Your thoughts wanted- Starfleet Medical Officers and Common Sense

[selek]

Hi all,


I was having a conversation with a very good friend of mine, and he was relating a tale from long, long ago, in which he wrecked a convention session of Trek by simply using his head.

Here's the set-up:

A set of terrorists had seized hostages and were holding them for ransom.

Starfleet responded in force, but the situation has quickly reached an impasse. If Starfleet raided their stronghold (or failed to meet their demands), the terrorists would kill their hostages.

Normal technological solutions such as transporters and stun grenades were apparently out of the question due to time constraints, and the lifesigns were too similar to differentiate between good guys and bad guys.

With a number of their prisoners wounded and dying, the terrorists agreed to accept a Starfleet medical officer ( a doctor) to care for their prisoners (and incidentally to gain an additional hostage as well).

While the medical officer worked, he carefully marked the position of each terrorist and when the opportunity presented itself, pulled his phaser and stunned each of the terrorists unconscious- ending the stand-off.

Now clearly, the terrorists were fools for: 1) taking hostages in the first place and 2) failing to properly search the medic when he arrived.

According to my friend, the argument was made that our friendly neighborhood Starfleet medic could not shoot the prisoners because he's a medic and therefore a "non-combatant". It was argued that the Hippocratic Oath states "First, do no harm" (which is accurate).

But the oath also states:

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

Does ending the stand-off quickly and expeditiously qualify as "all measures that are required for the benefit of the sick"? Or does it constitute "overtreatment"?

Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

The doctor unquestionably violated the trust of the terrorists, betraying them to prison at the least. Does this constitute saving lives, or "playing God"?

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

In your opinion, did the Doctor uphold his calling as a Starfleet officer or betray his calling as a doctor?

Is there really a conflict between the two?

The immediate threat to the life and health of his patients were the terrorists holding them hostage. Did the doctor's actions constitute "prevention" or "overreach"?

Is such a character a Starfleet officer first and a medic second? Or is it the otherway around?

May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

To my simple mind, the doctor's quick thinking and swift action saved the lives of all of his patients.

In the vein of the recent Prime Directive thread, however, I'm interested in the take of my fellow Narrators:

Do the lives of said doctor's patients (and his obligation to uphold Federation law) trump the unusually narrow interpretation of the Hippocratic oath insisted upon at the convention?

Keep in mind that the Oath is now optional- most doctors still take the oath, but it is no longer mandatory to do so.

This isn't the first time a Starfleet medic has been called upon to serve "the greater good" at the expense of his patient.

If memory serves, Doctor Piper kept Gary Mitchell heavily sedated (an action in direct contradiction to the interest of his patient) in order for Kirk to maroon him on Delta Vega.

Doctor McCoy wasn't above using weapons- or even killing- in order to preserve life- but we also saw several instances where he abused his medical authority in order to serve what he saw as the greater good-

First, he slipped Jim Kirk a mickey finn and faked the Captain's death during Spock's mating ritual.

Later, dealing with the Vians, McCoy sedated first the Captain and then Spock in order to ensure that it was he, not they, who was to be tortured to death.

In your considered opinions my fellow narrators, are the actions of these doctors a violation of the Starfleet code of honor, or are they in fact an example of the finest traditions of the Service?

Where would you draw the line?

[tunglashr]

First of all, is this a medic, or a doctor? There is a difference in more than name. A medic in this case would be a hospital corpsman, not a doctor. Today those men and women take an oath, outlined here:

"I solemnly pledge myself before God and these witnesses to practice faithfully all of my duties as a member of the Hospital Corps. I hold the care of the sick and injured to be a privilege and a sacred trust and will assist the Medical Officer with loyalty and honesty. I will not knowingly permit harm to come to any patient. I will not partake of nor administer any unauthorized medication. I will hold all personal matters pertaining to the private lives of patients in strict confidence. I dedicate my heart, mind and strength to the work before me. I shall do all within my power to show in myself an example of all that is honorable and good throughout my naval career."

Clearly, a medic could do whatever he wants to save his patients. No issues in any case.

If it were a doctor and he had chosen to take the hippocratic oath (which is now optional), he would have violated it by killing the terrorists. Had he instead used wide beam and shot them on heavy stun, then beamed out, that would have been perfect.

If this were to happen in my game, I would have conscience be an issue for the doc for a while and maybe even have an inquiry. They would find him innocent, but list in his record that he violated his oath. I would have minor mental issues come up from time to time as would make the game dramatic.

[selek]

First of all, is this a medic, or a doctor? There is a difference in more than name. A medic in this case would be a hospital corpsman, not a doctor. Today those men and women take an oath, outlined here:

"I solemnly pledge myself before God and these witnesses to practice faithfully all of my duties as a member of the Hospital Corps. I hold the care of the sick and injured to be a privilege and a sacred trust and will assist the Medical Officer with loyalty and honesty. I will not knowingly permit harm to come to any patient. I will not partake of nor administer any unauthorized medication. I will hold all personal matters pertaining to the private lives of patients in strict confidence. I dedicate my heart, mind and strength to the work before me. I shall do all within my power to show in myself an example of all that is honorable and good throughout my naval career."

Clearly, a medic could do whatever he wants to save his patients. No issues in any case.

If it were a doctor and he had chosen to take the hippocratic oath (which is now optional), he would have violated it by killing the terrorists. Had he instead used wide beam and shot them on heavy stun, then beamed out, that would have been perfect.

If this were to happen in my game, I would have conscience be an issue for the doc for a while and maybe even have an inquiry. They would find him innocent, but list in his record that he violated his oath. I would have minor mental issues come up from time to time as would make the game dramatic.

By way of clarification, the officer in question WAS a medical doctor and the weapon WAS on "stun".

The doctor killed no one.

Shall I take it, then, that you agree his actions were in the finest traditions of the Starfleet?

[tunglashr]

By way of clarification, the officer in question WAS a medical doctor and the weapon WAS on "stun".

The doctor killed no one.

Shall I take it, then, that you agree his actions were in the finest traditions of the Starfleet?

I dont think using stun, which by definition cant kill, is against their oath. It does say 'First, do no harm', so I guess under the most strict definition there could be a problem if someone had some kind of freak heart condition or if they fell off something and hit their head, but it is unlikely.

The most important question is this: did this problem with the oath lead to an interesting scene with superiors and tense roleplaying? If so, they were 100% right. If instead it was just a silly argument about what a doctor should do, they were wrong.

[selek]

I dont think using stun, which by definition cant kill, is against their oath. It does say 'First, do no harm', so I guess under the most strict definition there could be a problem if someone had some kind of freak heart condition or if they fell off something and hit their head, but it is unlikely.

The most important question is this: did this problem with the oath lead to an interesting scene with superiors and tense roleplaying? If so, they were 100% right. If instead it was just a silly argument about what a doctor should do, they were wrong.

As I understand it, it led to a piddling contest between the Narrator involved and the fellow stuck playing the character..........

[Pericles]

Nothing about the Hippocratic oath prevents a doctor form fighting or even killing to save their own or the patient's lives. That 'first do no harm' thing is in regards to the patient. Bashir was in multiple combats during the Dominion War and killed many times, so I do not see where the doctor did anything wrong, especially considering the phaser was on stun.

[tunglashr]

As I understand it, it led to a piddling contest between the Narrator involved and the fellow stuck playing the character..........

I cant side with your friend here. If you cannot put your trust in the GM and play the game, then the fault is yours. Arguing with the GM NEVER helps the game. There is no reward for being right, but the reward for going along could be a fun game session.

[Owen E Oulton]

I am in complete agreement with the Doctor's actions. You don't state what system you're using (probably FASA from the statement "Long ago". ICON has Disadvantages of "Code of Honour: Hippocratic Oath" and "Pacifist" which would affect his actions. Other Disadvantages which would complicate the situation would be such things as "Impulsive" and "Code of Honour: Defender" which would serve to force the situation...

[The Tatterdemalion King]

Nice move, Doc.

I would've had one of the terrorists go into cardiac arrest. Or have one of the hostages try to kill the terrorists while they were down.

[K.G. Carlson]

How did the doctor manage to shoot all the terrorists before they could take punitive action, either against a hostage or the doctor himself? Starfleet or not, I don't imagine the doctor's stats include a high energy weapons skill.

If these terrorists not only failed to check the doctor for weapons, transponders, etc but also clustered together to be taken out by a single wide-beam stun attack, they are the worst terrorists ever. Sounds like more of a Narrator error than Player screw-up.

[Cdre Bob Wesley]

I'd put the doctor on double-secret probation.

[Dan Gurden]

Weapon was on stun... So no harm was done.

OK, then the ONLY influencing matter then is whether the character was a pacifist... Unless he was out of character... Nowtt to trouble anyone with here...

Of course IMO the 'time constraints' arguement for the use of technology doesn't hold up. Its quite quick to beam everyone into a secured holding area and remove the weapons during the pattern biuffer stage, and was done on screen several times...

*edit*
Oh, and for the record... The hippocratic oath relates mostly to the doctors treatment of his patients... So all aspects of the oath that your doubter is trying to apply to the terrorists doesn't work either...

[Aldaron]

Well, I'm not a doctor, but a I play one on TV (sorry, couldn't resist )

Seriously, I'm not a doctor, but I was a trained nurse for 15 years, and part of nursing training is a variation of the Hippocratic oath.

And I would have done what the doctor did in a heartbeat.

I think he deserves the Pike for his actions, not a reprimand from a Narrator who's pissed because a player out-thought his scenario.

Just my 2 slips...

[Pericles]

I think he deserves the Pike for his actions, not a reprimand from a Narrator who's pissed because a player out-thought his scenario.

Just my 2 slips...

I have to completely agree. I've written a dozen full length adventures for Serenity and regardless of how much I try to cover all the bases, other people think of things that would never occur to me. If I left an exploitable flaw in on of my adventures, which I'm sure I have, as GM, I would be annoyed, but I would not penalize the player for out thinking me.

[selek]

I've written a dozen full length adventures for Serenity ....

Do you have a screenname over at the Cortex Boards?

I post there under the screenname Selek.