Friday, April 17, 2020

Devil's Choice & Other Dilemmas


Our epic Mahabharata describes an alternative, where Vidur said that “It is better to sacrifice one person in order to save the village”.
At that time he was referring to the devil’s alternative or devil’s choice of choosing the lesser evil which later on authors and philosophers have used to describe various situations.
Health professionals do not always have the luxury of making the right choices. The choice may at one extreme be - whether to keep the person on life support system when they know he is not going to live or allow him to die. In this case they end up being criticized on both choices. They are blamed for not providing medical care till the last moment and are also often accused of inflating medical bills due to prolonged use of life support system. The Devil’s choice is a metaphor used to describe medical choices that arise in circumstances where all the available options are both unwanted perverse.
When Texas Lt. Governor Dan Patrick suggested that the elderly should be willing to die in order to save the young, it caused a big uproar and public condemnation. Was he was just using a trade off between saving people from virus but condemning those who survive to a life of hunger and poverty  or he was just referring to the dilemma that if there is a bed in an ICU which can be given to the old or to a young then what would you choose? What was his intent?
 The answers are not simple.
 Frederick Forsyth in 1975 wrote an un-filmed screenplay titled “No Alternative” and later on in 1979 used the idea to write his famous book “The Devil’s Alternative” which simply means that irrespective of what choice you make blood is going to be spilled.
Decision makers have often used this alternative to choose the alternative with lesser evil. The doctors try to avoid this by just accepting the first come first served basis formulae. We have often used it in different forms, - Survival of the fittest or it is natural law or you are between devil and deep sea or out of frying pan into fire, etc.
Corporate strategists and war planners have used a variation of this called Devil’s Math to describe a situation where a decision requires harming a small group or an individual to save larger group. It is often used in corporate layoffs or in any situation where you are balancing the need of many against the need of a few. It just means that there are no good choices and you are doing something evil to a small group in order to prevent a greater evil from happening. The bombing of Hiroshima and Nagasaki was justified with this devil’s math.
There are many more such dilemmas that have been used often in books and films. ‘Sophie’s choice’ a film in 1982 based on the novel by William Styron (published in 1979) refers to the difficult decision making situation that a person finds himself in where no outcome is preferable over the other. This can mean either that both outcomes are equally desirable or both are equally undesirable. The choices could be whether one wants clean, or lower green house emission at global level.

In Cornelian Dilemma, named after Pierre Cornelia, a French dramatist, a situation is taken where a person must choose between two courses of action that either will have a harmful effect on themselves or others. A migrant laborer stuck in another state during lock down is faced with this dilemma.
In Hobson's Choice, even though it appears to be a free choice but actually it is not so, the choice is simple “‘take it or leave it”. The choice is between taking things that are offered and nothing at all.
All the above theories refer to decision making under difficult situations.
There are no ready made or easy answers in this situation as in the present case of extended lock down due to the Corona Virus. There are going to be problems whether the lock down is extended or not extended.  Countries will have to take a long time to overcome all the effects. But here again the Indian Government probably chose the lesser evil and the other countries used their own wisdom and assessment to choose lesser evils too.
As I said, there are no clear cut answers. There are no evident solutions. It’s all the math of trade offs between the available choices.

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