A seaman was seriously injured while getting his physical fitness training late in the afternoon. The weight fell on his foot and broke some bones. The level of diagnosis on the ship would not be enough for his predicament – he would only have to be sedated. He needed an emergency medical evacuation to an aircraft carrier where he would receive the needed care. However, there were obstacles to this evacuation. The ship was an old one and could not land helicopters. This meant that the injured seaman would have to be hoisted to a hovering helicopter. The seaman had never flown in a helicopter before, not to mention that he had never received training pertaining to emergency egress procedures or being lifted into a flying helicopter. The aircraft carrier was significantly far away and there was a likelihood of darkness setting in before completion of the mission – which in all aspects was unscheduled. On the other hand, it was anticipated that flying the following day or the day after would almost be impossible due to the expected weather conditions. Darkness was setting in and time was running out. A decision had to be made quickly. The ship’s commanding officer was faced with a dilemma.
As the ship’s CO, I would decide that the seaman to be sedated at the ship until the weather conditions were favorable for flying. Although there was a high likelihood that his condition might exacerbate and there was a risk of neurogenic shock due to pain, holding off the evacuation would be the best and most objective decision given the prevailing circumstances. Twilight was approaching and there was no guarantee that the evacuation operation would be completed before darkness. The fact that the injured seaman had no prior training or experience in being hoisted into a flying plane coupled with his injury would further complicate the operation. More time would be required to safely and hoist him without causing more injury or pain, time that we do not have. The ship could not land a helicopter and the evacuating helicopter would have to be sent from the carrier ship which was far away. Making two trips between the ships also required time. All preliminary evaluation of the situation pointed out to the possibility of flying in the darkness marred with bad weather.
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On the other hand, there was no clear timeframe for when the weather would be favorable for flying. The injured seaman would only have to be sedated and given the best possible care on the ship awaiting the evacuation. Even though the injured seaman is one of the ship’s crew whose life, service and contribution are as important as the others’, emotions for his pain and suffering would obscure objectivity in the situation. Humanity would advocate for the prompt evacuation of the injured seaman. However, that decision would be jeopardizing other crew members, the flight crew, and the injured seaman. Either decision to be made would have adverse risks and affects some parties involved. Objectivity in the decision making requires assessing the situation and choosing the option with the least risks to self and others. According to Johnson (2017), professional and legal ethical codes require those vested with the responsibility of making a decision should make the choices that least put their subjects, subordinate or colleagues in harm’s way.
The helicopter flight crew would benefit from the decision because the risk of flying in the darkness and bad weather would have been averted. The injured seaman would not benefit from the decision because his predicament would not be attended to for another couple of hours or even days. Sedation would only curtail his sensitivity to pain, but healing required complete specialized treatment and care. Delaying his access to the medical intervention would only make the injury worse.
Medical codes of ethics take a humanistic approach, where attention to an immediate harm, injury or condition is emphasized. The codes advocate for benevolence over objectivity, provided that the pressing situation is attended to – in this case, the injured seaman. According to O’neill’s analysis of Ayn Rand’s philosophy (2015), objectivity in decision making, however, takes a more “selfish” approach. The overall gains and benefits are evaluated, and decisions made are devoid of emotional or moral obligations.
References
O'neill, W. F. (2015). With charity toward none: An analysis of Ayn Rand's philosophy . Open Road Media.
Davies, A. (2017). Ethics, professionalism, rights, and codes. Language testing and assessment , 397-415.
Johnson, C. E. (2017). Meeting the ethical challenges of leadership: Casting light or shadow . Sage Publications.
