Essay 1- Bioethics
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Apr 3, 2024
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The Last of Us
Introduction
In this paper I will be discussing the ideas that are highlighted in the show called, “The Last
of Us” using principlism. I will take into consideration the questions poised like, “What should
the doctors in this situation do?” and “What should Joel do?”. After going over the ideas using
principlism, I will conclude that the doctors and Joel did not abide by the rules of principlism
towards Ellie and that due to the situation the doctors and Joel did not do the right thing morally
speaking, but they also did not completely do the wrong thing too. The essay will be broken
down into parts as follows.
Part 1: Applying Principlism to “The Last of Us” Case
The principles of Principlism consist of the Respect of Autonomy, Nonmaleficence,
Beneficence, and Justice. (Beauchamp, pg 5-7) The principle of Autonomy is Respect for
persons, where this let's humans have the right to be free to make choices for their own body. In
the “Last of Us” case this principle was somewhat upheld as Ellie heavily implied that she would
sacrifice herself in order to save others. However, the way Ellie was brought to the doctors is
what contradicts the Respect for Autonomy, since she had been smuggled by Joel against her will
and had not given consent to the doctors for possibly ending her life. In other words, the doctors
had not given or asked for her decision of what she wanted to do, even though throughout the
show she was willing to sacrifice herself. The other principle is Beneficence, which is the
obligation to contribute to a person’s welfare. In this case, Beneficence and Autonomy overlap
with each other because Ellie's choice to sacrifice herself is what can benefit others. Beneficence
is also upheld in a way because of how the doctors are trying to find a cure in order to help save
the people. However, the doctor's choices lead them to contradict with another principle which is
Nonmaleficence. Nonmaleficence is the principle of the obligation to not inflict harm on others.
The doctors do not uphold this because of how they are conducting a fatal surgery on Ellie
without her Autonomy. This shows how the doctors violate the principle of Nonmaleficence
because of how they are inflicting harm in order to gain Beneficence for their other patients. The
last principle is Justice, which is the distribution of health in a fair and equitable manner. For this
case, I am not entirely sure if Justice is upheld since Joel had saved Ellie. So it is unknown
whether her sacrifice would even result in a cure and be distributed to all people. In this case,
none of the agents, like the doctors or Joel, abided by principlism because of how there is no
respect for Autonomy. Without the respect for Autonomy, the other principles are not abided as a
whole because of how Ellie needed to be actively involved in what happens with her body and
life.
Part 2: Question asks “What should the doctors in this situation do?”
In this situation, the doctors should have done anything in their power to find a cure because
of how the fungus was destroying their civilization. In other words, the doctors had the right way
of thinking when looking at the situation from a “do or die” point of view. For example, a
situation that is closely related to this thinking is the trolley problem. Since the doctors are
thinking in a manner of killing one person to save a whole civilization or risking the civilization
in order to not harm this one person. (Merriam-Webster, p# 1) It shows that even though the
doctors violated the principle of Autonomy, they acted accordingly to the situation overall
because of how they were at a point where they had limited time and resources. In this situation,
the doctors did what they had to do in a way because if they just stood by and did nothing, then
there would be no hope at all. Everyone would just die because of how there is no one who is
willing to find a cure.
Part 3: Question asks “What should Joel do?”
With Joel what he shouldn't have done was lie to Ellie, because of how big the situation was.
In a way, it affects her Principlism because of how Joel is making her believe that she is not the
only one immune to the infection, which is not the case at all. By lying to her it can potentially
affect her judgment because of how she could believe that because the tests run on the other
immune people did not work, then that would be the same case for her. Or she could have
possibly thought of the “what ifs” on if the doctors would be able to find a cure through her. For
example, with Dax’s case it goes over how the patient who has the decision-making capacity has
the legal right to refuse or accept any and all treatment. (Burton, pg 1)This shows, with Ellie and
Joel, Joel basically made Ellie’s decision when he lied to her because of how even though Ellie is
capable of making her own decision, she doesn't know the full story which can affect the call she
wants to make for herself. This also violates the principle of nonmaleficence and autonomy
because of how Joel is harming Ellie with his lie in a way where her autonomy is affected where
she feels like her sacrifice could be for nothing.
Part 4: Possible Objections And Responding to Them
In Part 2, I argued that the doctors did the right thing in the situation they were in because of
how under these circumstances it was necessary to think in a way that can benefit the majority.
But one may argue that this is wrong because of how the doctors should not have abandoned
their morals and principles completely. Since at the end of the day the doctors are still
considering taking someone’s life. I respond to this by saying, how under these circumstances
where your whole civilization is on the line there is not a lot of time to think rationally as more
people become infected. Another may also argue that this is wrong because of how the doctors
were not respecting her Autonomy since they did consult what the plans were or had her actively
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be involved. I would respond to this by saying that in some ways, yes the doctors should have
asked for Autonomy rather than against her will, but again looking at the circumstances there
was no wiggle room. The doctors had to pick and make a decision between potentially killing
one person to save multiple lives or letting multiple lives die in order to do no harm to one
person. Also if the doctors had not done anything and let her live, Ellie would potentially still die
because of how the whole world was being destroyed. The only difference in her potentially
dying through the surgery rather than natural causes is that there is an opportunity for the doctors
to find a cure that can potentially save the world. In Part 3, I argued that Joel did not do the right
thing by lying to Ellie because it could manipulate her decision making since she does not know
the full story. But one can argue that he did the right thing because he was protecting her from
the doctors so that she would not feel burdened by being the only immune person and potentially
agreeing just because there were no other options. In other words, Joel saves Ellie because of
how he knew that she was willing to sacrifice herself to save others so by telling her that there
were more immune people it would give her less of a burden in her decision making. To this, I
would respond by saying that even if Joel lied to protect Ellie, she still had the right to fully
know what the full circumstances and risks were. She had the right because she needed to be
actively involved in the situation so that she is able to make the right decision for her body and
what she wanted. Joel violates her right of Autonomy because of how he is creating a fake
situation for her which can potentially affect Ellie’s overall choice.
Conclusion
In this paper, I have talked about the “Last of Us” case using principlism, discussed the
questions and why the people involved either did the right or wrong thing, and argued why
others would object and then responded to those objections. I considered the possible objections
to my argument but I have concluded that morally speaking, the doctors and Joel’s actions were
wrong, however looking at the situation and circumstances they did the right thing when
presented in a “do or die” situation. They also did not abide by principlism towards Ellie since
their morals and way of thinking were corrupted due to circumstances they were in which
affected their judgment call.
Works Cited Page
Beauchamp, Tom L. “Chapter 1: Principlism in Bioethics.”
Springer International Publishing
Switzerland,
2016,
https://www.uio.no/studier/emner/matnat/mn/MNSES9100/h11/undervisningsmateriale/literature
/BeauchampChildress%20chapter%208.pdf
Burton, Kieth. “A Chronicle: Dax’s Case as It Happened”
http://ldysinger.com/ThM_580_Bioethics/webcourse/03_course_docs/Dax-Chronicle.doc
.
“What Is the 'Trolley Problem?'.”
Merriam-Webster
, Merriam-Webster,
https://www.merriam-webster.com/words-at-play/trolley-problem-moral-philosophy-ethics
.
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