Decision Making

You are a paramedic arriving at an emergency scene. A group of scouts have entered a cave that is now filling with water. They were led into the cave by a rather large scoutmaster. Unfortunately, while leading them out of the cave, the scoutmaster somehow managed to get stuck in a narrow opening with only his head and shoulders protruding out. With his upper torso stuck outside the cave, it appears the scoutmaster will survive, but all the boys below will drown if they cannot escape.
After you have checked all possible escape routes and have attempted to extricate the scoutmaster, it becomes clear that the only way to save the boys is to sacrifice the scoutmaster, so he can be removed. This is, unfortunately, not the Winnie the Pooh story where Rabbit has the option of waiting until Pooh loses weight. What is the correct action for this case?

First, justify your decision using duty-oriented reasoning.
Second, justify your decision using consequence oriented reasoning.
Third, justify your decision using virtue-ethics reasoning.

Based on your analysis, consider what might be the ultimate dilemma of ethics? Based on your consideration, answer the following questions: What happens when we apply differential standards (all valid) to healthcare decisions? How do we determine who is ultimately right when different decisions are reached?
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Solution Preview

Duty-oriented reasoning would put the scoutmaster in front because your duty is to your patient and he is the patient. As a health professional, no matter the circumstance, your duty is to treat the body without taking into account what the person has done. Thus, if he was a criminal or a clergy, the same care should be given. In this case, the scoutmaster is the patient and you need …