Saturday, September 19, 2009

Value based leadership, a barometer on how to act

Value based leadership, a barometer on how to act

You are the administrator at a well- known community hospital. An accident in the hospital’s laboratory has caused deadly chemical gases to enter the ventilation system of the hospital. The gases are headed straight for a hospital room with three children. You are the leader and you must make a decision. If you do not intervene, those kids will be dead. If, on the other hand, you hit a switch, those gases will be re-directed toward a room with a single child meaning that one child will die and three will be saved. What do you do? You have 10 seconds to make this very difficult decision.

You are a loving husband married for 35 years to your lovely wife and still very much in love. Your wife suddenly is diagnosed with advanced cancer of the brain and the Doctor says she will not make it. In the next couple of months her condition deteriorates and she is in constant pain and agony. One night, she looks at you, holds your hand and says to you, “Honey, we have loved each other for many years, we have great memories, we raised wonderful children and we had a wonderful life. I am at the end of my rope. I can’t stand the pain any longer. Every minute is agony and unbearable. You must help me end this suffering. I need to go in peace”. What do you do?

You are a Doctor. You have three patients who will die very soon without an organ transplant. You have only two available organs. The first person on the list, the one who should go first is homeless and hasn’t contributed much to society. However, he is the most critical of the three and has been waiting the longest. He would die first if he doesn’t get the transplant. The other two are professionals, one a Lawyer and one a fellow Doctor who is also your friend. Is it acceptable to skip the homeless person and give the two organs to the Lawyer and the Doctor?

How about this one? You are a Medical Doctor, you have four patients that will most likely die without organ transplants, and one healthy patient who could provide those organs needed by the four sick patients. Is it morally acceptable to kill him in order to save the other four?

Philosophers, social and clinical psychologists have wrestled with these questions for hundreds of years. Studies are constantly being done to understand how human beings think. They try to find the explanation on why would a normal human being find it easy to hit the switch in the hospital to divert the deadly gas as in the first example and find it unacceptable to take organs from a living person no matter how many others might be saved.

Until now, no rational, consistent, moral principles that everyone agrees on have been found or have been accepted by all. In the situations above, “do no harm” and “do the greatest good for the greatest number” both fail to explain why most leaders, even most people, anywhere in the world would more likely hit the switch but not kill the healthy patient.

Where does our moral sense reside? Does it reside in our brains or in our hearts?
There were very interesting studies conducted by a Dr. Greene of Princeton University, utilizing MRI machines to measure brain activity when leaders and normal people face these moral dilemmas.
One of the examples they studied was that of a man driving along a deserted highway and sees a man bleeding by the side of the road. He stops and the man asks him to take him to the hospital. He realizes that taking this bleeding man to the hospital would ruin his new leather seats for which he had just paid $750.00. Is it morally acceptable to leave him bleeding by the side of the road? If not, then, is it morally acceptable to ignore a personal letter asking you for a donation of $750.00, sufficient to save the lives of 25 children who otherwise will die of a curable disease?

According to the studies, looking at these examples I have mentioned, most people will say that you should direct the gas to one person saving four but not kill someone for his organs and to help the bleeding man but not write a check for $750.00. Why is this?

The idea of killing someone for his organs or leaving someone to die by the side of the road engages the brain’s emotion regions (as measured by the MRI) more than the idea of switching the direction of a deadly gas or writing a check.

The example of who to give the organs to, the lawyer, doctor or homeless, most people rationalize their decision and the poor homeless guy is out of luck.
The couple married for 35 years, their values will dictate what they do. Religion is against Euthanasia and so are most of the States in the Union and Puerto Rico. Utah is the only State that permits it and they get lots of people spending their last day there. What would you do? Would you listen to your heart or your brain?

Philosophers, Psychologists, Theologians have argued for years about whether moral principles are based on emotion or reason. Dr. Green of Princeton says that what we have learned “suggests that emotion underlies our tendency to treat seemingly identical cases differently”.

Human beings usually make very rapid judgments about moral dilemmas with little variation in what they consider permissible. The power of moral intuition goes against the previously accepted idea that we consciously think these things through.

I find the study of the human animal so interesting and so complex. With so much to study and learn in the here and now, I wonder why so many so called psychics, astrologists and hucksters are able to sell people on the idea that they can predict the future.