The Grey’s Anatomy season 7 finale, from what I could tell, added a few twists and turns to a dilemma that is often used to determine one’s stage of moral development – the Heinz dilemma. The dilemma reads as follows:
In Europe, a woman was near death from cancer. One drug might save her, a form of radium that a druggist in the same town had recently discovered. The druggist was charging $2,000, ten times what the drug cost him to make. The sick womans husband, Heinz, went to everyone he knew to borrow the money, but he could only get together about half of what it cost. He told the druggist that his wife was dying and asked him to sell it cheaper or let him pay later. But the druggist said, No. The husband got desperate and broke into the mans store to steal the drug for his wife. Should the husband have done that? Why or why not?
Here’s the scenario that took place on the show:
Dr. Shepherd and Dr. Grey (two surgeons who are married) decide to conduct an FDA-approved study to determine whether a new drug aids in the reversal of Alzheimer’s. It is revealed that the wife of Dr. Webber (Chief of surgery), Adele is showing signs of Alzheimer’s. Aside: the Chief of surgery used to have an affair with Dr. Grey’s mother for quite some time. There happens to be an opening in the study being conducted by Dr. Shepherd and Dr. Grey. Dr. Webber, using his influence, persuades his two surgeons to include his wife in the trial. Later Dr. Webber has a conversation with Dr. Grey thanking her for being so vigilant about trying to help his wife (Dr. Grey was the one who noticed the signs of Alzheimer’s in Adele before anyone else did.)
It is nearly time for Adele to have surgery. Dr. Grey, having surreptitiously obtained the passcode to enter the lab where the drugs for the trial patients are being held, sneaks in to determine whether or not Adele is to receive the placebo or the experimental drug. Dr. Grey, seeing that Adele is set to receive the placebo, attempts to switch Adele’s placebo with another patient’s experimental drug, but is caught by Dr. Karev, who, at the time, was a bit flustered with his current workload. Later, Dr. Karev, remembering what he saw Dr. Grey do, attempts to persuade Dr. Grey to tell Dr. Shepherd or Dr. Webber what she had done because if the FDA found out, there would be severe consequences not only for her, but for the hospital.
In an act of drunken stupor, Dr. Karev confesses what he saw to Dr. Hunt (a higher-level doctor), who tells Dr. Webber. Dr. Karev is then asked to tell Dr. Webber everything that he saw, which, through process of elimination, leads Dr. Webber to understand that what Dr. Grey did, was effect something having to do with Adele, his wife. Upon learning of this, Dr. Webber immediately suspends Dr. Grey and, in part, takes some of the blame for what happened, having pressured Dr.’s Grey and Shepherd.
Now, I realize that this is quite a lengthy description, but I wanted to offer a bit of background, given that the history is what adds to part of the twist. It’s hard to directly superimpose Dr. Grey onto Heinz, but I think that what they both did is similar, and as such, those who answer one way about the Heinz dilemma will likely answer similar to the dilemma created by Dr. Grey’s actions.
Stage one (obedience): Heinz should not steal the medicine because he will consequently be put in prison which will mean he is a bad person. Or: Heinz should steal the medicine because it is only worth $200 and not how much the druggist wanted for it; Heinz had even offered to pay for it and was not stealing anything else.
Stage two (self-interest): Heinz should steal the medicine because he will be much happier if he saves his wife, even if he will have to serve a prison sentence. Or: Heinz should not steal the medicine because prison is an awful place, and he would more likely languish in a jail cell than over his wife’s death.
Stage three (conformity): Heinz should steal the medicine because his wife expects it; he wants to be a good husband. Or: Heinz should not steal the drug because stealing is bad and he is not a criminal; he has tried to do everything he can without breaking the law, you cannot blame him.
Stage four (law-and-order): Heinz should not steal the medicine because the law prohibits stealing, making it illegal. Or: Heinz should steal the drug for his wife but also take the prescribed punishment for the crime as well as paying the druggist what he is owed. Criminals cannot just run around without regard for the law; actions have consequences.
Stage five (human rights): Heinz should steal the medicine because everyone has a right to choose life, regardless of the law. Or: Heinz should not steal the medicine because the scientist has a right to fair compensation. Even if his wife is sick, it does not make his actions right.
Stage six (universal human ethics): Heinz should steal the medicine, because saving a human life is a more fundamental value than the property rights of another person. Or: Heinz should not steal the medicine, because others may need the medicine just as badly, and their lives are equally significant.
The important thing to remember here is that Kohlberg was not interested in what Heinz should do, instead, in how one would justify what Heinz has done. Interestingly, some have criticized Kohlberg’s work, claiming that it is too male-centric. Carol Gilligan argued that Kohlberg’s theories did not adequately describe concerns of women, but there has been research on both Gilligan’s model (Ethics of Care) and Kohlberg’s model and it was found that there was no significant difference in moral development between the sexes (here and here). Although, both of these studies are 20 years old, so things may be different today.