Case 7.4 describes Jim and Harald, a couple who had been together for an extended period of time before Harald was diagnosed with an HIV infection that had developed into AIDS with indications of encephalopathy (Thomas 256). Unfortunately, due to Harald’s severe diagnosis he was rejected as a participant in a clinical trial for AZT and was simply treated for symptoms. Harald and Jim, together with their friends who were also not qualified to participate in the ongoing trial and who didn’t want to be subject to the bribery and lies that other HIV patients had resorted to decided to enroll in an open arm in which they would consent to receiving the drug and be monitored for outcomes (Thomas 257). While Harald did eventually receive the drug, it didn’t save his life.

In his case discussion, Thomas et al. presented two questions: “does the principle of autonomy mean that very ill people should be able to access any drug they wish if they accept the risk and is cheating the system in order to gain access to a drug ethically acceptable if the alternative is death?” (Thomas 258).

According to Beauchamp et. Al. moral status does not equate to respect for autonomy. “Obligations to respect autonomy do not extend to persons who do not act in a sufficiently autonomous manner–and who cannot be rendered autonomous­–because they are immature, incapacitated, ignorant, coerced, or exploited” (Beauchamp 108). They then argue that infants, irrationally suicidal individuals, and drug dependent individuals fall into this category. I would argue that Jim and Harald’s complete disregard for authority, and decision to take a harmful drug proves their ignorance and therefore disregards their right to autonomy. That being said, people do unconscionable things for people they love.

This brings me to the second question. The sheer force of love has given mothers the necessary strength to protect their babies, has made people make utter fools of themselves as they coordinate mass flash mobs and parades in order to express their love for someone, and has caused individuals to abandon all moral reasoning to fight for those they love. While Jim and  Harold’s decision to organize and open arm, in which they would administer unapproved drugs, it undeniably unethical, in a case where death is the only alternative, it is justifiable.

What do you think? Would your decision be different if it didn’t involve obtaining a drug, rather a loaf of bread? For those of you who are unfamiliar with the reference, in the play Les Miserables, the protagonist, Jean Val jean, is initially imprisoned for stealing a loaf of bread to save his starving nephew.

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2016. Print.

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. Print.