us by God.
Assignment for Ethics in Decision Making by Tushar
Shekhar/GMITE09184/tushar.shekhar@gmail.com

c) Is it selfish for us to extend a persons suffering to satisfy our emotional need

of keeping him alive even when he cannot feel, or at cannot communicate to
us that he can feel, us.
d) Or is it selfish for us to possibly deprive a genuine patient of a scarce ICU
bed.
e) When doctors say that his chance of survival is almost nil, do we trust the
doctors experience and judgment or suspect their intentions.

4 Analysis
of
Various
Options
in
the
light
of
Environmental and Situational issues and their Effects
Option 1) Overrule the suggestions given by the doctor and let my father
continue on life support till the time even that was not sufficient to sustain his
life.
Effects:
1.1) Another patient with a chance of improvement could potentially be
denied an ICU bed, leading us to indirectly become a party in loss of life.
1.2) It would not burden us with the guilt of being a party in hastening the
process of my fathers death.
1.3) Doctors might anyways withdraw his life support without it being
evident or visible. The practice is highly controversial, but it is known to
happen in government establishment where there is a scarcity of beds.

Option 2) Allow the doctors to shift him to the General Ward and await his
departure
Effects:
2.1) We would probably cut short his life span.
2.2) We would deny a chance of Miracle where he could probably come back
to life.
2.3) Probably inflict emotional trauma on my Mother, who could think of it as
relinquishing my duties towards my parents.
Option 3) Take him to another better facility or hospital at the risk of losing him
during the transit

Assignment for Ethics in Decision Making by Tushar

Shekhar/GMITE09184/tushar.shekhar@gmail.com

Effects:
3.1)There was Amrita Institute in Kochi, around 60 KMs away where there are
better facilities.
3.2)Allow better facility and tests.
3.3) Given massive bleeding in the brain, moving him could endanger his life
even further and he may not be able to reach the new hospital at all.
3.4) It would give us a satisfaction that we did something that rather than
wait and watch
3.5) It would give our mother satisfaction that our family was able and
capable of taking care of a situation and discharging our duties.

5 Values and weightages

I am more of a Deontolist, believe in doing my duty and leave the result on fate or
god almighty.
My Values in Conflict under this situation are:
a)
b)
c)
d)

My duty towards my father (Keeping him alive and pain free)

My duty towards my society(Not being selfish by occupying an ICU bed)
My belief that God solely has the right to decide the matters of life and death
Not believing in Luck, believing in doing my duty and facing the
consequences.

The Theory of Justice and Theory of Rights came into play in points (a) and
(b) above. However, it was relatively easy for me to resolve since the weightage I
assign to my father is always more than that I assign to society, as long as it is
legal.
I assign (d) much more weightage, rubbishing any excuse of Luck. Also, most of
the times (c) and (d) would not conflict. However, in this case, the points (c) and (d)
above were in direct conflict and it was much difficult to resolve.

6 Initial approach or solution and final decision

Sunshine Principle would not work here since the matters were very private to
the family.
Ethical Workflow also would not apply since not everyone would think logically
and even asking the question or judging the answers was impossible or impractical.

Assignment for Ethics in Decision Making by Tushar

Shekhar/GMITE09184/tushar.shekhar@gmail.com

Initial Approach : Tell the doctors that matters of life and death are not for us to
decide and leave it upto them to take decision.
However, I soon realized that the doctors would themselves not take the decision
themselves, knowing that we have a doctor in our family and would exercise all the
precautions of ethics and ask us for explicit consent and actions.
Shifting of Weightage: Ultimately, I assigned the maximum weightage to (d) : Not
believing in Luck, believing in doing my duty and facing the consequences.
After some introspection, I also made myself understand that God will make
someone the medium of his actions, and if I were to endanger my fathers life due
to my actions, it would ultimately be according to Gods wish. In a way it was the
Ethical Rationalization that took place.
Final Decision:
Final Decision was to call up Amrita Institute at Kochi that was 60 KMs away,
secure an ICU bed at that hospital and transport my father in an ICU ambulance.
He made it alive and stable to the new hospital and more advance tests were
conducted at the new hospital. It was scientifically established that he is brain dead
and there was no chance of his recovery. He received terminal nursing care and
passed away in peaceful environment.

7 Any Controversy Arising out of the Decision

None.

8 Was the Decision Just and Fair

There were more ICU beds available at the Amrita Hospital at Kochi, but scarce ICU
bed was released for more needy patient at Alleppey. If we consider other patients,
the Decision was Just & Fair in Retrospect.
We cannot say if the decision was Just & Fair to the other recipient my Father.

9 Did it maximize benefits

The situation was to minimize the loss or the impact of the impending loss. The
Decision Minimized the Loss.

Assignment for Ethics in Decision Making by Tushar

Shekhar/GMITE09184/tushar.shekhar@gmail.com

9.1 What was the cost

The cost was the anxiety suffered while transferring him from one hospital to
another.

9.2 Who did it affect adversely

The affect was transitory and there was no permanent adverse effect of the decision
taken. The loss of life was unpreventable, so that adverse effect is not taken into
consideration.

10 Did it ultimately give the desired result

Yes, the desired result was to make sure that everything possible has been done to
save and lengthen his life.

11 Did you feel satisfied

Yes. Though my fathers early death has scarred my life, I am satisfied that I
performed my duties as a son and as a citizen of society.

12 In retrospect, would you have done the same thing

again or would you do it differently in hindsight
Given similar situation, I would take similar decisions.

Assignment for Ethics in Decision Making by Tushar

Shekhar/GMITE09184/tushar.shekhar@gmail.com