Bizarre Tales from the Delivery Room
By Bryan Caplan
I’ve cross-examined doctors before, but never like this! Offsetting Behavior‘s Eric Crampton remained enough of an economist to argue with the anaesthesiologist while awaiting the delivery of his second child:
There was some risk that Sue might wind up needing a transfusion as things got a bit complicated…
As I’m O negative, I noted that should Sue only need a small top-up,
I’d happily provide. The anaesthesiologist said that would not be
possible. The rest of the conversation went roughly as follows:
Me: Why not?
Her: Well, we’d need to do the blood tests to make sure it was all clean for transfusion.
Me: So, that would take too long then?
Her: No, that’s not the problem. Rather, if we ever found something
that the other partner might find cause for concern, we’d then face an
ethical problem. So there’s a rule banning these kinds of husband-wife
Me: Ethical problem?
Her: Imagine the case where we find the one partner has an STD which
the other partner would find out about because we wouldn’t be using the
Me: So if Susan needed a kidney and I were a match, I’d be banned from giving it then?
Her: No, we’d just make sure there were proper pre-counselling available so everyone were ready in case such a thing were found.
Me: Is there anything that ethicists don’t completely screw up?
Her: Well, it’s a complicated issue. I suppose if someone jumped up and down a lot and got a lawyer in…
a rare instance of clarity, I realized that arguing medical ethics with
the anaesthesiologist during the caesarean section might not be the
very best idea…
After a healthy delivery, Eric blogged what he would have told the anaesthesiologist:
There is, of course, a dead simple mechanism design solution to the
ethical problem here. The blood is taken, the donor and the recipient
both signing a form that if any ethically troublesome problem is found
in the blood, blood from the standard donor pool would instead be used
without additional notice to the recipient; the donor would later
confidentially be informed of the ethical problem encountered. Problem
Personally, I’m puzzled by the view that medical confidentiality should apply via-a-vis spouses in the first place – and baffled by view that medical confidentality should protect people’s right to risk infecting their spouse with STDs. If marriage were contractual, who’d agree even to basic confidentiality – much less confidentiality that put the life of the other partner at risk?