Ethical Analysis: John Q
The film John Q (2002) depicts the struggle of a father whose 9-year-old child needs a heart transplant the family cannot afford, and who lacks the insurance coverage to ensure his child can have this lifesaving surgery. John Q. Archibald holds an entire hospital staff hostage (including its administrator, physicians, patients, as well as the ER staff) to demand Michael is put back on the transplant list and continues to receive the care he needs to survive. This paper will analyze the extreme choice Archibald makes to preserve his childs life from the paradigm of virtue ethics.
Ethical Analysis
Virtue ethics is one of the three major ethical paradigms in philosophy. In contrast to utilitarianism or consequentialism (which emphasizes that ethical decisions should be analyzed from the perspective out outcomes) or deontology (which emphasizes following ethical norms or rules) virtue ethics stresses the need to honor moral virtues in ethical decision-making (Hursthouse & Pettigrove, 2022). Virtue ethics stresses the need to uphold the correct virtues when undertaking specific moral actions.
The film highlights the ethical quagmire that is for-profit American medicine. On one hand, as a parent, Archibald is upholding the moral action of preserving his sons life at all costs. He is standing against a system which is putting profits ahead of helping people. On the other hand, the virtue of preserving life and showing benevolence to patients is not upheld by putting hospital staff and other patients at risk. Although Archibald is depicting as releasing some hostages who are very sick, this does not discount the significant trauma to which he subjects the entire ER, not just the persons responsible for his situation. The fact he prevents other individuals from receiving care, as well as does psychological damage to them, cannot be overlooked.
On the part of the physicians themselves, medical ethics specifically holds that they must honor ethical virtues of fairness, honesty, judgement, kindness, leadership, and teamwork (Kotzee, Ignatowicz, & Thomas, 2017). In this scenario, the physicians must not just consider the fate of Archibalds son Mickey, but of all patients. Even if the system of medical insurance and funding patient surgeries is not what they necessarily believe in, they cannot treat each patient with the same love and care as they might if that patient was their own child. They are honest with Archibald regarding his sons prognosis.
On the other hand, not all the actors Archibald holds hostage are seemingly so blameless. For example, administrator Rebecca Payne puts profits over people in her statement that if Archibald cannot put down a $75,0000 payment towards his sons surgery, she is willing to allow the child to die. From Paynes utilitarian perspective, the hospital must stay in business and help the maximum number of people possible, versus focusing on the life of one child (Dimmock & Fisher, 2017)....
…if they did not like the financial and ethical decisions of their insurance companies and the hospital administrators.On the other hand, the administrators would likely not have taken such a cold, ethical calculus in determining whether to perform a surgery or not or set a deadline for a down payment for a life-saving surgery, if one of their own family members lives was at stake. The film suggests this perspective finally gains some validity in the eyes of the administration, as Payne agrees to add the childs name to the transplant list, despite Archibalds inability to come up with the $75,000 immediately. The film ultimately suggests that there is room for compassion and virtue in offering mercy to others, even if it does not validate Archibalds violence. Utilitarian calculus is not a way to govern society anymore than pure emotionalism (LeBar, 2020).
Concluding Reflections
Ultimately, the sympathies of anyone who has had to deal with the American healthcare system will lie with the father in the scenario. But ethically speaking, virtue ethics suggests that there is still a moral obligation to minimize harms by upholding as many virtuous ideals as possible, and the harms of Archibalds actions should not be discounted, even if his virtues are greater than those of the administrators focused upon profits. Viewed from a Rawlsian perspective, seeking some sort of compromise is necessary, given that promoting health of children is a universal good, and health is not…
References
Cassavetes, N. (Director). (2002). John Q [Film]. Evolution Entertainment.
Children’s health insurance program (CHIP). (2022). Healthcare.gov. https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/
Dimmock, M., & Fisher, A. (2017). Ethics for A-Level. Open Book Publishers.
Hursthouse, R. & Pettigrove, G. (2022). Virtue ethics. The Stanford Encyclopedia of Philosophy https://plato.stanford.edu/entries/ethics-virtue/
Kotzee, B., Ignatowicz, A., & Thomas, H. (2017). Virtue in medical practice: An exploratory study. HEC forum: An Interdisciplinary Journal on Hospitals’ Ethical and Legal Issues, 29(1), 1–19. https://doi.org/10.1007/s10730-016-9308-x
LeBar, M. (2020). Justice as a virtue. The Stanford Encyclopedia of Philosophy. https://plato.stanford.edu/archives/fall2020/entries/justice-virtue/
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