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I am a baseball coach/manager. In my stepson's baseball league, another team has a child (these are pony league players - 13 & 14) who has some arm problems. I know he has had an MRI (know the MRI tech) and also that his doctor instructed him never to pitch again. The coach and parents are aware of this too - yet the coach still pitches him in games. Other parents discuss this problem, yet no one seems willing to step up and do something about this. Since I know the story, would it be ethical if I anonymously informed the league? There may be a potential liability issue at stake here too. This kid is going to ruin his arm before he gets to high school. I am also trying to balance the confidentiality of the medical relationship vs. the kid's welfare. Should I even be considering this?

I agree with Thomas Pogge's remarks, but I also have a couple of cents to add. First, consider very seriously and act in light of the fact that your information comes to you second hand (from a lab tech and not the child's physician or parent)--unless, of course you are the MRI technician. Second hand reports are notoriously inaccurate, and so I suggest proceeding with caution and when you act qualifying your comments with the acknowledgment that your information may be inaccurate. The tech may be exaggerating the physician's instructions or otherwise distorting them. Secondly, it's worth pointing up front that (again unless you are the technician) that it was probably unethical for the technician to have given you medical information about the boy. Medical information is by law, custom, and moral principle extremely private material. The technician's poor conduct in providing you with medical information about the child further calls his or her credibility into question. Thirdly,...

Is it ethical for surgeons to use economic considerations when setting their fees? For example, is it ethical for a surgeon who is known to have better results for a certain operation to charge more than a surgeon who has worse results? Likewise is it ethical for a surgeon who has a scarce skill in a region to charge exorbitant fees for that skill simply because it would be unaffordable for most patients to travel to another region to attend another surgeon?

This is a fascinating question because medical care is not a commodity like many others--for example televisions or ice cream. It is a service related to the most pround of human needs. For that reason, I answer your first question with a "no"--but with qualification. It really depends upon what you mean by "economic considerations." I think it would be wrong to use simple supply-and-demand considerations where the supplier (the surgeon) charged the highest price the market will bear. Why? Because higher prices will exclude those with less money from the service, and I don't think it morally defensible to distribute essential medical services on the basis of wealth. Moreover, people suffering from illness are not in a position to bargain for fees with medical providers in the absence of coercion. (Think of how little a surgeon would charge if he or she were at risk of dying if a prospective patient decided to seek care elsewhere.) For this reason, I find the American medical system on the whole...

Is the sale of human organs ethical?

It is difficult to give an answer that would cover all possible cases, and I suppose I can imagine an individual case where purchasing a organ would be permissible. But as a practice or policy, it is not ethically permissible--this because a market for organs would provide incentives for people to sell when they shouldn't--for health reasons and otherwise. The poor and desparate would be exploited in the most horrific ways. If you'd like an example, the film, Dirty Pretty Things , offers a compelling portrait of just the sort of exploitation a market in organs would cultivate.

Can cardiac rescusitation of an individual with an inoperable brain tumor be justified? Who benefits? Glen.

Hey Glen, An interesting question, indeed. It reminds me, too, about why medical care is provided to people who've been sentenced to death. Look at it this way, though, all of us are going to die at some point. You might say that those with inoperable brain tumors just have a clearer picture than most about when and how they'll die. Knowing when and how one's going to die doesn't seem to be a good reason to deny that person medical care. And notice that even for those with inoperable tumors the picture isn't perfectly clear: Probability not necessity: Typically, people face some probability of death from the tumor, not certainty. Even one tenth of a percent chance of recovery is a chance and therefore a reason to administer rescusitation. Time: even if it were certain, a tumor takes time to kill. That time to live is likely to provide grounds for rescusitation. One of my uncles died of a brain tumor. While it was killing him he spent his time visiting family and friends, getting his...