“I am done. I am over,” says Bob before failing back to the pillow with quiet momentum.
“It’s like he is rushing down a river, and we have nothing we can do to slow him down,” says his daughter. Her voice is strong and carries the pain of her words in a no nonsense way, like it is not a burden at all. They are both strong like this, a family trait, and their strength fills the room. It almost vibrates with the effort.
Professionally when “Ethics” is mentioned it is usually in fairly specific ways. In a health care context Ethics is often associated with particular areas of question or conflict. Ethics is the process that we have to satisfy to be able to do the research that we think is indicated. My decision about whether Mr Smith has the “right” and the “capacity” to be able to make a particular decision is an ethical one. I use words like “autonomy” and “justice” to explain the reason why Mrs Tran should be offered a treatment. Our clinical teams have policies about our duty to provide ethical care for violently confused patients. We debate about issues like euthanasia on grounds that we describe as ethics focused on the rights and wrongs of changing our current clinical approach. Each of these are complex questions and the fact that they are so divisive demonstrates to us the difficulty (or even impossibility) of determining a path forward that satisfies everyone. Sometimes I wonder if it is for this reason that Ethics seems like such a frustrating topic. Why spend time thinking and talking about Ethics when the only thing we can be confident about is that someone’s answer is always going to be, “I disagree”?
Now, which way to choose?