The Ethics of Erasing a Bad Memory

...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.

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.

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.

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.

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.

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>

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.

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.

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.

Anarchy_Balsac wrote: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.

Trevelyan_06 wrote: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?

Anarchy_Balsac wrote:That's merely a theory and by no means fact.

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.

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...

Prrkitty wrote: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 .

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?

Trevelyan_06 wrote: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...

Anarchy_Balsac wrote:
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.

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.

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.

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.

Trevelyan_06 wrote: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.

Trevelyan_06 wrote: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.

Trevelyan_06 wrote: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.

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.

Prrkitty wrote: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.

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.

AtmaWeapon wrote: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.

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.

Trevelyan_06 wrote: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.

Trevelyan_06 wrote: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.

Trevelyan_06 wrote: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.

Trevelyan_06 wrote: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.

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.

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.