Starship health crisis sets stage for ethical debate
Starship health crisis sets stage for ethical debate
The patient the health care staff is viewing on the television screen is hit by a support beam at work, and it leaves him paralyzed from the waist down.
Coming from a culture with strong masculine tendencies, the patient decides he wants to take his life rather than live as a paraplegic who is more dependent on others.
A maverick physician offers him a slim chance to live and walk again through an experimental surgery that is untried on humans. But the patient's primary doctor, who is in charge of that particular hospital setting, objects, arguing that the surgery would needlessly risk the man's life. Meanwhile, the patient says he will kill himself if his only choice is to live without use of his legs.
Could this be the sort of ethical dilemma faced by health care professionals anywhere?
Not exactly. The patient in question is a Klingon, whose culture decrees he must kill himself if he is not whole physically. And the experimental surgery is only experimental for a 24th century starship, which is where it takes place. The hour-long episode, titled "Ethics," is from the syndicated television series of "Star Trek: The Next Generation."
Mary Robert, RN, C, director of education for Mercy Medical in Daphne, AL, showed her staff the television show to give them a launching base for a discussion on medical ethics and cultural considerations.
Mercy Medical is a Catholic-run health care organization that has facilities for acute rehabilitation, long-term care, hospice, home health, and residential care, including 157 inpatient beds and 120 assisted-living units.
"It was a lot easier for the staff to talk about a different culture in terms of Klingons rather than offending people by talking about black culture or Hispanic culture or any others," Robert says.
"Because people are so familiar with Star Trek, they could identify with those folks, even though they could separate themselves from the characters and know they’re not real," she adds.
Put yourself in their shoes
While the Star Trek episode was playing, Robert occasionally stopped the video to ask the staff to discuss how they would handle a particular ethical question.
"We divided the staff into small groups, and each group took the part of someone in the show," Robert explains.
When Robert stopped the tape, she’d ask each group to talk about the ethical problems facing each character up to that point.
"In the end, the Klingon decides to have the experimental surgery, and everything is going great until all of a sudden, it falls apart and you think he’s dead," Robert relates. "We turn it off there and say, Would you change what you have recommended now?’"
Robert has found that most of the staff members say, "No, he should go ahead with the experimental surgery." Then she lets them see the final two minutes of the tape in which the Klingon survives and walks again.
Most television shows deal with one simple issue, so they don’t lend themselves to good ethical debate, Robert says. But she has found that the television drama "ER," which is currently running on NBC, also has multilayered plots that could be used to discuss medical ethics. "The "ER" shows have story lines that don’t get resolved in an hour, and they’re not always happily ever after."
(Editor’s note: The episode, "Ethics," part of "Star Trek: The Next Generation" series, was aired March 2, 1992, as episode 116. The episode’s story was by Sara Charno & Stuart Charno; the teleplay was by Ronald D. Moore, and it was directed by Chip Chalmers.)
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