Q: My elderly aunt became ill and phoned me, a physician, to ask if she should call an ambulance. I surmised that she was severely dehydrated. From my hospital, I took a bag of saline, IV tubing, an IV lock and a needle. An unsuspecting nurse handed me the tape that secures the needle. I gave my aunt these fluids at home, and she soon felt better, as did I: my stealing $50 worth of medical supplies saved the taxpayers more than a thousand dollars for an E.R. visit. Did I do right? — E.G., New York
A: I love the hint of zany high jinks in the words “an unsuspecting nurse.” I respect your concern for your aunt and admire your ingenuity in curbing costs, but — there is a but — I am wary of your conduct. You were deceitful with your own hospital and imprudent in taking over your aunt’s treatment.
One doctor, the medical director of a large public hospital, e-mailed me to say: “We frown upon treating family members. It’s incredibly difficult to be objective in the best of circumstances.” He added: “The aunt’s bedroom is not the optimal environment for diagnosis or treatment. This physician took many shortcuts and may have done his aunt a great disservice by not performing a complete assessment.” He makes a persuasive case that while your diagnosis was correct, it was not certain to be: Your aunt might have had other problems requiring a more drastic response.
Your altruistic pilferage, while thrifty, was ethically dubious, requiring you to betray the trust of your co-workers. The medical director I spoke to suggests a less buccaneering alternative: “If he had asked for the supplies, his hospital would have undoubtedly given them to him.”
The real solution to such problems is to arrange health care so as to avoid so stark a dilemma, perhaps by providing local clinics or health professionals who make home visits, changes unlikely to occur any time soon.
Q: I am the proud father of a boy, 1, and a girl, 4. My wife and I do not practice corporal punishment — spanking — but some of our friends do and have asked that we spank their children when they are playing at our house and misbehave. Is this request reasonable? — C.D., Santa Fe, N.M.
A: It is not. Many parents are militant in defense of their putative right to discipline their children as they see fit: with a sound thrashing. But conversely, your friends may not impose their Neanderthal parenting practices on you, particularly when doing so would compel you to violate what I take to be not just a matter of child-rearing methodology but of moral principle: You do not hit children. That is what you should tactfully tell your friends.
When you do that, you probably ought not mention that spanking is banned or restricted in 22 countries. Such facts will only irritate them.
Update: C.D. told his friends that he could not spank their children. The friendship endures.
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