Ethics of Privacy and Respect for Other People's Property

I always teach my kids to ask permission before they touch other people's stuff. That is a basic value people learn early in life. So, one wonders if it is morally right for the BOC employees to check the stuff sent by nurses and doctors to their families and friends? 

Can I open this?

The Philippines is one of the top exporter of nurses and doctors around the world next to India based on the IBON data for 2014. The healthcare workers form the largest chunk of OFWs. They work abroad to provide for their families, families that they do not see often. Despite being physically away, these OFWs show their love and care to their family members with the gifts of love they send to them through balik-bayan boxes. As one popular courier tagline puts it "Ipadama mo sayong padala." Every balikbayan box sent is an expression of love from a lonely OFW healthcare worker.

The "expression of love" is ripped open by the Bureau of Customs employees before it even reaches the supposed recipient. Did the people in the Bureau of Customs ask permission from the OFW healthcare worker? Is it morally right to open other people's packages without their consent? Is it ethical to sort other people's property? Is it valid to rip open a "package of love" for suspecting something taxable inside? What happened to people's privacy? What happened to autonomy? What happened to respecting people's right?

Privacy is an ethical issue. Is it morally right to invade my privacy? Privacy is important for several reasons. Privacy is necessary to safeguard the freedom of individuals and groups. People have the right to keep private and personal matters from the public. If people have the right to privacy, it is morally wrong to violate that right. It is unethical to invade other's privacy and personal property. For the same reason, invasion of privacy is against the law. For example, when I go to the mall and the security guard wants to inspect my bag, the guard cannot just open my bag. That would be unethical. The guard would be violating my privacy. That is why, I would have to willingly open the zipper of my bag and allow the guard to take a peek and inspect what is inside. Only because I allowed the guard to check my bag was the guard able to do it. No invasion of privacy occurred.

The government is supposed to safeguard the people's right to privacy, not the one violating it.

However, we also know that privacy is not an absolute thing. We live in a society that requires us to share information to maintain order in our relationship with each other. Going back to our example, I cannot just refuse the guard to check my bag because of my right to privacy. If I do that, the guard can always refuse my entry into the mall. In the same way, the balik-bayan boxes need to have proper declaration from the OFWs sending them. It is the OFWs duty to honestly declare the contents of the package. We understand that the government needs some information from its citizen for it to be able to govern properly and execute their responsibilities well.

There should be a balance between the OFW's responsibility to share honest information and to the protection of it's right to privacy. One is not more important than the other. The government cannot also give lesser weight to either of the two. It would not only be unethical for the government staff to open packages without the owner's consent, the government would also be violating the people's human rights.

Let this not be another addition to the long list of human rights violation of the government to its people. How can I teach my kids to respect other people if they do not see their government respecting people too?

To do a CPR or not?

You are resident on duty in the ER of a private hospital. Then a frantic mother comes in with her 1 month old baby boy who was found unresponsive. She comes from a poor town at least 20 minutes away from the hospital. The mother said the baby had been sick with cough and fever for more than a week now. You quickly check on the vital signs of the baby boy: CR=0, RR=0 and unresponsive. The mother begs you to “do the best that you can to help my baby live.” You look at the baby and you think it is next to impossible to revive him. If the impossible does happen and you were able to get a heartbeat, there is only a slim chance the baby will live. You look at the mother and see her anguish. If you do the CPR, you know it will cost her a lot of money. Money she does not have, causing her to delay medical consult for her baby. Yet, you also want to give mother and baby a fighting chance.  It is also a bonus as you know it will help you gain valuable clinical skills intubating the patient, doing CPR and providing correct emergency drugs.

Is it OK to perform an expensive procedure to a dead or dying patient when there are no clear medical benefits? Is it justifiable to do a procedure out of compassion even if it may lead to more suffering for the family? Is it OK to do it because there are benefits the doctor can gain?

In this scenario, I suggest we consider 5 Ethical Principles. There are other more principles but let me focus on these five. It is important we consider the ethical principles of 1.)“beneficence” and 2.)“non-maleficence”  to the patient. Remember that the CPR is a medical procedure designed to reverse clinical death. Would the procedure benefit the patient? Would it not cause undue harm or suffering to him? How about to the family? However, we must not forget the 3.)"Principle of Futility." This principle looks into the length of life and quality of life. If there is low chance of survival and low quality of life after the procedure then it is futile. Of course, we need to consider the consequence of our decision to the family involved.  The issue of 4.) surrogate decision making and 5.) justice must also be considered. Since the baby cannot decide for himself, who decides best for the baby? Also, more than our own gain as doctors, we must prioritize the patient and the family’s welfare. What will happen to the family emotionally, psychologically, financially and socially after the procedure? Is it justifiable to decide clinically based on the financial capacity of the family? Communication with the family is also important. Being honest to the patient and the family will help us better decide on our actions.

So, what would you do?