You touch on important topics: ethics, the need to make hard decisions and (alas) to recognize that not all problems can be solved; they can (at best) be managed. Some situations are a Hobson's Choice, damned if you do, damned if you don't. In other words, no clear alternative. But the real sin is that many difficult issues that DO have optimal (not to say ideal!) solutions are not addressed simply because of social, political or other opposition to solving them.
Oh yes, and that a lot of our cherished democratic, moral and religious ideals are bullshit; or to be more fair perhaps, a lot of them quickly break down in extreme circumstances. Many moralists assert that the same morals, ethics and standards should apply in all times in all places. As a counter-argument, I would ask them if they would really demand that in a foxhole in combat as compared to a Sunday afternoon picnic in the park? I'd say not.
To borrow the analogy from the famous essay "Lifeboat Ethics" (short and highly recommended), most of our institutions in the West seem to honestly believe that all comers are welcome and equally entitled to be rescued and given a place on the lifeboat. The very idea that seating is limited and that trying to please everybody will kill everybody, is anathema and the mere mention of it is harshly punished. At least as applied to medicine, we may be approaching a point where the individual will figuratively be better off floating alone in his life vest or even treading water.
You touch on important topics: ethics, the need to make hard decisions and (alas) to recognize that not all problems can be solved; they can (at best) be managed. Some situations are a Hobson's Choice, damned if you do, damned if you don't. In other words, no clear alternative. But the real sin is that many difficult issues that DO have optimal (not to say ideal!) solutions are not addressed simply because of social, political or other opposition to solving them.
Oh yes, and that a lot of our cherished democratic, moral and religious ideals are bullshit; or to be more fair perhaps, a lot of them quickly break down in extreme circumstances. Many moralists assert that the same morals, ethics and standards should apply in all times in all places. As a counter-argument, I would ask them if they would really demand that in a foxhole in combat as compared to a Sunday afternoon picnic in the park? I'd say not.
To borrow the analogy from the famous essay "Lifeboat Ethics" (short and highly recommended), most of our institutions in the West seem to honestly believe that all comers are welcome and equally entitled to be rescued and given a place on the lifeboat. The very idea that seating is limited and that trying to please everybody will kill everybody, is anathema and the mere mention of it is harshly punished. At least as applied to medicine, we may be approaching a point where the individual will figuratively be better off floating alone in his life vest or even treading water.
There are no solutions, just trade-offs.