The Ethics of Erasing a Bad Memory

[Prrkitty]

http://www.time.com/time/health/article/0,8599,1671492,00.html?cnn=yes

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Quoting any part of the article without the rest of it would take away from the article as a whole.

This article touched me... in ways that I can't honestly put into words. I can understand the viewpoint of the patient as she was going into this procedure. But I can also see the viewpoint of the nurses... why the anesthesiologist did what he did at that specific moment in time... and especially the doctors inner dilemma with himself.

I hope the doctor comes to terms with himself for what happened during the procedure with this patient. At the time he did what he thought was best for that patient.

If the patient was me... I'd hope that exactly what happened then... would happen for me.

I've had the c-word (cancer) scare.

[Aegix Drakan]

...I can't fault the Doc in this case. I'd have probably done the same thing.

Being under surgery, and hearing a professional say (more or less) over the intercom "YOU HAVE CANCER" is the worst way to find out. And if it had been a false alarm, she would have suffered severe mental trauma over nothing.

Although I think toying with memories in such a way is morally wrong, I think that in some cases, it's acceptable, and sometimes even the only right thing to do.

If I were in that woman's place, I'd have wanted that memory wiped too.

[Prrkitty]

She died not knowing the full story of what happened... that's the dilemma for the doctor. He never told her.

And ultimately there's probably just as many people in the world that would say they'd want to know as there is those that would say they'd not want to be told.

[cyberkitten]

i don't think he did anything unethical, and i don't believe the woman suffered any ill effects from the decisions made by the two doctors. i found out the hard way that those medications don't always work the same way in every person. being in the operating room, during surgery, and hearing "oh my god, she's awake" is not a good feeling. granted, i was back out very quickly thanks to a quick anesthesiologist, but they were not only suprised i woke up, they were stunned that i remembered being awake, and could quote entire sentences of the conversations they were having.
trust me...coming from someone who's heard something unnerving in an operating room...we want to be asleep. we want to be oblivious and not even know about the mistakes that happened. it doesn't do much for your well being to have that memory. i'd much prefer to not have to keep those memories (it's happened to me more than once) in my consciousness.

[Prrkitty]

I was supposed to be "mostly unconscious" when they did my spinal injection (inserting a LONG needle up along on my spinal cord so they could inject the stuff they were injecting... into a specific bundle of nerves.

I wasn't unconscious... I was awake. And I could feel the initial prick of the needle and it's threading along my spine. Plus I could hear all the comments being said and I kept trying to tell them I could feel it all... they ignored me.

I'd have rather been unconscious.

[Anarchy_Balsac]

Wether or not she suffered any ill effects isn't the point. If it were me, I would not want the doctor to do that, and wether their intentions are good or not, I don't want doctors arbitrarily deciding what we should and shouldn't remember about experiences involving them.

His intentions may have been good, but he still crossed a line that should not have been crossed.

[Prrkitty]

Anarchy... now see I have to disagree with you *ONLY* because she heard *while* the procedure was being done. That ain't a good place or time for her to freak out. She was hooked up to all kinds of machines (I'm sure)... wires everywhere... so they needed her to stay calm, cool and collected... AND unconscious (so to speak).

<just my two cents>

[Anarchy_Balsac]

I understand that, but they could have explained that to her and asked. If it's explained to me that I'm way too hyper and the only way I can survive is to accept that "milk of amnesia" then fine, I'd accept it(for the record though, I would not wanna be conscious during surgery either). I'm not saying I don't understand why it was done, because I do, but it is still bad to cross that line, even when it seems right to.

[Trevelyan_06]

Here's the thing though, both sides of this debate are correct in their own ways. Everyone I think can agree that hearing about the cancer like that over the intercom is not a good way to go about discovering you indeed have cancer.

Now for the main debate. Should the knock out drug been used like it was? Well now, that's the question isn't it? Before we look at that in detail, we have to realize this. They had a split second to decide whether or not to use that or not to use that. We have the benefit of 20/20 hindsight. The decision was made in probably less than a second and the person that made it has to live with it forever.

Erasing the memory spared the woman the trauma of discovering she had cancer is such a shocking and scary way. However, it came at the cost of perhaps unethically violating her personal memories. But, what if they had decided they couldn't do that because it was in fact unethical for them and the woman suffered psychological problems from this that could have complicated the treatment for her cancer? In that situation would the doctor then feel bad because he could have spared her that memory and thus the problems that went with it? It's hard to say, and really I don't think it can be satisfactorily answered.

What about the doctor never telling her? Again, I think it's the same thing. Did not knowing hurt her, and would have knowing hurt her? The doctor knew that she didn't have long left to live and I think he wanted to spare her any and all unnecessary pains. I'd just like the say in conclusion though, that we can't know what would have happened had the doctor made different decisions. This is one of those ethical questions that has no real clear answer.

[Anarchy_Balsac]

You have a point about the psychological problems, however, if the situation was pointed out to her, and she was asked if she wanted to receive the treatment, but refused, at least it could be said to be her own fault(partially, the guy on the intercom was at fault too). They did have more than a split second to make the decision too, remember that it erases your last few "minutes" not your last few seconds.

[Trevelyan_06]

You have a point about the psychological problems, however, if the situation was pointed out to her, and she was asked if she wanted to receive the treatment, but refused, at least it could be said to be her own fault(partially, the guy on the intercom was at fault too). They did have more than a split second to make the decision too, remember that it erases your last few "minutes" not your last few seconds.

See though if they did this, it would have affected her subconsious mind perhaps. She could have said yes, I want to forget about this, but once having made that consious decision there is a good chance that her subconsious is going to move it to remember it for her. It'd be her bodies natural pyschological response to a traumic event. When they did it like they did, it really hadn't had time for the concept to sink in all the way and filter down through the many layers of her memory/mind. If they would have waited and asked her about it and she said yes, she probably would have consiously forgotten it but her subconsious would maybe have remembered. Which, would probably be a worse way to go even, because then she might have trauma associated with this memory but not be able to actively recall the memory, compounding the problem.

[Anarchy_Balsac]

See though if they did this, it would have affected her subconsious mind perhaps. She could have said yes, I want to forget about this, but once having made that consious decision there is a good chance that her subconsious is going to move it to remember it for her. It'd be her bodies natural pyschological response to a traumic event. When they did it like they did, it really hadn't had time for the concept to sink in all the way and filter down through the many layers of her memory/mind. If they would have waited and asked her about it and she said yes, she probably would have consiously forgotten it but her subconsious would maybe have remembered. Which, would probably be a worse way to go even, because then she might have trauma associated with this memory but not be able to actively recall the memory, compounding the problem.

That's merely a theory and by no means fact. If the drug erases your memory completely, there should be absolutely no recalling, subconscious or otherwise. For that matter though, if what you say is true, what's to have stopped the panicked trauma from burning the memory into her subconscious?

[Trevelyan_06]

That's merely a theory and by no means fact.
You're absolutely correct, that is just a theory and what you suggested may have indeed worked just as well. I should have used the word could and not would. That's the other thing that I'm getting at though. We can't know if there was a better solution to this or not because we're just computer chair generals here.

The trauma could very well have been burned into her subconscious even with the knock out drug. The thing to remember though, it wasn't. The result we have is someone who heard horrible news in an equally horrible way, who was apparently(we can't know for sure because we aren't her) spared both the conscious and subconscious memory of the trauma. Does this mean the ends justify the means? That's the million dollar questions that has been asked more times throughout the course of human history than can be remembered.

The decision was made split-second based on the opinions/observations of one man. Could there have been a better, more ethical way to do this? Sure there could have been. He very well could have talked it over with her, then did it and gotten the exact same results. I was merely trying to offer reasons why he possibly decided not to go that route and did what he did. It was his opinion that he didn't have the time to talk it over with her so he took action.

The topic is certainly open for debate and is probably one that should be debated. Ethics is not a black and white situation and is best served by debate.

[Prrkitty]

I've been thinking about this all day (for some reason) and I honestly feel sorry for the doctor. They (the doctor/anesthiologist) only had a split second to decide what to do before she totally freaked out on 'em.

For some reason my empathy for the doctor is on overdrive...

[Trevelyan_06]

I've been thinking about this all day (for some reason) and I honestly feel sorry for the doctor. They (the doctor/anesthiologist) only had a split second to decide what to do before she totally freaked out on 'em.

For some reason my empathy for the doctor is on overdrive...

Doctor's are often put into situations where they have to make such split second, and in fairness not so split second, decisions that will affect people for the rest of their lives. It's part of the reason why the schooling/training to become a doctor is so hard. A person that is a doctor has an awesome responsibility on their shoulders and many times they have earned the right to carry said responsibility. However, it's important to remember that they are still human and not above self-doubt and that's it's really fucking hard to be a doctor .

[Anarchy_Balsac]

Well actually we just haven't heard of her having subconscious trauma, that just means the information hasn't gone public if she has, not that it hasn't happened. My point was this is a decision that was made for her and without her consent, although the reasons for making the decision can be correct in a sense, the decision itself could not be.

The debate here is giving a person free will versus doing what's "best" for them, wether they like it or not. If we make decisions for a person in their life, it may result well for them, but who are we to say that what we did was right if that is not what they wanted? Does a person not have the right to choose their own fate?

[Prrkitty]

However, it's important to remember that they are still human and not above self-doubt and that's it's really fucking hard to be a doctor .

OH so true... we like to rag on doctors a lot but they hold the lives of so many people in their hands every second of every day.

Which is why they burn out so easily at that type of job...

[Trevelyan_06]

The debate here is giving a person free will versus doing what's "best" for them, wether they like it or not. If we make decisions for a person in their life, it may result well for them, but who are we to say that what we did was right if that is not what they wanted? Does a person not have the right to choose their own fate?

I don't think the anesthesiologist was trying to take away her free will. You are right though, he did what he thought best for her at the time. However, he is a medical professional and it's often his job to do such. If you're undergoing an operation to remove kidney stones and during the course of it they find out you have an appendix that is about to burst they aren't going to wake you up and ask you if you want it left in or taken out, they're going to do what's best for you at the time.

Now I realize that's a different situation from one's memories, but it has some of the same elements. This man was trying to protect the mental health of this woman by taking a traumatic experience that should never have happened in the first place. The decision can easily be picked apart by us with the limitless amount of time we have available, he didn't have that option. In his opinion he had only a split-second to let the woman suffer with the memory or erase it for her. Regardless of whether or not it could have been successfully erased after talking it over with her, his opinion was that he had to act immediately to get the desired effect.

In this I think he acted as a medical professional making a decision in the what he thought was the best interest medically of the patient. I believe there is a big difference between this and say, telling a person who they'll marry because you've decided it would be best for them.

[AtmaWeapon]

The problem here is that ethical analysis of an issue is rarely cut-and-dried and is almost always sensitive to context. I will return to this point.

Were I investigating this particular event as part of an inquiry, I am positive that my result would insist that a rigid process for announcing results were instituted; if the person reporting the results had not used the intercom, the dilemma would not have presented itself.

Now, to the dilemma. Doctors with bad news have somewhat of an ethical obligation to make a judgment of the person's psychological state and decide the best method to deliver the news. This doctor had already observed that this was not the right time to reveal it. The anesthesiologist had to make a decision; expose the woman to a more traumatic experience, or go against her wishes and erase the memory.

Personally, I'd say in a situation like this I'd prefer to sacrifice my rights to be told in a better manner. I honestly can't see how the woman was harmed by this decision. However, I don't think there's a "right" answer to this situation.

[Gleeok]

I think the Doctors involved in the procedure did nothing wrong. We grant them that power in those situations to make split-second decisions, and leave it at their discretion.

Personally however, I would be really pissed off if I ever found out that happened to me. There was no physiological reason to use anesthesia at that point in the operation, therefore in my opinion it was unnecessary.

[biggiy05]

It sounds bad but I'm glad doctor's get more shit than us emt's and firefighters. We get our asses busted all the time but it never goes farther than an angry phone call.

As for what happened. I think the decision to erase those few minutes of the woman's memory was the right thing to do. She died later but she died without knowing that. She was starting to freak out over her kids and such too so think about if he didn't do that. Her life could have been totally different and she could have had a break down, the family falls apart. A ton of different things could have happened.

[Anarchy_Balsac]

I don't think the anesthesiologist was trying to take away her free will. You are right though, he did what he thought best for her at the time. However, he is a medical professional and it's often his job to do such. If you're undergoing an operation to remove kidney stones and during the course of it they find out you have an appendix that is about to burst they aren't going to wake you up and ask you if you want it left in or taken out, they're going to do what's best for you at the time.

That is true, however at the same time, few people, if any, would complain about the removal of an appendix, especially when it wasn't good for them to keep it.

Memories are a quite different subject. Even bad memories can serve a person well, in addition to giving good memories something to compare to, remembering a traumatic moment, and knowing you got out of it can feel pretty damned good. Having had a few terrifying moments myself I know this pretty well.

There is a difference, afterall, between removing someone's cough, and removing their memories of that cough.


Now I realize that's a different situation from one's memories, but it has some of the same elements. This man was trying to protect the mental health of this woman by taking a traumatic experience that should never have happened in the first place. The decision can easily be picked apart by us with the limitless amount of time we have available, he didn't have that option. In his opinion he had only a split-second to let the woman suffer with the memory or erase it for her. Regardless of whether or not it could have been successfully erased after talking it over with her, his opinion was that he had to act immediately to get the desired effect.

He's an anesthesiologist, not a psychologist, it is neither his field of practice, nor is it his say. You bring up an important point however, in his opinion it was a split second decision, and that was a misinterpretation. You can't make mistakes with stuff that erases people's memories. I know it seems harsh to say that, and it is, but at the same time this isn't a small issue. Such a medication requires a huge responsibility amongst its handlers, and shirked that responsibility by making the decision for his patient.

It isn't like he wasn't trained not to do this sort of thing either. Because I can promise you that he was. So it's not as though there wasn't plenty of warning before hand that such a decision would be wrong. Even ignoring these warning signs for the right reasons is still ignoring them. It is no different than ignoring the hypocratic(sp?) oath, both are there for a reason, because medicine has to be objective, which goes back to your point about it being his opinon. You can not have doctors deciding when it's okay or not okay to just do things differently than the standard procedure. The moment you do so, medicine becomes non-objective, and opinionated medicine is a very bad idea.

Opinions are arbitrary, and medicine has to be based on science and reason, which is not. If a guy is hurt, he needs to be healed, if a guy doesn't want his memory erased, it needs not to be. If these things become less clear due to being arbitrary, it's easy to see how wrong decisions can be made. However you can never make a wrong decision if it remains objective. Or at least, it's much more difficult to.


In this I think he acted as a medical professional making a decision in the what he thought was the best interest medically of the patient. I believe there is a big difference between this and say, telling a person who they'll marry because you've decided it would be best for them.

Well if you want to get technical, what he did was not professional. Professionalism involves following a code of ethics, and I promise you that the code of ethics on "milk of amnesia" involves not ever using it on patients who did not first consent to its use on them.

He did do what he thought was right, but medicine is about what has to be done to treat the situation, not what the doctor felt was right.

[Prrkitty]

I totally agree that they did the right thing. And like I said earlier if I were ever in that very same/or similiar situation that I'd hope that my doctors would do the very same thing for me as they did for her.

Doctors need clear consciouses (spelling) when they deal with us patients.

[Anarchy_Balsac]

I totally agree that they did the right thing. And like I said earlier if I were ever in that very same/or similiar situation that I'd hope that my doctors would do the very same thing for me as they did for her.

Doctors need clear consciouses (spelling) when they deal with us patients.

I understand that, but as any medical professional would tell you, breaking your medical code of ethics just to have a clear conscious is no excuse for doing so. It isn't like it would take all that long to just ask her if she wanted the memory removed, and it could easily still be done in time for her to forget about it.

[AtmaWeapon]

You can take the moral high ground, but you were not in the situation. I presume you have never been around someone who is hysterical? You can't exactly tell them to chill so you can ask them an important question.

A binary decision was made, and neither outcome is desirable. It's not even worth doing a utilitarian analysis in my opinion, because both outcomes were bad. I would support either decision, but had I been in the woman's shoes I would have wanted them to do what they did.

[Anarchy_Balsac]

You can take the moral high ground, but you were not in the situation. I presume you have never been around someone who is hysterical? You can't exactly tell them to chill so you can ask them an important question.

A binary decision was made, and neither outcome is desirable. It's not even worth doing a utilitarian analysis in my opinion, because both outcomes were bad. I would support either decision, but had I been in the woman's shoes I would have wanted them to do what they did.

For the record, I agree it's a tough situation, and I know how it can be to handle someone who is hysterical(I worked as a security guard for over a year, believe me I know), but that's just how it's going to be no matter what job you go to. There are tough situations out there which will greatly tempt you to make the wrong decision, but that doesn't justify said decision. Would she have wanted this? Maybe, but it isn't something which is certain.

The simple fact is, he did bring his opinion into this decision, and as a doctor, that is not something which is okay to do. I know why he did it, and emphasize, but it still wasn't right.

[Trevelyan_06]

I agree that medicine has to have guidelines to it, and it'd be great if there was a giant book that held every conceivable medical situation in it that had this easy and quick to use index. Unfortunately as we all know that is an impossibility. At times situation like these arise that don't have clear cut guidelines to them, or happen as the result of other guidelines being violated giving rise to new and unique situations. That's what happened here. Normal guidelines would be NOT to tell a patient this type of news in such a fashion but due to the malfunctioning intercom that guideline was violated.

That's where the anesthesiologist's decision comes in. The guideline on how to tell a patient this news was accidentally violated due to malfunctioning equipment, cause the patient a great deal of unnecessary trauma and discomfort thusly violating the Hippocratic oath. The anesthesiologist, saw a way in which he believed he could negate that trauma and discomfort. I think it's a moot point that he wasn't a psychologist. I think it was plain to see that she was in distress and that this memory was going to be a source of trauma to her. It may have been a violation of the oath to use the drug in such a manner but it was done as an attempt to correct another violation of the oath. This does beg the question of, "Do two wrongs make a right?" But again, I think we need to focus on the fact that we are very far removed from the situation.

[Anarchy_Balsac]

I agree that medicine has to have guidelines to it, and it'd be great if there was a giant book that held every conceivable medical situation in it that had this easy and quick to use index. Unfortunately as we all know that is an impossibility. At times situation like these arise that don't have clear cut guidelines to them, or happen as the result of other guidelines being violated giving rise to new and unique situations. That's what happened here. Normal guidelines would be NOT to tell a patient this type of news in such a fashion but due to the malfunctioning intercom that guideline was violated.

Well actually they do have said guidelines. That's what the code of ethics that doctors have to swear to is there for. I'm more than certain that obeying them to the letter at all times is not an easy task, I'm not saying it is. It is however, necessary. The oaths which doctors take are clear and are to be obeyed in all situations, even when it would seem that they should not be.

Yes, it would be nice if there was a guidebook that would allow stuff where blurred lines occur to be handled perfectly, and indeed, one does not exist. However, the oaths, which you can not get a medical license without taking, are at least able to minimize error. The truth is you can't eliminate it, and as you have noticed you're going to do everything perfectly, but the guidelines which he was given in order to minimize error were still disobeyed. These were guidelines which he swore to, and without knowing what the patient would have wanted, there is no way to effectively say that what he did was right. However, with that said, seeing as how we don't know if breaking his oaths was the right decision, and he went ahead did it anyway, there is reason enough to say that what he did was wrong, even if it was for the correct reasons.


That's where the anesthesiologist's decision comes in. The guideline on how to tell a patient this news was accidentally violated due to malfunctioning equipment, cause the patient a great deal of unnecessary trauma and discomfort thusly violating the Hippocratic oath.

It was, however, violation of one oath does not justify violation of another.


The anesthesiologist, saw a way in which he believed he could negate that trauma and discomfort. I think it's a moot point that he wasn't a psychologist.

But again, that's him bringing his opinion into medicine, and medicine can never be based on opinion. The point that he isn't a psychologist was just that, because he isn't, it can't be argued that he had the right grasp on how this would end up effecting her mental health, because that definitely isn't necessarily true. Even an actual psychologist could make a mistake on that front, someone who is far from it certainly doesn't have concrete knowledge.


I think it was plain to see that she was in distress and that this memory was going to be a source of trauma to her. It may have been a violation of the oath to use the drug in such a manner but it was done as an attempt to correct another violation of the oath. This does beg the question of, "Do two wrongs make a right?" But again, I think we need to focus on the fact that we are very far removed from the situation.

For the record I don't like the "Two wrongs don't make a right" thing because it is very often abused to argue that people shouldn't be punished for their crimes and stuff.

That said, this correction was still wrong. Yeah, sure, it was done only in the hopes of rectifying something which should not have happened, but at the same time, in doing so, he did something else which should not have happened. It's not like opening a virus then shutting off your computer before it erases your hard drive, this was a human being, a living and breathing person, not some machine that you can just correct your mistakes with by simply erasing them.

[Trevelyan_06]

All of those are good points. My overall opinion on this is is that it could probably be debated by both sides bringing up good points and counter points. I think it's safe to say that it most likely one of the many gray areas of ethics.

My personal opinion on this is that it was probably one of the best decision in a situation that had many possible outcomes, none of the particularly good. Was there probably a better solution? Yes, I believe there probably was. However, it won't ever be know for certain because as I've said, we weren't all there. Also, having said all this, let me say that I can defiantly see your side of this Anarchy. Everyone is going to have their own ideas on whether or not this was a good decision or not. Things like this are what makes debate possible.

[Anarchy_Balsac]

Well yeah, the right thing to do is certainly in a gray area and that's the problem. You have a gray area of right and wrong, but what you do and don't do is black and white, with no gray area. I don't deny that there is no way to know absolutely what was right for the patient, my argument is more about how ignoring your oaths as a doctor can lead to bad things.

Opinions are never black and white, there are always gray areas, yet knowing that the things which you do to a persons body is always black and white(He either used "milk of amnesia" or he didn't, he didn't sort of do it), opinions must be left out. But that's why the oaths of medicine leave opinion out, because the effects you have on your patient either exist or they don't, unlike opinion, they have no gray area.

[AtmaWeapon]

Here is the Hippocratic Oath:
I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.Arguably, it applies little in this situation. So, I followed links for a while and found a similar article on Duties of a Doctor (http://www.gmc-uk.org/guidance/good_medical_practice/duties_of_a_doctor.asp). Once again, how this situation is covered is in question. Surely this is a violation of the patient's right to make decisions about their treatment, but it could be argued that the action was taken in the patient's best interests. In the end, the clause at the bottom is a gaping loophole, effectively saying "these are just guidelines".

No professional code can address a situation like this.

[Anarchy_Balsac]

Aha, indeed the hippocratic oath is not specific to the particular drug used. But then again, I never said that it was, I mentioned it to draw a demonstration of how it is there to make medicine objective, and show how it compares with the ethics surrounding that drug. I do indeed know someone who is studying to be an anesthesiologist, and in fact, they are trained never to use that drug without consent of the patient. They are required, before getting their medical license, to include that among their code of ethics, hippocratic oath is more general doesn't apply to any specific treatment, but rather how general procedures are to be done.

So while it can be argued that he didn't disobey the hippocratic oath, it can not be argued that he did not act unethically, that did not neglect his training, and that he did not violate procedures which he agreed to before taking the job. Because in fact, he did.

BTW - I'm not sure what about the last clause says that it is just a guideline.

[Aegix Drakan]

...I see both sides of the argument, but...

I still belive that the doc did the right thing. he just "erased" a terrible thing that never should have happenned. Plus, it was only a few minutes.

Ok, Just to make my point clear, I absolutely side with the doc on this issue, BUT!!! When it comes to the manipulation, deletion and replacement of memores (I.E. As seen in Trace Memory) Then I'm totally against it. It's not for us to toy with people's minds.

It's just that sometimes, to prevent tragedies, we need to break the rules. >_> I know this can be abused to hell and back, but...In some rare instances, it holds true.

[AtmaWeapon]

You are still trying to pretend like ethics are an exact science. Their application is more of an art. I do not subscribe to the Kantian school and I do not believe there is such a thing as a universal maxim.

They call these situations dilemmas for a reason. A dilemma is a problem where ethics provides a conflicting view of the correct action; either choice requires violating some supposedly sacred rule.

A classic example involves a group of tourists being led through a cave by a tour guide. This particular cave exists below sea level, but when the tide is low its entrance is revealed. As the time for the tide to come in approaches, the tour returns to the entrance. However, a small cave-in has occurred and the entrance is much smaller than when they entered. The tour guide attempts to exit the cave, but gets stuck.

The tide will start flooding the cave in 30 minutes. There is dynamite in the tour guide's backpack (which the tourists can still access), but using it to open the entrance means killing the tour guide. However, if the entrance is not reopened, all of the tourists and the tour guide will drown.

Here, we have a conflict with the proposed maxim "It is always wrong to kill a person". You may not believe it, but there are those who would not kill the tour guide, preferring to die knowing they did not kill a man. However, one could argue that in this case inaction makes the person responsible for the death of every person.

We need not bring death into the picture to create a dilemma, though. Suppose a poor man has been laid off from his job and is unable to feed his family. He attempts to steal some food from a grocery store and is caught. Do we agree that he should go to jail, or do we feel like his actions were excusable given the circumstances? Strict believers in the law would argue that he clearly broke the law and punishment must be rendered. Others might have sympathy and point out his alternative was to watch his family starve. Do we throw him in jail and leave his family to their own devices?

The key point to keep in mind is the meaning of the phrase "justice is blind" has two sides. There's the happy friendly meaning that indicates that no matter your walk of life you have the right to a fair trial when accused of a crime. Then there is the ugly side that indicates justice cares not about context, but reduces all issues to a true/false, "Was the law broken?".

That which is just is not always right.

[Anarchy_Balsac]

I know this can be abused to hell and back,

And that's exactly what I'm afraid of. It wouldn't worry me so much if there wasn't potential for abuse. In this case, I would still say it was wrong since we can't know if that's what she would have wanted, but it wouldn't be so bad if not for potential abuse. I do agree at least, that it would be nice if we could break the rules and always be right about when we do it.


You are still trying to pretend like ethics are an exact science. Their application is more of an art. I do not subscribe to the Kantian school and I do not believe there is such a thing as a universal maxim.

In some cases it certainly can be. When you swear in your code of ethics to heal anyone and everyone, simply because they need healing, that sounds pretty exact to me. There are indeed cases where they are more arbitrary(engineering for example), but medicine is not such a case.


They call these situations dilemmas for a reason. A dilemma is a problem where ethics provides a conflicting view of the correct action; either choice requires violating some supposedly sacred rule.

But in this case, a conflict of ethics is not actually present. It is indeed true that the intercom thing should not have happened, however that does not give doctors the right to violate their ethics further. I do agree that conflicts of ethics do in fact exist, but I'm afraid I can't see eye to eye on this being one of them.


A classic example involves a group of tourists being led through a cave by a tour guide. This particular cave exists below sea level, but when the tide is low its entrance is revealed. As the time for the tide to come in approaches, the tour returns to the entrance. However, a small cave-in has occurred and the entrance is much smaller than when they entered. The tour guide attempts to exit the cave, but gets stuck.

The tide will start flooding the cave in 30 minutes. There is dynamite in the tour guide's backpack (which the tourists can still access), but using it to open the entrance means killing the tour guide. However, if the entrance is not reopened, all of the tourists and the tour guide will drown.

Here, we have a conflict with the proposed maxim "It is always wrong to kill a person". You may not believe it, but there are those who would not kill the tour guide, preferring to die knowing they did not kill a man. However, one could argue that in this case inaction makes the person responsible for the death of every person.

And indeed, that would be an example of an ethical conflict. It is much different however, from treating a human being like a machine, and simply erasing a mistake you made on it. In the case of what we are discussing, it was a panicked person, she was the only victim, and after the first ethic had been breached, there was indeed potential to correct the situation in a way other than what was done. Also there may have been a good reason for her to wanna live through it, since surviving a battle with death can be exhilarating(being near-missed by a car for example).

In the case you spoke of above, someone dies no matter what, and there is no way to correct either mistake. In the case of what happened with what we're talking about, it was indeed possible to make the correction without another ethics breach. While it could be argued that we don't know if they'd have been able to keep listening long enough to hear them out, we don't know if she'd have preferred to live the memory and tough it, having had the experience of recovering from cancer, as opposed to just forgetting it.


We need not bring death into the picture to create a dilemma, though. Suppose a poor man has been laid off from his job and is unable to feed his family. He attempts to steal some food from a grocery store and is caught. Do we agree that he should go to jail, or do we feel like his actions were excusable given the circumstances? Strict believers in the law would argue that he clearly broke the law and punishment must be rendered. Others might have sympathy and point out his alternative was to watch his family starve. Do we throw him in jail and leave his family to their own devices?

The key point to keep in mind is the meaning of the phrase "justice is blind" has two sides. There's the happy friendly meaning that indicates that no matter your walk of life you have the right to a fair trial when accused of a crime. Then there is the ugly side that indicates justice cares not about context, but reduces all issues to a true/false, "Was the law broken?".

That which is just is not always right.

I agree here, but 2 things:

1. The idea that we will always do things right is just that, an idea. It is far from fact. Objectivity may not always result in the right decision being made, but it's a damn sight better than what subjectivity would bring.

2. Law is similar in this aspect to medicine. But it is also in many ways different. Which is one reason why we have trials, and sentencing. Because sentencing and crimes are indeed handled case by case(no pun intended), and the law also has plenty of gray areas. So the way laws are enforced can be and in fact is at least a little more subjective than the practice of medicine, because law is a bit more arbitrary than whether or not a person is injured.

[Aegix Drakan]

I hate to be nitpicky litte guy but this comment kinda struck a chord with me...


When you swear in your code of ethics to heal anyone and everyone, simply because they need healing, that sounds pretty exact to me.

...>_> One could argue that "deleting" that traumatic memory was a form of "healing"

[Anarchy_Balsac]

...>_> One could argue that "deleting" that traumatic memory was a form of "healing"

No it is not. Sure people can play semantics and stuff, but I'm not going to suddenly start believing that concrete facts are in fact, not concrete because someone wants to argue semantics about what concrete, or in this case, healing means. You can argue it to be mental healing, but that is not something which a doctor has discretion over, that is something which a psychologist has discretion over.

[Russ]

I joinded this discussion a little late, but here is my opinion. I think that what the docter did was wrong. It was wrong for him to erase her whole memory of the incedent. It was wong for him to go against her will not to be put to sleep. And lastly, it was wrong of him to never tell her the incedent. He never told her, and I can garenty (I know that's spelled worng) you that that incedent is going to haunt him for the rest of his life.



...>_> One could argue that "deleting" that traumatic memory was a form of "healing"


I hardly call erasing a bad memory "healing". It is ore of the oposite effect. How will a patient ever get "healed" if all his (or her) bad memories are erased.

[Rijuhn]

*Include everything Anarchy_Balsac has said in this thread thus far*

To be honest man, it seems like you're more concerned about this whole thing than the lady who died from the cancer. And are you preparing for a debate class, or running for a political office? It seems that way with all of your logical arguments. Somehow though, I doubt that is the case, considering the hours you've spent arguing the same case in every other post of yours.



Anyway, my take on the matter is that the "put-you-to-sleep"* dude did the right thing at that moment in time. I would be concerned about the lady freaking out while being in the OR, and possibly hurting herself by freaking out, ie. running out of the room half dressed with fresh stitches on her neck.

I do think, however, that it is wrong to withhold the information from the patient indefinately. At some point the doctor should've sat her down and told her exactly what was going on with her body. That's it from me, so everyone continue to beat a dead horse if you like. :rolleyes:


*I don't feel like looking up, or attempting to spell anastesiolgist(sp?) at 4:37 am in the morning.

[Russ]

I still think the docter should not have gon against the lady's wishes. I am just like her, I never wish to be put to sleep and I certainly don't want my memory erased. So I can easily syphathise with her. The docter should DEFINITLY at least told her what happened afterwards.

[Anarchy_Balsac]

To be honest man, it seems like you're more concerned about this whole thing than the lady who died from the cancer.

So? What's wrong with having valid concerns about where crossing the line may lead? And if you read, yes I am also concerned with the patient herself. I stated several times that she may have indeed wanted her memory, we just don't know.


And are you preparing for a debate class, or running for a political office? It seems that way with all of your logical arguments. Somehow though, I doubt that is the case, considering the hours you've spent arguing the same case in every other post of yours.

That is a text book ad hominem attack and it is irrelevant.


Anyway, my take on the matter is that the "put-you-to-sleep"* dude did the right thing at that moment in time. I would be concerned about the lady freaking out while being in the OR, and possibly hurting herself by freaking out, ie. running out of the room half dressed with fresh stitches on her neck.

She was sedated, she would not have been able to do so, while she freaked out a bit more than it seems a sedated person should be able to, the fact remains that she would not have been able to just get the hell up and go running out of the room like that. Also, he's an anesthesiologist, if she did indeed show signs of being ready to do something drastic which could hurt herself(which is rediculus because she'd have to be pretty damned stupid to get up and run out while she is also fully aware that her body is sliced open, or even loosely stiched) he could have used, well, anesthesia, which would not have erased her memory, but he didn't.

[AtmaWeapon]

She wasn't sedated, she was under local anesthetic.

Your case just developed a crack. You suggest he could have chosen a drug that sedated her but did not erase the memory. Her clear wish was to not be placed unconscious. It is my opinion that if he violated her wishes so far as to knock her out, it is only humane to erase her memory of the event as well.

[Anarchy_Balsac]

She wasn't sedated, she was under local anesthetic.

Okay, I'll admit I don't know the difference, but what is it?




Your case just developed a crack. You suggest he could have chosen a drug that sedated her but did not erase the memory. Her clear wish was to not be placed unconscious. It is my opinion that if he violated her wishes so far as to knock her out, it is only humane to erase her memory of the event as well.

I will admit that it was a poor choice of words on my part. What I meant was this:

It is my understanding(and correct me if I am wrong) that doctors may sedate patients without consent, including by using knockout drugs, when they start to pose a danger to themselves and/or others. This does not however, mean that they can erase memories, it is entirely different.

Also, violation of one right definitely does not okay violation of another. Tranquilizing someone for their and/or other's safety is not the same as violating their memories, nor should it be treated as such.

[Prrkitty]

Sedated means you're out cold and won't know squat (I'm not sure if you're on breathing help, etc).

Local anesthetic means you're basically still conscious but are kinda on the edge between being awake and not awake.

[Anarchy_Balsac]

Sedated means you're out cold and won't know squat (I'm not sure if you're on breathing help, etc).

Local anesthetic means you're basically still conscious but are kinda on the edge between being awake and not awake.

Gotcha, I think the latter is what I meant when I said that. Well live and learn.

[Breaker]

Local anesthetic means that they numbed her arm and performed the procedure. She was completely concious in the operating room, even having a conversation with the doctor while waiting for the test results to come back.

The only 'fact' in this thread is that none of us were there.

The article, which was written by the doctor, notes that he had finished stitching her up when the results came back. She became hysterical when she heard the results of the lab work over the intercom. It doesn't say whether or not she was posing a danger to herself or just how hysterical she really was.

From some of your comments, I doubt many of you have ever seen the inside of an operating room, or ever met an anesthesiologist for that matter. He was standing by her side ready to push an already preselected medicine into her IV that would slip her into an amnesiac sleep in the event that anything disrupted the patient.

'Milk of Amnesia', which could be anything since it doesn't specificy what exactly he dosed her with in the article, works so effectively that it will immediately knock your ass out. The side effect is short term memory loss, which is pretty common among any strong anesthesia or sedative.

If she was extremely hysterical and posed a danger to herself, then the anesthesiologist acted appropriately. If she wasn't, which I doubt very much considering she was just told she had bad cancer, then they should have talked to her and attempted to calm her down.

This isn't even really an issue worth debating since we can't know what really happened. We only have the author of the article's guilt ridden confession of the incident.

Regardless of the situation, the comments that the doctor made afterwards were unprofessional and made it seem like he and the anesthesiologist were selfishly acting to save their asses at her expense.

If she was strong enough to undergo the entire procedure of slicing a piece of bone off with only local anesthetic, then I would think they would have been able to calm her down. She clearly expressed a desire to not be put under anesthesia from the beginning, so they should have respected that if she wasn't putting herself in physical harm. If they didn't, then they were just bad doctors.

Guess what kids?

There are a lot of them in the world that don't give a shit about you or follow a strict code of ethics. I've met doctors that probably couldn't even spell the word morality, let alone express it.

[AtmaWeapon]

Breaker I agree with you until the last part of your post, because you contradict yourself.

We weren't there, we don't know the situation, we can't assume we know what happened.
I assume she was hysterical because of the situation.
I assume, based on this information, they could have calmed her down.
__________________________________________________ _____________
Bad doctors.

Hypotheses 2 and 3 are mutually exclusive. Both contradict hypothesis 1.

[Anarchy_Balsac]

Guess what kids?

There are a lot of them in the world that don't give a shit about you or follow a strict code of ethics. I've met doctors that probably couldn't even spell the word morality, let alone express it.

Yes, and they need to lose their medical licenses. And plenty of them do. In extreme cases they even go to jail, which I agree that sometimes they should, depending on the nature of their bad decisions.

As for milk of amnesia, it's called propofol (http://www.google.com/search?hl=en&client=firefox-a&channel=s&rls=org.mozilla%3Aen-US%3Aofficial&hs=OVK&q=%2B%22propofol%22&btnG=Search). And frankly, erasing someone's memory is not okay just because they are getting hysterical and posing a danger to themselves and/or others, that's where you give them knockout drugs. And after seeing this, if I am ever in a situation where there's an anesthesiologist involved, I will demand a drug test after the procedure to make sure no propofol is used. If there is, I'll sue for malpractice.

You do bring up an effective point though. We don't know how hysterical she was or what the doctors actual motives for using propofol were. I've been arguing extremely conservatively about this, only arguing the best case scenario, but truth be told, I'm not at all convinced that he necessarily had good intentions. It's entirely possible that his reason was to cover everyone's ass for the major fuck up that happened over the intercom. And the fact she wasn't even told she had cancer after the fact, and recurring cancer at that, and she died because she was unaware of this and did not go back to the doctor as a result, guess what? We're looking at a possible manslaughter case.

It isn't necessarily, but just to cast some light on it, the worst case scenario is every bit as worth mentioning as the best case.

[Breaker]

She was told she had cancer several weeks after the incident in the operating room. The delay was so that they could confirm the diagnosis.

[Anarchy_Balsac]

She was told she had cancer several weeks after the incident in the operating room. The delay was so that they could confirm the diagnosis.

I must have missed that detail. I would have to question why she did not go back to the doctor if she was indeed told that not only was it cancer, but recurring cancer.

[biggiy05]

I must have missed that detail. I would have to question why she did not go back to the doctor if she was indeed told that not only was it cancer, but recurring cancer.

Not everyone wants treatment when they find out they have cancer. Some people just want to live their life until it takes them down.

[Anarchy_Balsac]

Not everyone wants treatment when they find out they have cancer. Some people just want to live their life until it takes them down.

There probably are indeed people like that out there, but given her reaction, I would think it was highly unlikely that she was one of them.

[biggiy05]

There probably are indeed people like that out there, but given her reaction, I would think it was highly unlikely that she was one of them.

She knew she had cancer after the operation but she obviously didn't seek treatment.

This is something that nobody will ever know the whole story too. Without knowing what she wanted or did it's hard to tell.

[Anarchy_Balsac]

Here's the actual quote:


Ten minutes later Ellen woke up, happy and even-keeled, not even knowing she'd been asleep. From the recovery room she was home in time for dinner. "The procedure went smoothly, but we'll have to wait for the final pathology reports," I said, which was not exactly the whole truth, but it let me get the oncology people cued up, a proper diagnosis, and Ellen herself emotionally prepared. I would give her the bad news at a more appropriate time.

The ending was not quite happy; it was a recurrence of the cancer she'd had years before — fairly rare for that type of tumor. Ellen died of it about six years later. I confess I never told her about the incident with the intercom.

It doesn't exactly say she didn't seek treatment. I somehow doubt that, panicked as she was to hear what she did, that when the news was indeed brought, she didn't want to be treated. Having died of it six years later doesn't specify why she died of it, only that she did. She may or may not have been being treated as she was dying, it doesn't say.