Decision

(The tutorial continued.)

I paused for a moment, and then began my story.

"Let's say you are the emergency call medical officer. A nurse in the ward tells you there is a middle age man just admitted for acute chest pain. Heart attack is possible, but, more likely than not, it's nothing really serious. At the same time, another ward calls you and says that they just admitted an old woman with severe chest infection. Well, she also has many other problems, say, some form of cancer, and, even without this infection, she is not expected to live for anything more than a few months. The dilemma is: Which patient should you see first?"

My students had their mouths wide open.

"Oh, we can do away with all details of medical science, as well as any discussion about the principles of triage and resource allocation," I became more serious, "I just wish to show you a general principle: The scenarios you guys presented always involve one patient, and there's almost always no dilemma in this situation - because there's something called patient autonomy, or, we can ask individual patients to be their own god and make the decision. The real problem actually comes when a decision involves two or more patients with conflicting interest - in which case you have to play god and make the decision."

PS. My argument was obviously simplistic. For example, for a single patient, there may be more than one party, and their interest may not agree with each other.