You Decide - Choices and Consequences Assignment: The "You Decide" assignment presents a difficult and painful dilemma, with you in an imagined professional role. Go through the You Decide presentation, make the decision it calls for, meet you’re your team or partner to discuss, and compose a paper and presentation that explains your decision and your reasoning and justification for it. You are called upon to make a painful medical decision and to explain it both orally and in writing.  Who benefits from what you decided, who gets denied a needed benefit, and why?  You will compose an official memorandum that will be kept for the record and could potentially be read not only by your Peer Review Committee, but also by those involved in charitable fundraising, which supports hospital development, as well as by others with financial interests in the decision. You will see notice that there is time pressure in the simulated situation, so remember that you would not have the luxury to dawdle in the decision-making process, and as the decision-maker, you would not have the luxury of consulting a broad spectrum of advisors.  It falls on you and your team or partner to decide! Include in the document and presentation the utilitarian ethical philosophy of John Stuart Mill (from attached) and one other ethical philosopher of your choosing that we have studied to date, and use both of those philosophies to bolster your decision. This paper will be at least 2 pages and no more than 3 pages with a 2-3 minute oral presentation on which you and your team or partner may (ideally and preferably) collaborate. Remember, both professional written form and potential audience, as well as tone when writing this sensitive memorandum. Scenario Ok, Lead Surgeon, it is time to do what you do best! There is a lot at stake. The decision must be made almost immediately. Like all actions, you will need to write your decision into medical documentation before you begin. Yes, that means YOU! In the limited time before you would begin surgery, you need to consider the cases; the technical issues involved also, and write a Memorandum for the Record to document what decision you made and what considerations you included in your process. This will be on the record, so it needs to be thorough in case it needs to justify your actions at a later date. Role You are the Lead Surgeon in a major hospital, and by virtue of your seniority you are also the key decision maker for transplant cases. Right now you have three people who are waiting and hoping for a suitable heart to become available. Your cell phone rings suddenly, and you are notified that a heart has become available-meaning that you need to make a quick yet sound decision about which patient will receive the heart and then schedule surgery for today. Players Jerry Male, 55 year old family man, mid-level manage Jerry, a father of 3 children and at the age of 55, is in the Ward awaiting a suitable heart for transplanting. Hi.

1. You Decide - Choices and Consequences
Assignment:
The "You Decide" assignment presents a difficult and painful
dilemma, with you in an imagined professional role. Go through
the You Decide presentation, make the decision it calls for,
meet you’re your team or partner to discuss, and compose a
paper and presentation that explains your decision and your
reasoning and justification for it.
You are called upon to make a painful medical decision and to
explain it both orally and in writing. Who benefits from what
you decided, who gets denied a needed benefit, and why? You
will compose an official memorandum that will be kept for the
record and could potentially be read not only by your Peer
Review Committee, but also by those involved in charitable
fundraising, which supports hospital development, as well as by
others with financial interests in the decision.
You will see notice that there is time pressure in the simulated
situation, so remember that you would not have the luxury to
dawdle in the decision-making process, and as the decision-
maker, you would not have the luxury of consulting a broad
spectrum of advisors. It falls on you and your team or partner
to decide!
Include in the document and presentation the utilitarian ethical
philosophy of John Stuart Mill (from attached) and one other
ethical philosopher of your choosing that we have studied to
date, and use both of those philosophies to bolster your
decision. This paper will be at least 2 pages and no more than 3
pages with a 2-3 minute oral presentation on which you and
your team or partner may (ideally and preferably) collaborate.
Remember, both professional written form and potential
audience, as well as tone when writing this sensitive
memorandum.
Scenario
Ok, Lead Surgeon, it is time to do what you do best! There is a

2. lot at stake. The decision must be made almost immediately.
Like all actions, you will need to write your decision into
medical documentation before you begin. Yes, that means YOU!
In the limited time before you would begin surgery, you need to
consider the cases; the technical issues involved also, and write
a Memorandum for the Record to document what decision you
made and what considerations you included in your process.
This will be on the record, so it needs to be thorough in case it
needs to justify your actions at a later date.
Role
You are the Lead Surgeon in a major hospital, and by virtue of
your seniority you are also the key decision maker for
transplant cases. Right now you have three people who are
waiting and hoping for a suitable heart to become available.
Your cell phone rings suddenly, and you are notified that a
heart has become available-meaning that you need to make a
quick yet sound decision about which patient will receive the
heart and then schedule surgery for today.
Players
Jerry
Male, 55 year old family man, mid-level manage
Jerry, a father of 3 children and at the age of 55, is in the Ward
awaiting a suitable heart for transplanting. His wife Joanie is a
stay at home mother with no education beyond high school and
no career. Jerry is the middle level manager at a carpet
distributing business and 5 year short of his retirement
eligibility. Jerry and Joanie have three teenage children aged
14, 16, and 19. The 19 year old is a sophomore at college; the
14 year old is mildly autistic, and the 16 year old is an astronaut
wannabe. If Jerry gets the heart, his chances of living another
10-15 years are very high. His heart is damaged due to the use
of steroids in his early 20s when he was involved with
bodybuilding before the dangers of steroid use were fully
known.

3. Lisa
Female, 12 year old lifelong health issues
Lisa is one of those precocious girls - a doll-like girl at the edge
of becoming a teenager. She reads voraciously and yet likes the
activities of a younger girl playing with her Barbie Doll. She
has suffered health issues all her life due to various viral
infections and a lupus-like immune deficiency. Her heart was
damaged during a nasty bout with pneumonia last year and
actually stopped for a brief period. Her mother knew to begin
CPR on her or she would have died there. Even with a
transplant, her chances of surviving into her 20s are not good.
She is the only child in the family, and they cannot bear more
children. Her parents will do anything for her, and they have
offered to donate $2 million to the hospital's construction of
specialized facilities if she can get a heart soon enough. Her
father is also a noted oncologist working in the same hospital
but in a different department.
Ozzy
Male, 38 year old homeless drug abuser
Ozzy is a single 38 year old man with no family. He has lived
homeless and in shelters for at least a decade. He was brought
to the Hospital through the work of a local charity that assists
such men with no assets or insurance. His heart condition is due
to continued abuse and overdosing of crack cocaine, and
without a transplant he will not live out the month. In recent
months, has become involved with troubled teens at a local
homework and tutoring hangout, and he has provided the
wisdom and insight that only an abuser can know about where
life can go. He has signed a contract with the same charity that,
if he gets the transplant, he will continue working at the after-
school homework hangout as a counselor-mentor for at least one
year after the transplant. With the transplant and successful
staying off the drugs, he could live another 10 years - maybe
more. Recidivism is a severe risk with his history of abuse, and
if he returns to using crack he would quickly damage the new

4. heart and die within months.
Dr. Doe
Male, 35 year old Lisa's Dad, the oncologist
Dr. Jonathan Doe is Lisa's father. He has offered the hospital $2
Million Dollars in exchange that his daughter gets the heart
transplant. He is an up-and-coming oncologist in the same
hospital. He is loyal and totally committed to Lisa; while not
obnoxious and pushy, his presence is keenly felt around the
professional community in the Hospital and there is a need for
his $2 Million.
One of the great ongoing situations that calls for ethical
decision making is the reality that there is almost always a
greater need for something than there is a supply to meet the
need.
For our assignment and scenario, the demand is the life-and-
death situation of the need for transplantable organs and the
rather small and transitory supply. Hard decisions need to be
made, and there is little time to think things through. These are
emergency situations.
Transplantable organs become available on short notice--usually
because a donor has died for reasons unrelated to the organ.
They need to be removed and transplanted very quickly because
they only remain fresh for a limited period. Then there is the
whole complicated issue of tissue type matching. There is also
an ongoing concern about how long recipients can wait.
Studied thus far
Ethics and Aristotle

5. Debating Saints: St. Augustine and St. Aquinus
Hobbes-Locke discussion of the Social Contract.
1 Philosopher of the week Transcript Kant speaks: My name is
Immanual Kant. You will hear about me throughout your study
of ethics as the person who devised a “Categorical Imperative.”
What, you may ask, is that? It is a statement of my view of
ethics, in a positive, direct order to follow. My Categorical
Imperatives states that you should “Act only according to that
maxim whereby you can at the same time will that it should
become a universal law.” Stated in an easier way, you should
““Act in such a way that you treat humanity, whether in your
own person or in the person of another, always at the same time
as an end and never simply as a means.” Many people call me a
Universalist, or an Absolutist, because I feel that if you believe
it is wrong to lie, then you should never lie, even if the end
result is not good. If lying is wrong, then it is always wrong. If
you believe it is wrong to kill, then you should never kill, even
if the end result is not good. If killing is wrong, then it is
always wrong. Your class will discuss this during your threaded
discussions this week by discussing the situation of the Crazed
Murderer. Many of you will wonder, “What would Kant do?” If
you read the accompanying lecturette and discuss this well in
the threads this week, I believe you will understand my
philosophy on ethics well enough to be able to answer this
question at the end of this week. Good luck and work hard in
the threads. I hope you will espouse my ethical view after this
week for the rest of your life.
1

6. Philosopher of the week Transcript
Mill speaks:
My name is John Stuart Mill. How exciting to be a part of a 21st
century Ethics
course. Once again, I see that my fears about democracy
perhaps have come
true. When you have done some research about me, and read the
lecturette,
you will find that I lived during the late 19th century, in
London, and that my wife
Harriet Taylor and myself feared that we lived in a society
where bold and
adventurous individuals were becoming all too rare. My critics
thought that the
prospect of a mass democracy in which working-class opinion
would be
oppressive and perhaps violent frightened me. This was an
untrue belief. The
truth is that middle-class conformism frightened me much more.
My ethics state that individual liberty and the rights of the
individual are by far
the most important of all! I also believed in women’s rights and
liberty back
when no man believed this. How can we love the individual, if
we deny this in
women? The answer is, “We cannot!” Women and men should
be treated
equally in all things!
I am a Utilitarian. That which is useful is that which is right. I
have lain down "one
very simple principle" to govern the use of coercion (meaning

7. legal penalties) in
society --- we may only coerce others in self-defense - either to
defend
ourselves, or to defend others from harm. All of this “saving
people from
themselves” is rubbish! It is not the role of the government to
make people
behave “better.” It is the role of the individual to do this. Only
by adopting a
principle of self-restraint can we seek out the truth, experience
the truth as "our
own", and fully develop our individual selves. Your Patriot Act?
You will discuss
this during our class. How can this be good? Do you feel safer?
Are you willing to
give up all of your rights if that will make you 100% safe?
One of your great Americans said, “Give me liberty or give me
death.”
Americans, do you still believe this? I do wonder. Read my
Essay “On Liberty.”
You may learn something. Good day!