OT: Doing the Greatest Good

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Nickmark59
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OT: Doing the Greatest Good

Postby Nickmark59 » Tue Apr 26, 2011 9:03 pm

This was written for the fire service but in so many ways it reflects on so many matters in life.

"The man who makes no mistakes does not usually make anything."

From Don KonKle PFESI Executive Director

Charles Bailey

We know for a fact that burning homes are not safe; in fact, they are
downright dangerous
By Charles Bailey

There is a dusty office lit by a sliver of sunlight reaching through the
curtains. It's a tiny space full of books and knick-knacks from far away
places. Its lone occupant is a bespectacled gentleman who wears a tweed
jacket with elbow patches and has the habit of peering over his
spectacles to read. He smells of stale pipe smoke, he does not smile, he
thinks...

In the land of hypothetical reasoning (LHR), a large tour bus crashed
today spilling people onto the highway. It was a gruesome scene. The
first phone call to 911 was answered in 9 seconds. Within 60 seconds of
initial call, the initial response was dispatched that included a mass
casualty assignment. All LHRFD personnel are trained and re-certify each
year in mass casualty strategy and tactics.

The first ambulance on the scene was overwhelmed. There were about 60
people on the bus. It was bad. The ambulance officer followed the rules
and began to call for help and start triage.

As he moved through the bodies checking for pulses, he passed over those
that did not have one including a darling little boy of about 6. He
passed by arterial bleeders, by people pleading for help.

He was unable to provide even a word of comfort. What kept him moving
was the idea that if he stopped to help one really hurt person on the
edge of death, that he would lessen the chances for others. He was
driven to, "do the greatest good for the greatest number."

In a few days he will wonder whether he could have done more for that
little boy, "...if only I would have checked a few more seconds, would I
have noticed a pulse...?"

Few of us would disagree with the idea that we have to do the greatest
good for the greatest number. We could also say that maxim is the
underlying moral imperative of fire/rescue service. But if it is, how
does it work?

LHRFD is dispatched to an overturned propane tanker with active fire
venting from a rupture point on the tank. The incident is on a remote
stretch of highway with no readily available water supply, but there is
a home for the elderly and infirm only 200 feet from the crash site.

The truck driver is trapped in the truck and resources are limited. Does
the engine officer concentrate on rescuing the trapped truck driver who
is burning to death in front of them or do they leave him to burn while
they drive to the home for the elderly and begin to move the occupants
to the far side of the building?

If the moral imperative is to do the greatest good for the greatest
number, you have your answer.

It is a well-established fact that firefighters die in burning
buildings. It may not be their leading cause of death but it is a
significant factor in the annual tally. We know for a fact that burning
homes are not safe; in fact, they are downright dangerous.

So when the fire department arrives at a burning house and Mrs. Jenkins
meets them in the front yard pointing at a bedroom window, screaming
that her son is still inside the house, can we "do the greatest good for
the greatest number?"

In this case, the greater number are the five guys and girls on the
first arriving engine. If I use a moral rule that we all agreed to at
the beginning of this discussion, I cannot ethically ask five people to
place themselves in harm's way to save one person. To search that home
would be, by the rule, unethical.

The readers are thinking, 'Of course we would try to save that little
trapped boy.' But if you do, you cannot do that AND do the greatest good
for the greatest number unless:

The good for firefighters was sufficiently subordinate to the good for
the public that the loss of a firefighter was somehow a lesser loss than
the loss of the boy, which would imply that the humanity of a
firefighter discharging his or her duties was somehow less than the
persons who they aimed to save or
The notion of greater good is trumped by lives in need of saving. But it
can't be that simple, or else we would have tried harder to save the
apneic little boy trapped on that bus or,
The notion of greater good is of limited utility ( I think this is the
answer)
...but if we do not seek to maximize the greatest good for the greatest
number, what are we doing? I am not sure!

There is a fire in a 9th floor apartment. Fire dispatch is confident
that there is an elderly occupant trapped in the apartment. On arrival,
the LHRFD finds a minor smoke condition on the 9th floor with multiple
people attempting to evacuate.

As they approach the door of the fire apartment, they can hear the dying
gasps of the elderly occupant. It is hard to stretch the hoses because
people with babies are trying to exit the fire floor.

The LHRFD does the "greatest good" and leaves the door to the fire
apartment closed until they can get the floor clear of exiting
civilians. Twenty minutes pass, they enter the fire apartment, the
occupant is dead. They feel very bad. Sometimes the greatest good just
does not feel right.

A tired old-fashioned alarm clock, the kind that winds up and has two
bells on top begins to fill the quiet office space with a cacophonous
reminder that its time to move to classroom, 102 and teach 30 less than
eager students about the difference between utilitarian ethics and
deontological ethics.

As he rises to leave he takes one last puff of the pipe, and wonders if
firefighters should try something new and act only according to that
maxim whereby you can, at the same time, will that it should become a
universal law.

About the author

Charles Bailey is a career Battalion Chief in Md. with nearly 20 years
of active service. His hope it that firefighters everywhere will begin
to ask hard questions about their operational behaviors and obligations
to society using sound science mixed with common sense. You can contact
Charles with feedback at Charles.Bailey@FireRescue1.com.


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