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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