Doctrine of necessity - Killing for the greater good!

 Doctrine of necessity - Killing for the greater good!

Is it a rational decision to kill one for a lesser harm than the potential loss of lives?

What justified killing one to protect many? Will the killing of Hitler can stop the killing of millions of people? Will killing one person to save 6 people who need organ transplant make it justifiable? 

But where do we stand on emergencies and defence?

What makes killing people who are a threat to your life makes it acceptable?

Many of such dilemmas wander around especially in the mind of a healthcare professional while making many health based decisions. These decisions often become more critical when the life of one human is at stake in order to protect the life of another human. That’s where medical practitioners practice doctrine of necessity.

Now, what is the Doctrine of necessity?

In simple words, it’s the constitutional use of emergency powers when and if needed but it’s not as simple as it seems especially in the life of healthcare providers.

To make it more hard, there are religious conflicts as well to deal with such situations as “What God might want us to do or If God will and wishes”. Let’s take an example of conjoined twins, where one of the twin babies had to die for the survival of another baby since survival of both was not possible. The parents of the twins would choose to ignore the scientific reasoning based on the belief that if God wishes both babies will survive. What might looks like a clear murder of two babies wasn’t got that much negative reactions from audience because of the excuse of the believe and looks justify.

Now compare this situation with another scenario, when the four people on the boat  had to kill the weaker one among them in order to survive without food and water. The later one didn’t get the same response from the audience however, serious actions were taken against the criminals. These ideas often end up confusing the people in charge and they enter into their own battle of right and wrong making them compromise on the right decisions. 

However, in developed countries we see very clear restrictions and guidelines about many of such scenarios. But the situation gets a little more messy for the healthcare providers in underdeveloped as well as developing countries.

Pakistan and Doctrine of Necessity

When talking about laws, regulations and ethics in the health care system we often find massive gaps in developing countries as compared to developed countries which is why more people suffer in Pakistan by the hands of healthcare providers and why most people are reluctant to visit doctors even today!.. What might look like negligence from a doctor is actually not the fault of one person but it’s the fault of the whole organization and the whole system is responsible for it. 

Now, the question arises: do we have any choice?

Remember slow and steady wins the race, introduction of doctrine of necessity has already been done in Pakistan in 1954 and what was not lawful is made lawful in case of emergencies but it’s still not clear what is considered an emergency situation. 

In the end, the problem is still persistent and the doctors are still confused as ever with no confidence to take life saving decisions on their own all because of the unavailability of proper guidelines. Let’s hope in years to come the life of Pakistani healthcare providers become a little more easy and they are not questioning themselves every now and then if they did the right thing or not.