Wednesday, February 4, 2009

Ethics and Law...Mutually Exclusive?

I was reading about an interesting court case today: Coombes vs. Florio. In brief, Sacca, a 72-year old cancer patient of Dr. Florio, was prescribed several common drugs that cause drowsiness, dizziness, and should not be used before driving (i.e. oxycodone, hydrocodone, and other sedatives). While Sacca was undergoing cancer treatment, he was advised by Dr. Florio not to drive. However, once the treatment was completed, Dr. Florio informed the patient that he could resume driving (even though Sacca was still receiving prescriptions for the common opioids above). One day, while Sacca was driving, he got into an accident and killed 10-year old Kevin Coombes. It was later concluded that a combination of factors, including Sacca's general health condition, as well as the influence of the drugs, contributed to the accident. Later, the Coombes family sued Sacca.....AND Florio! The case against Sacca is self-explanatory (although Sacca died soon after the case opened and the case was later settled). The allegations against Florio, however, resulted in far more intriguing results. The suit brought against Florio argued that the physician should have informed his patient of the possible side-effects of the prescribed drugs, and Dr. Florio should have forewarned the patient not to drive while under the influence.

The decision for this case was met with controversy and while the lower courts ruled in favor of Florio, the case was later brought to the Supreme Court of Massachusetts where it was again, met with a mixed bag of feelings, which are not the subject of tonight's blog. I'd like to discuss the more salient point here: should a physician be held responsible for his/her patient's behavior? Isn't this similar to asking whether or not the bar tender should be held responsible for a drunken person's behavior after they leave the bar? Or even the host of a party...if I throw a party, serve alcohol, and one of my drunken guests leaves and gets into an accident, should I be held responsible for this guest's behavior? Alternatively, if I'm a fitness trainer who helps a client get into great shape, can I take all the credit for the client's newfound health? In other words, if we are could potentially contribue to a specific decision that a person makes, how large or small of a role do we play in the person's behavior as it relates to us?

My personal opinion: The answer to this question would vary depending on the person asking it: an ethicist or an attorney?! While the law may outline a series of specific guidelines for certain problems, true ethics (the definition of which would, in itself, create a new subject) may point towards an entirely different direction. As critical thinkers, I think that whenever we get at a cross-roads where we have to make a difficult decision that may affect another person, we should be able to assess both the legal and ethical aspects of the decision and their respective consequences. I am not suggesting that one should always make one or the other decision, but merely that we should be AWARE!

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