(no subject)

[sythyry]

After last night's deeds, there has been some debate among my friends. In Vheshrame, the Healers' Guild has one policy; in Yistreia, it has another.

Ghirbis' Position: The responsibility of the healer to her patient is supreme. She must take all plausible measures she can to save his life and cure his condition. (Illegal and immoral measures aren't plausible, etc., etc. Don't be silly.) A healer with several patients having crises should get help for all but one of them. A healer with one patient in a crisis and another not currently in a crisis should attend to the one in the crisis, and not reserve anything for the one not currently in one -- bearing in mind that few crises last longer than a day, and most resources are renewed at each dawntime.

Havune's Position: The responsibility of the healer to the community of patients is supreme. The healers should take all plausible measures she can to protect her patients collectively. A healer with several patients having crises should get help for all but one of them if she can; if she cannot, she should act to do the most good that she can with whatever resources she has. A healer with one patient in a crisis and another not currently in a crisis should help the one in a crisis, but save some cley for the other.

[Poll #520528]

Comments

[cowboy-r.livejournal.com]

As a monster healer, who has worked in crisis medicine on the battlefield, I have to say that they're both right, and they're both wrong. We don't have cley, or spells, but we do have expendable supplies. How many battle dressings have I got? How much morphine?

The way we solve this is by a process called triage. As we encounter wounded, we make a decision as to what category the person is in: Will they die, regardless of heroic measures? Will they live, regardless of heroic measures? Will they live, only if heroic measures are taken? It's the last category that's dealt with first.

Navy Hospital Corpsmen and Army Medics are responsible for the fact that, in my world, my nation's soldiers have a 98% chance of surviving their wounds if they survive the initial wounding. It's a record we're damn proud of.

And we do it all without spells. Your healers need to learn more about medicine without magic.

[goodluckfox.livejournal.com]

Amen to that. The inhabitants of Sythyry's world are a people for whom arrows through the head, heart, and other vital organs are mere nuisances. A people who can die several deaths/resurrections is part of their medical and judicial systems. A people with *guaranteed* reincarnation if they DO die. A people who have ONE kind of plague, easily cured, and not the dozen dozens of varieties that we do that are mutating into resistant forms.

I don't understand what he meant by "all but one." Why would you get trreatmetn for all but one of your patients? If you've got five patients, there's not much difference between helping four and helping five; either way you're going to be spreading yourself thin.

I would say that given the obviously less critical nature of World Tree medicine (they've got so much going for them) that it would seem to me that if it actually takes heroic measuares and all your cley to save someone, you should do so. Odds are anybody else that you MIGHT have to help will probably keep for a bit longer.

Loxley

[(Anonymous)]

"all but one" meaning that the healer should tend one patient and get other people to help all but that one.

[yotogi.livejournal.com]

Again, not to seem contrary, but that may not be completely possible. Medicine as we perform it relies on a complex set of biological and chemical principles that may not actually apply to the Tree. Not that I disagree with you, mind; I voted 0, there's rightness and wrongness to both arguments. Just offering that, at night, their sun goes out, so there's really no saying if physics and chemistry et cetera are going to work the same way.

[cowboy-r.livejournal.com]

They need an empirical society to find out how things work, in the absense of magic... or with magic.

[goodluckfox.livejournal.com]

I don't think the Cyarr have Healoc...

[gavinfox.livejournal.com]

Who knows what sort of practices that mirror our ways of healing the Cyarr might come with... in enough years, Prime healers may be able to learn a thing or two from them... as preposterous as it sounds. Necessity is the mother of invention, after all...

[sythyry.livejournal.com]

[ObPrejudice...]

Ridiculous. They're not prime.

[justicezero.livejournal.com]

Yes. And so, in this case, they have a specific weakness. One which they must compensate for. You recall your lessons on 'impractical uses of Destroc', do you not? If all one has is a tool not directly suited for the job, one finds interesting ways of solving the problem with the tool one -has-, and further, in doing so, must by necessity learn a great deal about the nature of the problem.

[sythyry.livejournal.com]

Typical monster attitude, that!

[Typical prime attitude, that. -bb]

[yotogi.livejournal.com]

Good luck getting the nobility to agree to that one.

[sythyry.livejournal.com]

There is no "absense of magic" here. Absense of cley, yes.

[gavinfox.livejournal.com]

I think what they mean is that your healers need to learn about the processes of the body and ways to heal without expending cley, because there ARE ways of doing very effective healing without lots of cley. However, in order to discover these ways efficiently, there needs to be some sort of structure in the culture to gain large amounts of empirical knowledge on how the body works...

[goodluckfox.livejournal.com]

True. But the physical laws are so wildly different there that it may be harder to do research. I mean, here, we can use the scientific method, and our experiments are repeatable. There, they may run the same experiment three times and get FIVE different final results. Plus most of what we know as biochemistry prolly doesn't work. We're made out of patterned quarks, muons, leptons, and assorted other hoohadery at the quantum physical level, and they're made out of raw magic at a similarly fundamental level.

It makes my brain hurt.

That said, I think it would be a hoot to see Sythyry use some of his off-Tree knowledge that we've been sharing with him. I can picture the converation now...

Sythyry: (something he could only have learned from us)
Everyone Else: Sythyry, has the nendrai driven you mad? You're not making any sense. Now stop speaking foolishness.

Loxley

[kistaro]

I gave it a 2. This isn't a new issue for me; it was discussed extensively in Biomedical Ethics class. I've taken the utilitarian viewpoint of "as best as can be done for all involved, without sacrificing the sanctity of the individual."

It makes for very, very difficult trade-offs. If the supplies required to save one person's life could instead be used to save six people, that one person is dead. It doesn't matter who it is, or how much I care about that particular person. It is irrelevant if that person is a noble or a commoner; that person is lost. Six can be saved with the supplies; in this case, an individual loses to the community.

Consider the wrong done to the six individuals who would die instead. Can their end be justified under "It was this one other person who my attention was directed to"? Is not a healer's job to heal, to prevent death?

However, I can't support position 3 or 4. I do believe there's a point where an individual should get a bit of credit. Consider a situation where someone has been through most of a long, difficult, and expensive recovery, and xe's at the last stage of it. Some other disaster comes up, however, and the lives of two people are in danger. They could be saved, but it would drain or destroy the resources for the first person's recovery- and the first person would be killed.

In that case, the one person would survive; two would perish. One person was nearly healed, and xir family had gone to great expense to see health again- only for defeat to be snatched from the jaws of victory. Two others were saved, but what of the expense lost?

Yet if two, just caught in a drastic disaster, die- they were lost when the disaster occured.

The "3" position would probably kill the one for benefit of the two. Although I disagree with that, in another way, I can't truly fault it.

Consider the potential more extreme case: actively killing someone. A practice common to our world is that of organ transplant: if an organ of a person's body fails, and it turns out that the corresponding organ of a freshly-dead person would work (it's not what killed the freshly-dead person, and it's compatible) in its place, the organ can be transplanted from the dead person (who, all things considered, doesn't really need it anymore) to the living, generally saving that person's life. (Machines only go so far.)

So what if a patient who would survive even if left completely alone other than the basics of food and water- or even some unlucky passer-by waiting in the waiting room for a friend- could be killed, and save lives? What if one person could be killed, to save five others?

It would be, to me, a reprehensible act. But... I can see how some people would think that way, would support it.

Here's a more difficult case. Consider a doomed person. Xe is dying, and nothing can prevent this, nor recover from such a state. Xe has about one week of life left, and that's mostly on artificial means- living by machine or sustained magic, depending on the universe.

But three other people are dying. The organs of this one person- who will be dead in a week- can save the three others. His can save the other three; none of the other three could save any of the others. All three people who could be saved by this one person's organs, however, will be dead within two days, machines/magic or no. Does the doomed person have any right to live the week?

I have no good answer for that one.

For that matter, what if the death of one healthy person could save not one, not ten, but millions? Implausible in the field of health- but what about a much-needed assassination of a perverted, cruel dictator?

[collie13.livejournal.com]

My answer is right down the middle -- because to me it's all context-driven. I had emergency training many, many years ago, although I've been in very few emergencies. I understand triage, and in a "normal" emergency I know I perform quite competently. I've even been lightly dinged in an emergency, and still done my best to aid others who needed the help also, since I was on so much adrenaline I didn't initially realize I was bleeding. When it was pointed out to me, I couldn't feel any pain, so figured it couldn't be that important.

On the other hand, I've never been in an emergency where it's my beloved lying there injured. Quite frankly, I doubt I'd be thinking rationally at that point about how many dressings I had and whether I should be working on this person or that one. I'd be rational in the sense of not forgetting my emergency training, but I also know myself well enough that I'd probably be very, very focused on my sweetie, and not give a flying flip who else was there.

I realize this will probably make me sound quite selfish, but I think it's the truth. Here and now we can calmly and thoughtfully say we'd do this or that in an emergency -- but when the proverbial shit actually hits the fan, I've found few people are actually that cool and collected. ;)

[terrycloth.livejournal.com]

Our society (specifically, the nation I live in) tends strongly towards Ghirbis' position, and it makes medicine very expensive, even if you're not in a crisis, because so many resources are being used up on one crisis or another.

As a result, many illnesses don't get treated until they become crises, and then they're all the more difficult to treat...

So I'd have to agree with Havune.

[niss-the-ai.livejournal.com]

I side with the individual here, mostly ("-2"). Favor the good of the group enough and you get the argument Kistaro alludes to: you have no right to live if killing you would be convenient. Good policy for dealing with dictators -- Sythyry, if you captured a murderous tyrant would you give him a cushy cell, a fair trial, and plentiful snack food? -- but not someone whose only crime is having "precious vital fluids" to spare.

On the other paw, if it's purely a choice between saving one sick person and saving several other sick people, I'd go with the several. Recently I saw a sign asking for donations for a kid who needed a "multi-viceral transplant"; ie. several new organs. I sympathize with the kid, but wouldn't it make more sense to save a bunch of kids who each need only one?

By the way, why does it have to be a Rassimel woman? It seems as though even Ilottat would be qualified for that job.

[sythyry.livejournal.com]

I'll consider the ethical question the next time I capture a murderous tyrant. At the moment I think I'm more likely to be one of the victims -- everyone else with any power is happily using me for their own purposes.

The point of this is to give Ficina the best milk possible, in the most natural way possible. Getting a real Rassimel woman is that. Getting, say, a Rassimel man be-femaled for the occasion (Yarwain), much less an Orren wearing Cloak of Another God, would not be.

[coppercheetah.livejournal.com]

I admit to having had, at one point, an ideology that I would always in all things try to make everyone happy. To try whenever possible to provide contentment and comfort by means of compromise and creativity to satisfy all involved.

I was an idealist. Idealism is not realism.

Reality has taught me in the following years that more often than not, such a utopian compromise is not possible, and you must make the hard decision to let some be disappointed or left wanting. It is not for lack of love for them, but for the understanding that you must help as many as you can. It should be your goal that if possible, to help everyone, and to be content with helping as many as you can. To come to that realization broke several things in me for a very long while, but I have come to accept it.

I have a loved one. One for whom my life or anyone else's at one point would have been a small price to pay for their survival. Thoughts of the extremes I would do for the one forced me into yet another harsh realization: To care for as many as possible, sometimes the ones you leave wanting are ones you care about, ones you so desperately wish were not the most logical choice, but must follow the same rules as everyone else. I was left at an impasse of mind against heart.

[ Perhaps sadly, I think my mind and heart are still at war over this one: Niether will yield, and I fear I will fail to follow either if such a moment of trial ever came to pass. To my loved one, I only ask that we hope such a moment never happens, so I never have the chance to ultimately fail. ]

I have also come to recognize I am, also, an individual. An individual who deserves to live and be happy just like every other individual. Is my happiness weighted any more or less than theirs? Another harsh realization: I must include myself in my decisions for making people happy, for leaving myself wanting may be worse than leaving another in such a state if by saving myself, I may save more people. I will always have the worry of taking selfish action when it is unnecessary, and this is why this realization was so hard to accept.

From a conceptual point of view, I would choose to follow my mind, and save as many as possible. There are, and will always be, mitigating factors which could possibly weight the saving of certain individuals over others, but speaking strictly conceptually, I feel my duty is still the same as my younger self: To make everyone happy.

Even if I must allow some to suffer.
Even if the ones I must let suffer are those I cherish.
I only pray I never come into this choice, for I fear that while I can say this in concept, in practice, I've yet to know if I have the resolve to follow through, and to accept the consequences afterward.

I think that, in reality, I will attempt to save as many as I can, but my heart will cause me to fail to allow those I love to suffer. And so, I chose a '1'.