Who Says You're Dead? (Jacob Appel)
OVERVIEW
“Who Says You’re Dead?” by psychiatrist and bioethicist Jacob Appel, presents a list of 79 medical and ethical dilemmas to ponder, many of them relating to death. It’s like 79 trolley problems… but in a hospital. The goal of the book is simple: to “convey the intellectual pleasure of engaging with complex ethical questions.”
Here were some of my favourite questions:
· Should inmates on death row be given organ transplants if they need them? Should death row inmates be allowed to donate organs immediately prior to their lethal injection? Should there be an incentive for doing so, or would this constitute state coercion?
· Laurie’s grandfather has terminal heart failure and has been on a ventilator for months, unconscious. She wants to take him off the ventilator. But what if her motive is that the tax codes are due to change in a few weeks, and after that time half of her grandfather’s fortune will be inherited by her great uncle (instead of her)? Further, what if her grandfather hadn’t wanted to be kept alive on a ventilator – would her motive matter then?
· Daniel, a conjoined twin, petitions a court for surgery to separate him from his twin brother, Ezekiel; the surgery carries a 30% risk that one of the twins will die, and Ezekiel objects to the surgery. What should the court decide?
· During a shortage of ventilators, should long-term ventilator patients be taken off them, and those ventilators given to those with acute illness who have a very good chance of surviving?
· Does a physician’s ethical duty to preserve confidentiality extend beyond death? If a patient died of AIDS but never wanted their family to know their diagnosis, should the physician conceal this information?
· Should euthanasia be allowed for minors who can’t consent? (e.g., babies with severe genetic abnormalities who won’t live more than a few months)
· There is a mix-up at the morgue: a corpse meant for cremation is instead embalmed and donated to the local medical school for their anatomy course. The error is discovered three months after the dissection. Should the morgue inform the family? The truth would cause the family psychological harm with no benefit. Is it unethical to withhold the truth?
WHAT NOW? (actions for mortal atheists)
No recommended actions (this book was just a fun stretch for the brain)
IN SUM:
Is this book entirely secular? Hard to say – many of the scenarios do involve religious belief (in fact many of them wouldn’t even be dilemmas if it weren’t for the religious beliefs of the patients/families), but because these are just thought experiments, I’m not sure how seriously you need to take that into account.
If you had to describe the book in one sentence? Brain teasers for the amateur bioethicist.
Who should read this book? Those who loved the above examples.