While sleep deprivation fosters much college agony, it is also a serious issue in the medical field. Doctors that have to work many hours, and oftentimes late at night, have to stay on task every minute, because people’s very lives may be in their hands. As a result, some doctors turn to performance enhancing drugs, such as Vasopressin (2) —though this may be a more dangerous stimulant. Studies show that doctors who work longer hours tend to make more mistakes when working on a certain task (1). However, a physician’s job does not allow for many mistakes. In fact, one mistake could cost the life of a single patient. So is it unethical for doctor’s to take performance enhancing drugs? I think the answer to this is no, it is not unethical. Why? Because in taking these drugs, the doctor is helping a great number of people, and preventing mistakes in the procedures.
If an athlete were to take performance enhancing drugs, it may be considered unfair to his opponents, and if a student took performance enhancing drugs, his integrity may be put into question, but when a physician takes performance enhancing drugs, his motives tend to be different. Perhaps the doctor is in fact trying to get ahead of other doctors, but how would he be getting ahead? He would be helping other patients more effectively. Therefore, in striving to get ahead, he would really only be helping his patients. However, if the doctor’s motives are not to “get ahead” then they are probably to stay awake on the job, or to better help the patients. In order to do this, he may turn to mental stimulants, that keep him focused and on task. No matter what the doctor’s motives may be, if he takes drugs that keep him awake and concentrated, his performance on surgeries and procedures will be less prone to fault, thus benefiting all his patients.
While some people use enhancement drugs for their own profit and benefit, and theirs only, at least in a direct sense, when a doctor uses cognitive enhancing drugs while working many hours, he is profiting not only himself, but perhaps hundreds, if not thousands of patients by lowering the chances of mistakes (1). If sick patients are allowed to take enhancement drugs to for healing their ailments, then why can’t their doctor take performance enhancing drugs to heal their patients in a safer and less mistake ridden way? I think that yes, when doctors use cognitive enhancers it only benefits their patients, and is thus ethical.
(1) http://wellness.blogs.time.com/2009/10/13/for-doctors-less-sleep-not-long-hours-linked-with-more-mistakes/
(2) http://www.independent.co.uk/news/uk/smart-drugs-slip-through-gap-in-law-1531330.html
4 comments:
I agree with Birgitt and think that we should allow physicians who perform longtime surgeries to take cognitive enhancing drugs. People’s motives are not justifiable, that is, they can never be clearly analyzed and listed. With current technology we never know if a physician taking cognitive enhances is doing so only for the wellbeing of his patient. And even without the technology we have reason to doubt that this goal is not purely his motive, taken into consideration no cognitive enhancer is entirely free of side effects.
Then why is it less controversial for surgeons to take cognitive enhancers to concentrate better and stay awake longer when students and athletes are reprimanded for gaining unfair advantage with drugs? I think there are two main reasons. First, when surgeons take cognitive enhancers, it is more for avoiding risk than for gaining advantage. Difficult and complicated surgery can well go over twenty hours. When a surgeon takes cognitive enhancer before such a surgery, he is more concerned about not making mistake and thereby losing a life rather than outperforming his peers and getting promoted. I’m not sure how a surgeon works his way up to build reputation and establish status, but intuitively the consequence of causing medical accident is severe enough to make surgeons take drugs.
Secondly, even if some ambitious physicians do go to extremes and take cognitive enhancers unnecessarily, by doing so they at least benefit the patient and the patient’s family meanwhile. Consider when they do a good job they save life or improve patient’s quality of life substantially, their self-serving act can be justified to some extent. Students and athletes who take drugs, on the other hand, benefit only themselves and gain an unfair advantage. Therefore surgeons have better reasons to take cognitive enhancers to boost their performance.
I agree with Birgitt that in order to fully understand the ethics of cognitive enhancing drugs, one must define the group taking these drugs. With athletes who use enhancers, they are indeed only doing so to win at all costs and these rewards will solely benefit that particular individual. Also something to consider is a quote from Francis Fukuyma’s book “Our Posthuman Future: Consequences of the Biotechnology Revolution” which says that “The original purpose of medicine is to heal the sick, not turn healthy people into gods.” Those athletes who take performance enhancing drugs do end up revered by the public as gods for their impressive athletic performances, and this isn’t the original goal of medicine and technology as outlined by Fukuyma.
However, doctors and physicians who take cognitive enhancers should be given a special category when debating the ethics in these situations. I believe that many doctors who take enhancers may do so for questionable reasons, such as they want to beat the performance of other competing physicians or take enhancers for purely selfish reasons. I think that these internal ethics may in fact need to be addressed in a different context but a better performing physician does in fact produce better results for the patients. Therefore while it feels slightly wrong to condemn athletes who use performance-enhancers, I think that the use of cognitive enhancers by physicians is indeed ethically sound since it benefits the majority.
Sources relevant to my post:
http://www.nytimes.com/2008/03/09/weekinreview/09carey.html?pagewanted=all
After reading Birgitt's blog about doctors and surgeons using performance enhancing drugs in order to stay awake to perform surgeries at the end of long days, I too agree with her sentiment that this is an ethical use of performance enhancing drugs. Birgitt's blog also made me think more about performance enhancing drugs and the different motives associated with their use. Rather than proclaiming all of the performance enhancing drugs sound and ethical or dismissing them all together as immoral and unethical, it is important to look at each case individually to specifically determine the ethics behind it.
In sports, when athletes knowingly cheat the game and try to gain a competitive edge on their opponents, this use of performance enhancing drugs is generally viewed in a negative manner, as it should be. However, in this case, doctors who take these drugs will be able to save lives by limiting mistakes due to being tired. Furthermore, their goals most likely will be able to perform better for their patients' well being. Even in the event that their motive is to further their own careers, a by-product of that is still that the patients benefit because of the increased awareness during procedures.
The one instance which could be unethical would be a situation in which a doctor takes these performance enhancers to boost his reputation and then decides to stop once he has reached the pinnacle of his career. In that case, the patients could be misled when believing that the doctor or surgeon is one of the best in their field. However, I believe that this type of performance enhancing drug is ethical because its use could benefit many patients who are "under the knife" late in a surgeon's shift and that most surgeons look out for the best interests of their patients and do not place the success of their careers over the well-being of their patients.
I'm afraid I'm not convinced. In my mind, the ethics of cognitive enhancement are rooted not in the effects that their use would have on a playing field (in the figurative sense as well as the literal) but rather the effects they have on the individual who uses them. In setting out modern medical ethics, Belmont and Helsinki deal primarily with the protection of the individual above that of the greater good; human beings cannot be used as means to an end. As a relatively novel field of pharmaceutical research and production, very few studies of the long-term effects of cognitive enhancing drugs have been performed, and even fewer have been conclusive or gone undisputed. For physicians and surgeons to be taking cognitive enhancing drugs to stave off sleep deprivation and perform long, complicated, and involved surgeries would mean that they are essentially being coerced down a potentially self-destructive path. While it is most certainly an awful proposition to lose a loved one to a botched surgery, society cannot place the onus of drug use onto its doctors any more than it can demand an individual to take antidepressants to be more agreeable for the overall well-being of the general public. The level of a doctor's commitment to his or her patients can and very often does go beyond what is reasonably expected of a man or a woman, often at the expense of his or her well-being, but that is an individual decision on the part of the doctor that should not be informed by public duress.
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