Michael Garowee
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Justin Krez
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Michael Battaglino
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A.P. Anderson
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Everyone has their own personal set of ethics. Some folks are stricter than others, but generally speaking, most people at least try to act decently, even if they somehow twist the term "decent" to include texting in a movie theater. The world of professional ethics is a bit different. Ethicists have to take a hard look at how ever-shifting rules affect our entire culture. And boy have we thrown them some curveballs ...
Do you have tattoos? Barbed wire on the bicep, little butterfly on the ankle, maybe "No ragrets" on the back of your head? Whatever it is, we're betting that none of your ink has thrown the entire medical world into question. That's what happens when doctors discover tattoos reading "Do Not Resuscitate" on a patient. This gives medical personnel the unenviable task of determining whether the tattoo is meant as a legally binding life and death order or simply as a bad joke. Don't laugh -- and not just because it's not funny -- joke DNR tattoos are an actual thing. One guy got the tattoo because he lost a bet, but fortunately, his paperwork confirmed that he did, in fact, want to live when he was hospitalized in 2012.
In 2017, a 70-year-old man was admitted to a hospital unconscious, in septic shock, and lacking any identification. The only thing he had was that pesky DNR tattoo. His doctors had to call in an ethics consultant, who determined that the tattoo could indeed be interpreted as the patient's genuine wish. But the issue remains controversial in the exciting world of medical ethics.
A patient's family could theoretically sue a physician who let their loved one die based on some bad ink, but then, a patient could theoretically wake up and sue once they found out their DNR was violated. Something to keep in mind before you take out hundreds of thousands of dollars in medical student loans: You could theoretically be ruined by a dumb joke tattoo.
In the year 2000, a 34-year-old woman from the Maltese island of Gojo was pregnant with conjoined twins, Jodie and Mary, attached at the pelvis by fused spinal cords. Jodie had developed a healthy brain, heart, and lungs capable of supporting herself, but Mary hadn't developed any of them properly, and relied on Jodie's to survive. It's kind of like when your shiftless brother shows up to crash on your couch, except somehow even sadder.
Now, Mary was pretty much done for no matter what, but if she didn't stop using her sister's organs, she might take Jodie down as well. That left their parents with three options: 1) Just kinda, you know, chill on the whole thing, letting both twins die in three to six months, 2) separate them right away, letting Mary die but giving Jodie a good chance at a normal life, or 3) separate them only when it was truly necessary, which would more than likely kill Jodie along with Mary. The parents, devout Catholics, chose the "Jesus take the wheel" route, to which their medical team responded, "Wait, 'Let's do nothing' wasn't really an option," and kicked the decision up to the English court system.
There is precedent for this kind of thing. In 1977, a Jewish couple in Philadelphia faced the same conflict. Torn between killing one daughter outright and dooming the other by not doing so, they left the decision up to rabbinical scholars, who determined that separation was permissible because the "weaker" twin was already "designated for death" (also the title of our least favorite Steven Seagal movie).
Jodie and Mary's case worked its way through the courts, ending with the Court of Appeal's decision to proceed with the surgery. Mary passed away the day after the operation, and Jodie has since grown into a healthy teenager who happens to have a hell of a "two truths and a lie" strategy up her sleeve.
In May of 2014, Iowa State Representative Henry Rayhons visited his Alzheimer's-afflicted wife Donna at the nursing home where she lived. According to him, she was upset because she'd been moved from a private to a shared room earlier that day, and he spent his visit calming her with hand-holding and prayer. Her new roommate had a different interpretation of the evening's events, claiming that Henry entered the room, closed the privacy curtain, had sex with Donna, and then exited into the hallway. A security tape showed him tossing a pair of panties into a hamper, and his semen was later identified in her bed. Normally, what goes on in the marital bed is between a couple and their gimp, but Donna's doctor had previously directed Rayhons to cease sexual activity, having judged that she lacked the mental capacity to consent. A few weeks later, Donna Rayhons passed away, and Henry Rayhons was arrested immediately after her funeral for third-degree sexual abuse.
If Rayhons indeed had sex with his wife that day, the question of whether the act constituted assault isn't entirely clear cut. A hospital examination immediately following the incident found no signs of physical assault, but her ability to consent remains murky, despite her doctor's previously stated opinion. Dementia progresses gradually, with symptoms fluctuating from day to day. There is no medical consensus on when an Alzheimer's patient is no longer able to consent, and many experts believe the desire for sex persists even past the point when patients can no longer take care of themselves. They may not remember your name, but they do remember the way to Bone Town, it seems. Nurses close to the situation attest that even at her worst, Donna Rayhons always reacted positively when her husband came to visit. Which, of course, means basically nothing either way.
Whatever the case, Henry Rayhons pleaded not guilty, maintaining that no sexual activity had occurred on the date in question, and he was eventually acquitted. While no definitive proof ever came to light, the preponderance of evidence we do have (which also included a confession, later ruled invalid, as well as some suspicious changes in his story) suggests that the jury didn't believe Mr. Rayhons, but also didn't see fit to punish him for having sex with his wife, who may have been willing but was not able to be willing.
It's ... complicated.
In 1982, Andrew Wilson shot and killed a security guard while robbing a Chicago McDonald's, because people who have a good sense of risk versus reward don't hold up drive-thrus in the first place. Fortunately for him, eyewitnesses identified the killer as a man named Alton Logan, who was sentenced to life in prison. It's not like things totally worked out for Wilson, as he was being held for killing two police officers in an apparently unrelated incident at the time. But he just didn't need that on top of everything else, you know?
Illinois Department of CorrectionsPictured: Logan (Left) looking absolutely nothing like Wilson (Right)
Now, Wilson had admitted as much to his two lawyers, secure in the knowledge that attorney-client privilege prevented them from telling anyone. The attorneys attended Logan's sentencing, reasoning that if the falsely accused man were sentenced to death for the crime, they'd be free to violate privilege in order to save a man's life. But no such luck. For the first time in history, it was a bad thing that an innocent man was not sentenced to die.
Wilson died in prison in 2007. His lawyers had at least convinced him to let them disclose what they knew after his death, and armed with decades-old affidavits, the pair had Logan freed in 2008. By that point, he had already served almost half his life in prison, so something tells us he didn't send them a thank-you note.
With any new drug, there's a testing phase that usually consists of clinical trials, wherein one group is given the real medication while another is given a placebo that does nothing. Now, here's where things get complicated: Western standards of care prohibit anything but the approved treatment for HIV-positive pregnant women, even in the context of a clinical trial. So U.S. researchers instead take their trials to places like Malawi, reasoning that many women there wouldn't receive any treatment otherwise, and we kind of have to do trials to figure out if these drugs work on pregnant women.
But it doesn't feel entirely moral to deny effective, established treatments to such vulnerable populations, especially when we refuse to deny those treatments to more, uh .... "Western" patients. But then again, there might be an even more effective treatment out there, and we have no way of finding out besides putting those extremely vulnerable people at risk in the first place.
aryfahmed/Adobe StockThis positive involves a lot of negatives.
To further complicate matters, Malawi has made some giant leaps in providing care to HIV-positive pregnant women in the last decade. In 2011, the nation's Ministry of Health formally mandated approved treatment for every HIV-positive pregnant woman, resulting in a 748 percent increase in Malawian women receiving treatment. So by participating in "cutting-edge" U.S. studies, Malawian women might receive inferior treatment when compared with the state-sponsored care now available to them. This is but another chapter in the long history of friction between medical science and brown people -- one that illustrates that while the person in the white coat might have the best interests of humanity at heart, that doesn't necessarily mean yours specifically.
Justin Krez is a vagrant who is alternatively writing or day-drinking in a P.F. Chang's. You can't find him on Twitter, but you might find him meditating in a cardboard box. Michael Battaglino is a new contributor to Cracked.com. Be sure to check out some of his other work if you enjoyed this article. A.P. Anderson is a freelance editor and comedy writer from Athens, GA. He once sold a potato to Michael Stipe. Find him on Twitter: @Breezus_H
That last one there was like a much more complicated version of Dallas Buyers Club.
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