ETHICS IN CONTEMPORARY AMERICAN LIFE

CASES FOR STUDY

Case I. An American Airlines 747-400 with 250 passengers is en route to Paris. Midway over the Atlantic, a very distraught flight attendant lets herself into the flight deck followed by an intense looking young man, not a member of the flight crew . The flight attendant explains the young man, who speaks rudimentary English, has a gun, a knife and a device he claims is a bomb. He has already killed a passenger to demonstrate his determination, and has handed a note to the flight attendants demanding to be flown to Libya. None of the crew is armed and no federal marshals are on the flight. The Pilot turns the controls over to the co-pilot and attempts to explain that with U.S. sanctions in place against Libya, the plane will not be permitted to land safely there, but the response is adamant. Fly to Tripoli or be blown out of the sky. Holding the flight attendant with knife to her neck, the hijacker sits on the jump seat in the cabin with his gun in clear view and accessible to the pilot. If the pilot seizes the gun, the hijacker may kill or seriously wound the flight attendant, and in any case may endanger the plane and the rest of the passengers. The pilot is convinced after observation of the hijacker's state of agitation, based upon training afforded by the airline, that the only chance is to seize the gun and kill or disable the hijacker. Before the pilot can make a move, however, the hijacker asks for some coffee to drink and the pilot instructs another flight attendant to bring Irish coffee, the hijacker not realizing it contains alcohol, which he is forbidden by his Islamic religion to drink. The hijacker drinks the coffee not recognizing the strange taste as alcohol, which immediately renders him a little woozy. Noticing the effect, the pilot grabs the gun, which discharges into the hijacker's abdomen, causing a large, bloody wound and the collapse of the hijacker, who dies of blood loss soon thereafter. The pilot lands safely at Orly Airport in Paris.

Case II. A Catholic priest in Lubbock is hearing Mary's confession. Mary has previously confessed a sexually active life and now confesses she is pregnant by Jésus, a migrant worker who has been in town for several months during the cotton picking season. From Mary's description, the Priest recognizes Jésus as a penitent whose confession he heard last week, which disclosed that (1) Jésus had multiple unprotected sexual encounters during the last few months, and that (2) Jésus, during a hospitalization for a hernia repair a while ago, learned that he is HIV positive. Mary, knowing Jésus has no intention of acknowledging his child and supporting it, has recently taken up with Fritz, an older man who has said he would care for Mary and raise the child as their own. Mary has moved in with Fritz and has sexually consummated their relationship.

Case III. Jack and Jill are in their mid-seventies and have been married 35 years. Jack is a lawyer who retired 10 years ago from a successful practice and has been teaching at a small college in south central Pennsylvania. He has two children by a previous marriage that ended in divorce. Jill is a writer who published several successful novels in the late 60’s and 70’s, but after raising four children from her first marriage, she experienced writer’s block and has never again published. Fifteen years ago, she developed severe rheumatoid arthritis, which has now invaded many organs, and although after numerous surgeries she is functional and can control the pain with steroids and analgesics, she has grown weary of life. Jack is a recovered alcoholic who suffers episodic depression, which up to now has been controlled by the routine ingestion of anti-depressants such as Zoloft. In the market crash of 1987, Jack lost most of his capital and many of his real estate investments were foreclosed. He has a modest pension fund, but it fails to keep pace with any significant inflation; while Jill has a little independent capital, neither of them foresees being able to maintain their modest lifestyle indefinitely. Their genetic profiles plus their present more or less stable state of health indicate that they have significant years left, and both of them worry about “outliving their money.” Dr. Feelgood, their joint primary care physician, has been treating them for many years, and has always made it clear to them that he favors taking good care of ALL his patients’ needs, and seeing to their comfort.

Jack and Jill have entered into a suicide pact, which they now seek to implement by using Dr. Feelgood’s implied promise and accumulating a sufficient supply of tranquilizers and barbiturates for a fatal dose. Dr. Feelgood does no more that supply prescriptions on request for pain and anxiety relief. Jill eventually died in her sleep of a fatal dose. Jack, however, while slipping into a totally comatose state, remains alive on respirator, but showing little or no brain activity.

Case IV. Gladys is a supermodel who has been unable to achieve pregnancy with Ted, her news anchor husband. As a public couple with “everything going for them,” they want to raise a “model family” of at least two, but probably no more than, three children. Gladys is advised by her physician that there is a fertility drug that has been successfully used in Europe for several years, but is not yet approved by the FDA, that he believes would work for her. The drug is freely available in Mexico. When Ted and Gladys do a TV special in Acapulco soon thereafter, Gladys purchases a substantial supply of the drug and begins to take it in the doses prescribed by her physician. Gladys, without her physician’s knowledge, is also taking a form of Vitamin A known as Retin A, which is an agent for preserving clear, unblemished skin, which is important to Gladys’ work. Gladys is unaware that Retinoic Acid (Retin A) is a notorious agent for causing fetal deformities in pregnant women, and other complications of pregnancy. The fertility drug works, Gladys is suddenly pregnant with what is certain to be multiple births, at least twins and maybe more. Her physician discovers that she has been taking Retin A and advises an early stage abortion. Both Ted and Gladys have taken public stances as “pro-life” supporters, both from and political and religious point of view.

Case V. Jekyll, a leading physician in Houston, is convinced that Hyde, his close friend since college and his partner in practice, is having a sexually active affair with his wife. To test his theory, Jekyll makes elaborate arrangements to attend a three-day seminar at UT Southwestern in Dallas, including hotel reservations at the Holiday Inn Select, across from Love Field, and ensures that both his partner and his wife know well in advance of his plans. On the appointed day, Jekyll bids his wife goodbye, tells his partner how to reach him in Dallas and goes to Houston Hobby where he boards a flight for Dallas, arriving an hour later and immediately checking into the hotel, and then going to UT Southwestern and registering for the seminar. After exchanging greetings with a number of colleagues well known to both Jekyll and Hyde, Jekyll takes another flight back to Houston, arriving about midnight. Waiting in the bar until about 2 a.m., Jekyll then proceeds home letting himself in through a back entrance with a hidden release to the alarm. Upstairs, as expected, he finds both Hyde and his wife nude in bed, sound asleep. Applying a fast acting inhalant, he renders both unconscious. Using surgical tools in his home case, he castrates Hyde in a neat procedure, leaving the remains in a tray on the night table, and then departs, taking the 6 a.m. flight to Dallas and returning to his hotel room. When Hyde groggily awakes about 8 a.m., and discovers his plight, he goes into shock and suffers cardiac arrest. Jekyll's wife requires some time to regain her composure, and to call EMS, but by the time of EMS's arrival, Hyde is dead.

Case VI. Ned Washington, an elderly black man of indeterminate age, was having a few beers in a tavern in a small town in a southern state. Several white patrons became annoyed at Ned's repeated playing of the same tune on the juke box and complained to the bartender who told Ned to leave. When Ned ignored him, the bartender physically ejected Ned from the premises, accidentally throwing him up against a passing police officer who was knocked over by the force of Ned's body. Enraged, the officer beat Ned about the head and shoulders with his baton, causing severe contusions, concussion and unconsciousness. After several days in the hospital, Ned died of his injuries. The police officer and the bartender were separately tried and acquitted of state criminal charges. The U.S. Department of Justice brought charges against both men for violation of Ned's civil rights; again, both were acquitted. Ned's widow then sued both men in civil court for wrongful death, and won an award of actual and punitive damages totaling several million dollars. All this legal activity is lawful under the U.S. Constitution.

Case VII. Jodie and Mary were born as conjoined twins. The twins were not born with identical internal body parts, and Jodie was almost entirely dependent upon Mary’s heart and lung function to survive. It was clear to the physicians involved in the case, at least two of whom had considerable experience with surgical separation of conjoined twins, that without surgical intervention, both girls would die within a relatively short time. Mary would be unable to thrive and continue to support both bodies as they grew. It was unclear what “Quality of Life” might be enjoyed by Mary during the time of her survival, since it was impossible to predict how long that might be and what functions she might be able to perform, given the limitations imposed by their conjunction, which occurred primarily at the base of the spine. Jodie was not conscious, owing to the malformation of brain mass and function. The doctors recommended surgical separation, which could result in “normal” life for Mary, provided the surgery were performed promptly, and that other therapies could be employed to assist her growth. The parents, who did not disclose their grounds for doing so, whether religious or otherwise, declined the surgical intervention. The doctors, who were responsible for the care of the infants by virtue of hospitalization which could not be terminated without severe danger to both children, sought the assistance of the courts to permit surgical procedures to separate the children. The Court agreed and the surgery was performed, with Jodie expiring shortly thereafter. Mary’s condition is still critical, but reportedly improving.

Case VIII. A Counselor in private practice, you have a new client, Mr. X, who states he suffers from “bipolar” disorder which he controls with medication prescribed by a psychiatrist. Prior to taking the medication, his illness caused him to hear terrifying voices commanding him to do violent acts, and rendered him so enervated by the attacks that he could not function in a job or intimate relationships. However, the medication itself, although controlling the symptoms, is producing other undesirable effects, i.e., rendering him sluggish, dull, unable to experience joy, eager anticipation or enthusiasm. From past experience with various medications, he lives in terror that he will experience sudden onset of new symptoms. After a few months of counseling, he begins to experience feelings that increase his fears. He feels helpless and is losing hope. Finally, he announces to you, in confidence of the counselor relationship, that he is going to commit suicide rather than suffer the continued pain of his mental illness, and he asks you not to intervene or notify anyone of his plans.

Case IX. You are a resident of the Great State of Camelot. Camelot, an island off the coast of Southern California, enjoys unusual environmental conditions, such as precisely the amount of rain, which never appears before 9PM and disappears before dawn, necessary for bounteous crops and vegetation; a comprehensive system of underground tunnels providing transportation of solar powered electric cars to every major intersection in every community in the state, and a very rapid companion system that links every community to a central airport containing an exhaust system that simultaneously removes any contamination from the air; a negative income tax which supplements the income of all below a comfortable level of subsistence, with revenues drawn from an inexhaustible supply of surplus power from its patented, exclusive advanced technology solar power gathering system; home schooling for all provided by live internet connected systems in which children interact as if physically in company with each other, with comprehensive library research services available on line; etc., etc.. Camelot is a state of the United States of America, having been admitted when it was aboriginal and poor, the quality of its resources having been developed by its inhabitants, who were inbred, but developed rapid genetic pool mutation purely by accident of fate, resulting is extraordinary creativity and development. Its inhabitants enjoy good looks, excellent health, which is maintained by a universal health care system that covers all its inhabitants. All the children are above average. Camelot permits no permanent immigration. Immigrants on a temporary basis must pay a prohibitive occupancy tax. During the several generations of its development, Camelot was supported in large part by taxes from other states of the U.S.

Case X. The Supreme Court of the United States has granted a stay of execution to an inmate who has been on death row in Texas for 11 years. The inmate has been assessed by developmental psychologists as having the overall mental capacity of an individual of no more than the age of 10, possibly younger, in the case of some reasoning skills. He was convicted at the age of more than 21 years of raping and murdering a 19 year-old woman under circumstances that would ordinarily indicate cruelty and lack of human compassion of any sort. The inmate is of Hispanic background. His victim was a white, middle class woman. At his trial, he was represented by an attorney who appeared to be sleeping from time to time, and at other times bore a strong odor of alcohol.