by Craig Klugman, Ph.D.
Chicago Med (Season 2; Episode 10): In this episode a heart patient returns from a previous episode when a heart is found for a transplant. However, the patient who is 3 years sober had a couple of alcohol shots that morning upon learning that her friend had died. At a meeting of the transplant committee Dr. Latham—the cardiothoracic attending—says that the rules are clear, she must be sober for 18 months before a transplant. Dr. Charles—the psychiatrist—is conflicted, concerned that he misread the patient but also knowing, as he states, that often it takes a slip before a person with an addiction takes recovery seriously. This meeting shows a contrast between deontological ethics—following the standard without concern for consequences—and ethics of care—focusing on caring and nurturing. After the committee votes against the transplant, Latham seems concerned that he may have missed something and asks Charles why he is conflicted. The response is that the patient seemed to have true regret for her slip. But when the only other matching patient is in San Diego and there is not enough time to get her and the heart together, the decision is made to go ahead with the transplant anyway, rather than let the organ die. Thus, this is a case of having your cake and eating it too: The committee gets to follow the rules, but also gets to be compassionate and caring.
The more concerning ethical challenge in this episode revolves around a jockey who is brought to the ED after collapsing.