When Does the End Justify the Means?

We often sit in awe of the miracles of modern medicine. We have managed over the last few centuries to dramatically decrease the mortality rate and increase peoples’ lifespans. The question we often don’t ask is what did it take to get to this point? When do the ends (medicinal cures or vaccines) justify the means?

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I recently started thinking about these questions while reading the series Maze Runner (SPOILER ALERT). I also watch a show called Dark Matters on the Science Channel that often highlights the tension between morality and scientific discovery. Instead of simply talking about the ethics of scientific discovery, I will use two stories, one fiction (Maze Runner) and one non-fiction (Dark Matters), to explore the boundaries between ethics and advancements in science.

Dark Matters, Season 2, Episode 2 re-tells the breakthrough of scientist Louis Pasteur in discovering the rabies vaccine. This was the first human vaccine and laid the groundwork for all the life-saving vaccines we have today. But how was it discovered? Dr. Pasteur lied to the patient, whose life he may or may not have saved. A nine-year-old boy had been bitten by a rabid dog. The boy had a 50/50 chance of actually contracting rabies, but the experimental vaccine would only work before the infection had set in.

To get the boy, his mother and the boy’s physician to agree to the treatment, Dr. Pasteur told them that he had successfully completed trials on 50 dogs. In fact, the doctor had not yet completed a single trial, and he had also attempted a similar treatment on a young girl, who had died after two injections. Dr. Pasteur also didn’t tell the boy that part of the “treatment” involved injecting a high dose of the disease into his bloodstream to test whether the treatment had actually worked. (Even if the boy had not had rabies previously, the injection would ensure that he had it.) Fortunately for the boy and his mother, Dr. Pasteur’s treatment worked, and the doctor has gone down in history as curing rabies. But at what potential cost? What if the experiment on the boy had not worked? How long would it have taken before vaccines were discovered? Do the hundreds of thousands of lives saved by the vaccine outweigh the potential harm to one little boy?

Maze Runner presents similar ethical conundrums but set in the future. This time, it is about saving the entire human race from a rampant disease (that the government had also released, but I won’t get into that). In an effort to find a cure, the government rounds up children (many of whom have a natural immunity to the disease) and puts them through horrific experiments where the majority of them die. Similar to the logic Dr. Pasteur must have used to justify his experiments, the government officials and scientists believed killing the few to save the many was acceptable and defensible, even if morally repugnant. And if I put myself in their place, how far would I go? You are watching the end of the human race. Are a few lives worth the potential to find a cure that will save millions? Unlike the rabies vaccine, the experiments in Maze Runner do not lead to a cure, and it appears that dozens of children died in vain. But hindsight is always 20/20. What lengths would you go to if you had to watch your friends and family succumb to a terminal illness?

Despite all of the advances in modern medicine, we still have a number of diseases that only end with a death sentence–certain types of cancer, ALS, AIDS, and the list goes on. Although killing innocent children by lying to them would seem to go too far under any ethical standards, should we let people consent to potentially dangerous experiments in the hopes that maybe they will be cured? Do we hold ourselves back from scientific discoveries by being “too safe” and risk averse?

I wish I had answers to these questions and that there was some bright line rule that would work in all circumstances. On the other hand, maybe the important part is not to have all the answers but to make sure to keep asking the questions.

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