agonyaunt | Entries tagged with the ethicist

My 78-year-old mother has moderate dementia and suffers from mood swings, depression, anxiety, agitation and disturbed sleep. One of her doctors recommended a low-dosage CBD/THC gummy to alleviate these problems. She takes one daily and, combined with other therapies, now experiences more stable moods and better sleep.

The issue is my mother’s conviction that marijuana is for drug addicts and criminals, never mind that medical marijuana is legal in our state. She is so vehemently opposed to marijuana use that she disapproved when my dying sister used marijuana years ago for pain relief from inflammatory breast cancer. I have to lie to her about the ingredients in the gummies, which I casually refer to as ‘‘multivitamins.’’ Is it wrong to give my mother a drug that she would never have voluntarily taken on her own? — Name Withheld

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misbegotten

Source:

I was recently gifted a family heirloom — a century-old five-carat diamond ring. It is most likely worth six figures. I was shocked; I am not very close with the relative who gave me the ring, by his choice. There are a lot of painful relationships in this particular branch of the family tree. As an adult, I have always tried to be kind and respectful to all of these relatives, while keeping my distance.

The relative who gave me this ring had used it to propose to his now ex-wife, and it was implied that I might use it to replace my engagement ring. (I have no idea why, as I love my engagement ring.) That is the only reason I can surmise that he gave it to me and not to any of his own children. He also said the ring originally belonged to my great-great-grandmother, but it actually belonged to her childless sister (who long survived her). I’m fairly certain that my mother was the only one of her siblings who visited my great-great-aunt on a regular basis.

My husband and I are newly married, and we find ourselves thinking about the value of this ring and how it could change our lives. A down payment on an apartment? A college fund for future children? And so on. We neither come from money nor make much money. If we sell this ring, it is a once-in-a-lifetime windfall.

I’m worried my relative would want the ring back if he knew I was considering selling it. But this is not the kind of sentimental heirloom that everyone in the extended family knows about, and part of me would not be surprised if he never asked about it again. He is also very wealthy, so as a financial asset the ring matters much more to me. Still, he could, one day, ask about the ring, and who knows what ugliness might ensue from this complicated family if I sold it. But I’m more concerned about my own ethics here — what are my rights regarding this gift, and what explanation do I owe? — Name Withheld

( On gifts )

conuly

1. DEAR ABBY: I am 76. My husband and I planned our final wishes for cremation because I have had a lifelong fear of being buried underground. My children from my first marriage are Jewish and very much against cremation. When I told them my wishes, they attacked me with a barrage of negatives about cremation, such as, "You won't go to heaven," "You won't see your deceased mother or grandson in heaven," "We won't be able to say kaddish for you," etc., so I immediately changed my plans. My husband and I purchased side-by-side crypts, thinking it was an acceptable alternative.

I was wrong. For the last month, they have continued to push me to change to a regular burial. I finally had enough and told them to respect my choices and never discuss this with me again. So now, no contact at all except an occasional text from my grandchildren. Any advice or help would be appreciated. -- UNHAPPY IN FLORIDA

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2. Around a decade ago, my mom informed each of her children that she and my stepfather put a codicil in their wills disinheriting any of their children married to someone not recognized as Jewish by her local Orthodox Rabbinate.

I believe a will is not just about money; it’s also an expression of values and love. I have strongly objected to this codicil, or more specifically, to her having informed us about it: The two are thereby using their wealth as an implicit weapon in service of their religious views.

She says I’m reading too much into it. She claims she informed us in the name of “transparency,” so we wouldn’t be surprised later, and that it’s her money to do with as she pleases, anyway — though she concedes that she also informed us in case it may influence decisions we make.

I’ve since married someone who fits her definition of a Jew, so the codicil doesn’t apply to me. Still, I have three middle-aged siblings who are all not religious and unmarried, and I think they remain so at least partially because they’re stuck, unable to both follow their hearts and avoid betraying my mother’s love — and its most powerful signifier, her will. Is she right to have the codicil? And to have told us about it? — Name Withheld

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ermingarden

Warning for discussion of suicide:

When I was a young child, my friend’s 14-year-old brother died after hanging himself. Nearly everyone, including my friend, believes it was suicide. My cousin happened to be one of the paramedics who arrived at the scene and administered CPR to him unsuccessfully. Many years later my cousin (now deceased) shared some information with me about the incident that makes it appear that it was not suicide but an accidental hanging from autoerotic asphyxiation.

My friend has always struggled with not understanding why her seemingly happy brother wanted to end his life at just 14 years old. I’m fairly certain her father, who found him, knows it may have been accidental but has never shared that information with his daughter. Her father is now in his 90s. I think my friend would be comforted by learning that it may not have been an intentional suicide. But it could also cause her more anguish knowing it might have been accidental. Putting aside the ethics of how I acquired the information, what are my obligations to my friend? Name Withheld

You asked me to put aside the ethics of how you came by the information, but I don’t think we can. Whether we should pass on information depends, in part, on how we acquired it. Your cousin had an ethical duty to not disclose what he learned outside the context of medical care. You have a weaker but real reason to keep the information to yourself: We should all contribute to maintaining the conventions of medical confidentiality.

Even after people are dead, it’s wrong to reveal information they would justly have wanted kept confidential. (This consideration fades with time, in part because the potential knowers we care most about are people with whom we have a substantial connection, and their numbers diminish as time passes.) You may have another reason to bite your tongue. When your cousin told you these things, he may have explicitly asked you to keep them to yourself. And promises do not lapse simply because the promisee has died.

It would certainly have been wrong, in any case, for you to share the information you gathered as mere gossip. But you’re considering sharing the information in order to give solace to the dead boy’s sister. And there are two parts of what you have to say. One is that he was evidently engaging in autoerotic asphyxia, something he probably would have preferred to keep private; another is that he evidently hadn’t meant to kill himself, something he probably would have wanted his loved ones to know.

You think that the father has known all along. If that is the case, it would have been best had he told his daughter what he knew, rather than let her believe for years that her brother was driven to kill himself by distress that the family had failed to recognize. Would learning the truth from you much later have the same positive effect? Bear in mind that this revelation would trail another one: that you and her father have both hidden something important from her for all these years. That might harm her relationships with each of you. (Indeed, because her father would be implicated by any disclosure, you should consider discussing your quandary with him first, although this decision will depend on the nature of your relationship with him, and on whether you judge that conversation would be productive.) Bear in mind too that your friend would come to realize that her grief over the years was entwined in a misunderstanding. She may need to mourn again.

Assessing these pros and cons of speaking up now, you should ask this question: If you were in your friend’s situation, would you want to know the full story? That may help you answer a second question: Will your friend be better off, once she has time to reflect, if you belatedly tell her now? You know her well. You can only be guided by your intuitions here. If your answer to these two questions is yes, then the reasons I’ve identified for keeping quiet would be outweighed by the potential benefit: deepening her understanding of what must remain a harrowing event in her life.

ermingarden

I have raised two sons without financial help from their father and recently put the oldest through college. He is now 23 and is working a minimum-wage job. He finds it tedious, but he’s stuck with it while he looks for better opportunities.

He lives at home, and I don’t charge him for anything, even though his food, cellphone, car insurance and car-maintenance expenses all add up to substantial sums. I figure he needs to save up funds so that he can eventually become independent and move into his own apartment. (He pays for his gas, work lunches and outings with friends.) His younger brother will start college in two months, so I am preparing for another four years of significant expenses. These costs will strain my budget; although I work full time, I will add weekend hours to my schedule.

We live in Los Angeles and frequently witness the sad plight of destitute people living in tents throughout our neighborhood. Recently, my son drove past a homeless woman with two small children and stopped to give her some money. He had no cash and instead got her cellphone number so that he could send her money through a payment app. He gave her $1,000 — nearly half his savings.
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ermingarden

I come from a working-class family. I have worked very hard in school and graduated college with little debt, so when I was given the opportunity to attend an elite law school, I took it — along with a $150,000 price tag. Some people may scorn me for such a decision, but this was my dream school, and I saw it as a ticket to an echelon of society and opportunity that was otherwise entirely barred to me. ( Read more... )

ermingarden

I am a physician, and last year, I took care of a white female patient in the hospital for a bacterial bloodstream infection. A few days into her stay, she began referring to Black staff members by the N-word and to our receptionist by an anti-gay slur. As the supervising physician, I made it clear that this was unacceptable. In general, with challenging patient behavior, I find it best to clearly lay out expectations and the consequences for violating them. So before talking to her, I discussed the situation with the nursing staff and hospital risk management, and we concluded that if she persisted in using this language, we would discharge her from the hospital, against her will if necessary.
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ermingarden

My brother is 16 and lives with my parents. I am in my 30s and live several hours away. We have good relationships with one another, although my parents are extremely anti-Covid vaccine and anti-mask. They cannot be reasoned with over the issue.

After the Delta surge died down, I went home to visit. My brother — who is no rebel — asked for my help to get vaccinated because my parents would not let him.( Read more... )

ermingarden

I recently ended a romantic relationship with a military officer. One sticking point was his revelation that, before dating me, he had sexual relationships with multiple enlisted women who served under him and were in his direct chain of command. He said that he wished he hadn’t engaged in these relationships, as knowledge of them could lead to significant disciplinary action and possibly a dishonorable discharge; he disagreed, however, that they were wrong or potentially harmful or compromising for the women involved. He asked me to keep those relationships secret. I agreed, but that decision has weighed heavily on me ever since. I’m struggling now to reconcile my responsibilities to preserve his confidentiality with my responsibility to reveal information that might help protect other women. Your thoughts would be most welcome. Name Withheld
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ermingarden

My daughter is in a newly romantic relationship with her best friend, who is also female. Both are in their midteens. My daughter recently confided in me that they have had sex. She insists, however, that I am not allowed to tell the friend’s mother, because the mother wouldn’t let them have sleepovers or hang out as much. My ex-husband is the one who hosts the sleepovers, and he looks the other way when they are in the bedroom, reasoning that (or so my daughter tells me), “It’s OK because there are no penises involved.” I am not as close with the friend’s mother as my ex-husband is, but we are friendly. Am I obligated to tell this woman the truth about the nature of our daughters’ friendship? Are my ex-husband’s actions egregious? Name Withheld
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ermingarden

I work in an office with cubicles six feet apart, but we are all up and about throughout the day. We are supposed to wear a mask every time we step outside our cubicles, but for short interactions that often does not happen. The C.D.C. says the risk is higher if people are within six feet of one another for a total of 15 minutes in a day. That is probably the case for all of us. My closest cubicle mate is unvaccinated and came down with Covid. He did not tell anyone, but I found out, and I am furious that he exposed me and did not tell me. He is now out on quarantine, having told others it was a different illness.

Therapists are expected to break the confidentiality glass and tell a target if his or her life is in danger. Can I do the same? If he exposes us carelessly, our lives could be in danger. I could wear an N95 all day, I suppose, but what about the others? In any case, such measures are not foolproof. Given his carelessness and refusal to be vaccinated, and the real possibility that he could be reinfected, is it ethical to share the fact that he has Covid? Name Withheld ( Read more... )

Current Mood: frustrated

ermingarden

My only sibling, an older brother, is facing kidney issues and may need a donor. I dread receiving a call asking me to fill that role.

When we were quite young, he regularly beat me up, switching to emotional bullying when I was about 11. My parents never thought to intervene. As we got older, distance helped us eventually get along. But in our 50s, when I announced I was marrying, he bullied our mom into rewriting her will to ensure, should I predecease him, that my future stepson would not inherit any of the estate: He would get it all. When settling the estate some years later, he went after more than was justified and showed a marked lack of trust in me. I really don’t think any of his behavior was intentionally malicious — just what he felt he deserved or needed for his own safety. At that point I had enough and stopped interacting with him, except for birthday cards. I’ve politely laid out my feelings in a letter; he eventually acknowledged he may have made “some errors.” But that’s about it.

What’s my ethical responsibility? If it were one of my close cousins needing a kidney, I would most likely be fine with it. But for someone who has never been able to provide, undoubtedly because of his own childhood trauma(s), a “normal” brotherly relationship, I think this would raise old feelings of being his victim. Name Withheld
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ermingarden

A very close, decades-long friend who has been a professional colleague — we are both family-practice doctors, though we currently work in different states — is spreading misinformation when it comes to Covid-19. She thinks vaccines have toxic ingredients and are unnecessary. She also thinks that the case and death rates of Covid are overblown. Recently, she emailed that she has been prescribing ivermectin and hydroxychloroquine for use against Covid.

As bad as I think her misinformation is, I feel that she has crossed the line in prescribing drugs that multiple studies have shown are not effective for the prevention or treatment of Covid-19. Professional standards state that I must report her to the state board of medicine, just as I must report a colleague who was abusing drugs or alcohol. On the advice of a former medical-school classmate who is a bioethicist, I wrote to my friend stating that she could lose her board certification and her state medical license.

As might be expected, she is not vaccinated and has no plans for her or her family to be vaccinated. Obviously, I will not change her mind. As bad as I think her advice is for herself and her family, though, it is wrong and harmful when it comes to patients in her care. So what do I do? –Name Withheld

There are over a million active physicians in the United States — more than the entire population of Austin, Texas. Even if a vast majority respect the practice guidelines set by their medical boards, there will be those whose training proves no match for the misinformation that incubates online, and their absolute numbers will not be insignificant. Sometimes ideological identities can undercut professional ones. When doctors reasonably believe that a member of their profession is endangering patients, they should pass what they know on to the medical authorities in the states where they work. Alas, you have good grounds for such concern. That she’s your friend made it appropriate to tell her first that you thought she was exposing herself to risk for violating the strictures of her profession. At this point, though, your obligations as a medical professional are the overriding ones. The sort of misinformation she’s both purveying and putting into practice is among the reasons that this pandemic’s costs in sickness and death have been so great.

Current Mood: angry

ermingarden

A friend had Covid more than a year ago and does not think she needs to be vaccinated. When I raise the issue, she says that she has been tested and still has some antibodies or that she has had a recent negative coronavirus test.

I have an immune-system disorder and have had to be extremely careful during the pandemic. I have now had two vaccines and a booster shot, and my friend has extended several invitations for dinner at her home. I don’t think it’s unsafe to go to her home for dinner, because I am fully vaccinated. But I worry that the unvaccinated may allow the Delta variant to continue to spread and possibly mutate, putting everyone at risk once again. I do understand that some people have medical conditions that prevent them from getting a vaccine or object to vaccines for religious reasons, but my friend does not fall into either category. Given how strongly I believe in vaccination, should I decline her dinner invitation on principle? Name Withheld

There are two things you might call principles here. The first is that people like your friend ought to get vaccinated because it contributes to the common good. Even if you’ve had Covid, vaccination further lowers your chances of reinfection and helps slow the spread of the disease. This is a practice that we all benefit from and that we should do our fair share to sustain. That’s a principle I agree with.

The second principle is that one shouldn’t dine with people who ignore principles like the first one. For you, this is mainly an expressive act. Your friend must know that you think she’s mistaken; refusing to dine with her is presumably a way to underline your disagreement. You would be a better judge than I am of whether this is likely to encourage her to get vaccinated as well — or whether you would be damaging your friendship to no effect. That matters, because when our friends do something wrong, our aim should be to encourage them to do better, not to make them indignant or resentful.

Another approach might be more effective. Vaccines don’t always work well in people who are immunocompromised. If you feel safe, I hope it’s because your doctor was able to make that assessment in your case. Still, even if the risks to you are low, they would be even lower if she were vaccinated, too. Asking her to get vaccinated for your sake might be more effective than telling her that you so disapprove of her position that you don’t want to spend time in her company.

minoanmiss

My daughter spends half her school day in an arts high school, the other half in a traditional high school. Recently, she shared with me instances in which one of her peers had plagiarized in the arts school and cheated on exams in the regular high school. She told me that her peer is considered, by teachers in the art school, to be a superior writer.

One afternoon she came home from the arts school upset because the cheater read aloud a supposedly original poem that my daughter recognized as having been written by a former student. She quietly pointed out to the cheater that she recognized the work. The cheater shrugged.

I think my daughter has an obligation to stop the cheating by informing the teacher. I suggested that she photocopy the original poem and give it to the teacher and allow the teacher to reach her own conclusions. I think that my daughter is loath to do anything because in part she is upset about being upstaged by a cheater. I think this emotional sidebar is secondary to the fact that the cheater is stealing from the whole class: Writing from the cheater is not a good sample for others to workshop because it is not original and taints the learning opportunities of the other students. At the traditional high school, the cheater’s test scores may also wrongly modify the grading curve, which affects the grades of all other students in the class.

My daughter’s friends independently became aware that this student is a cheater and plagiarizer. They urged my daughter to “rat” on the cheater. I wish these friends had informed teachers before now. It seems unlikely that the friends are willing or able to join together to talk to a teacher. But I really want my daughter to take a stand here. Am I wrong? Name Withheld

Young people belong to a world of group norms, and a central one favors loyalty to their peer group over the authority of their elders. In ordinary circumstances, “ratting out” a peer violates that norm. A member of the group can get away with it if others regard the wrong in question as itself a betrayal of the group and as a serious violation. They aren’t likely to be impressed by your specific objections — your point about its effects on the grading curve or your claim (which I don’t quite get) that a good poem is a bad sample if it’s stolen. The norm violation that will register, oddly, is the cheater’s showing off, the effort to make himself or herself look better than the rest. The cheater’s classmates will have resented what your daughter resented: being upstaged.

The real reason this young person should be reported is that what he or she has done is wrong. Yes, cheating of this sort does slightly damage other people, by misrepresenting their relative capacities. It may also be bad for this young person if it brings him or her to a place where expectations of his or her performance are higher than they should be: The cheater may have to keep cheating to maintain appearances, thereby increasing the likelihood of being found out and discredited. But the heart of the wrong here is that the cheater is deceiving teachers, taking advantage of their good will and the unearned respect they have for him or her. Honesty, like all virtues, entails a whole complex of attitudes and behavior.

You, like some of her classmates, want your daughter to take sole responsibility for seeing that this wrong is recognized and punished. Upholding the value of honesty, in this way, would make sense if she were the only person who was in a position to do so. But she isn’t. And it would be cowardly of her friends to have her bear all the social risk here. A better solution is at hand: A group of those who know what’s going on should come forward together. You doubt that they’ll do this. But has anyone asked them to? And isn’t that the first thing for your daughter to work toward?

She could, of course, just slip the evidence to the teacher anonymously, or she could inform the teacher along with a request for confidentiality, assuming she thinks the teacher would respect that request. Why am I suggesting the other approach, then? Because the collective affirmation of honesty would be a better outcome for her peer group. They could think of themselves as having chosen to speak out against cheating. And that might help them keep to that norm in subsequent years. Nothing fixes a value in your mind better than having stood up for it together with your friends.

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Agony Aunt

April 2025

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Page Summary

conuly - I am so not a fan of The Ethicist
misbegotten - I Was Given a Ring as a Treasured Heirloom. Can I Sell It?
conuly - Two letters in which the answer hinges on Jewish law
ermingarden - The Ethicist: Her Brother Most Likely Died From Autoerotic Asphyxiation. Do I Tell Her?
ermingarden - The Ethicist: I’m Supporting My Adult Son. He Just Gave $1,000 to a Homeless Woman.
ermingarden - The Ethicist: Is It OK to Take a Law-Firm Job Defending Climate Villains?
ermingarden - The Ethicist: Can I Withhold Medical Care From a Bigot?
ermingarden - The Ethicist: Should I Have Lied to Help My Kid Brother Get Vaccinated?
ermingarden - The Ethicist: Military Ex-Boyfriend Slept with Subordinates
ermingarden - The Ethicist: My Daughter Is Having Sex With Her Best Friend. Must I Tell Her Mom?
ermingarden - The Ethicist: Can I Reveal a Colleague's Covid Diagnosis?
ermingarden - The Ethicist: Must I Donate a Kidney to My Awful Brother?
ermingarden - The Ethicist: Colleague Prescribing Ivermectin
ermingarden - The Ethicist: Unvaccinated Friend
minoanmiss - The Ethicist: Should My Daughter Speak Up About A Classmate's Plagiarized Poem?

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