A friend of mine is a doctor. One day she refused to perform a dangerous procedure for a patient. The procedure had already failed once, and she knew for a fact if it didn't work the first time it wouldn't work this time either. The patient insisted that she do the procedure anyway. He turned out to be a big donor, and a hospital administrator told my friend that she could either do it or lose her job. She wasn't doing that well financially at the time, and had three kids to feed at home. Put yourself in her shoes. You're staring in the administrator's face. There's a 3% chance this procedure will kill the patient, and a 0% chance it will help him. What do you do?
I hope you'd walk away, and I hope I would too. But my point is, it's easy to say what your ethics are, and a lot harder to act ethically in the moment. Doing that little thing you were sure you would never do is so easy when your boss is staring at you, or your coworker needs you to cover their ass, or you stand to make an extra $20k a year if you get this job, or whatever.
My friend said she realized that day that in order to be a good doctor, you have to always know, at any given moment, that you might just have to walk away. You have to be ready.
I'm not a doctor, but it's a rule I've taken to heart.
Sure. Although if we want to get nerdy about it -- and I trust we do -- that saying was a lot more useful before scientific medicine. When doctors mostly had tools like bloodletting available to them, and didn't know to wash their tools before doing surgery, it was almost always better to do nothing. (Interestingly, religious prohibitions on seeing doctors made quite a bit of sense back then ...)
In modern medicine, it's almost never a choice between doing harm and not doing harm. It's more like, "well, assuming we've properly guessed what's wrong with you, the studies say you have a 20% chance that this surgery will work and won't kill you, and a 10% chance of living more than three months without the surgery. Your family will have to go into debt to make the surgery happen, so your call." The best you can do is explain as much as you can to the patient and let them decide -- so it becomes their impossible ethical decision instead of yours. That's better, right?
She did the procedure. She got lucky and the patient wasn't hurt. Then she found a job in a hospital run by doctors instead of administrators.
I feel bad even telling this story, because my friend is a super ethical person and this is far from her proudest moment. But that's how these things go, right? You come to a moment where every practical consideration tells you to do the thing you don't believe in, and no one ever has to know, and it probably won't cause any harm this one time ... and you become someone you never wanted to be. It takes real strength and forethought to make the right call there in the moment.
I hope you'd walk away, and I hope I would too. But my point is, it's easy to say what your ethics are, and a lot harder to act ethically in the moment. Doing that little thing you were sure you would never do is so easy when your boss is staring at you, or your coworker needs you to cover their ass, or you stand to make an extra $20k a year if you get this job, or whatever.
My friend said she realized that day that in order to be a good doctor, you have to always know, at any given moment, that you might just have to walk away. You have to be ready.
I'm not a doctor, but it's a rule I've taken to heart.