His right side was paralyzed, he spoke in a garbled way,


From: Munson, Ronald. INTERVENTION AND REFLECTION.6th ED.,Belmont, California: Wadsworth Publishing Company,2000 . Page 243 Scenario #2

Jeffry Box was eighty-one years old when he was brought to Doctor’s Hospital. His right side was paralyzed, he spoke in a garbled way, and he had trouble understanding even the simplest matters. His only known relative was his sister four years younger, and she lived half a continent away. When a hospital social worker called to tell her about her brother’s condition, she was quite uninterested. “I haven’t seen him in fifteen years,” she said. “I thought he might already be dead. Just do whatever you think best for him. I’m too old to worry about him.”

Neurological tests and X-ray studies showed that Mr. Box was suffering from a brain hemorrhage caused by a ruptured brain vessel.

“You can fix it?” asked Dr. Hollins. She was the resident responsible for Mr. Box’s primary care. The man she addressed was Dr. Carl Oceana, the staff’s only neuro surgeon.

“Sure,” said Dr. Oceana. “I can repair the vessel and clean out the mess. But it won’t do much good, you know?”

“You mean he’ll still be paralyzed?”

“And he’ll still be mentally incoherent. After the operation he’ll have to be placed in a chronic care place, because he won’t be able to see to his own needs.”

“And if you don’t operate?” Dr. Hollins asked.

Dr. Oceana shrugged. “He’ll be dead by tomorrow. Maybe sooner, depending on how long it takes for the pressure in his skull to build up.”

“What would you do?”

“I know what I would want done to me if I were the patient,” said Dr. Oceana. “I’d want people to keep their knives out of my head and let me die a nice, peaceful death.”

“But we don’t know what he would want.” Dr. Hollins said.

“He’s never been our patient before, and the social worker hasn’t been able to find any friends who might tell us what he would want done.”

“Let’s just put ourselves in his place,” said Dr. Oceana. “Let’s do unto others what we would want done unto us.”

“That means letting Mr. Box die.”


  1. Reading Comprehension

State what the Rule Utilitarian and Natural Law positions would be in this case and why you think so for each position.

Critical Thinking

Using the DIALECTICAL PROCESS state what your ethical position would be on the case of Mr. Box and why. You are to take a position and defend it. You should use some ethical principle to decide what you think is the morally correct thing to do. You must state those principles and explain how they have been applied to the situation. You should indicate that you have rejected alternative positions to your own and the reasons why you have done so.  In so doing you need to enunciate clearly the values and ethical principle(s) you are using to both reject the alternative positions and to defend or support your own.

Use this template or form to make certain that you include each part of the process-parts a to e

Label your parts with the letters a to e to make very clear that you have done each part.

Dialectical thinking: the 5 parts

  • a. Take a position on this question or issue Be as exact as you can be.  Be precise in your use of language (ethical principles and values).
  • b.  Provide the reasons why you think this position is better defended by reason and evidence than are the alternative positions Position defended using reasoning (ethical principles and values) in support of the judgment (conclusion of the  argument).  You state the reasons why the position you take makes sense and has evidence and reasons (ethical principles and values) to support it other than your feelings or personal preference or your opinion or what you were brought up to believe or what just about everyone you know thinks or believes.   Philosophers have offered such reasons (ethical principles and values) and evidence for the positions they have taken and you should consider them and if you agree you can and should so state them in support of your own position.
  • c.  State the reasons why you found the other positions flawed or less defensible than the one you are defending
  • d.  State the criticisms of your position
  • e.   Respond to the criticisms- rebuttal- how do you defend your position in light of those criticisms
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