Over the holidays, I stumbled upon a remarkable news story. A nurse in New Jersey, serving a life sentence for murdering 29 of his patients, has agreed to donate a kidney to an acquintance.
You can check out the story for more details, but I will outline the basics. The nurse, Charles Cullen, decided several years ago that he wanted to be New Jersey’s answer to Dr. Kevorkian. So he began killing older and weaker patients, people he thought were suffering and would die anyway. He did this by overdosing them on medication, typically insulin or digoxin.
In a brief review of Cullen's life, twothings stand out. First, Cullen is a deeply disturbed individual. He as attempted suicide on many occasions and has a documented history of spousal abuse and alcoholism. Divorce records indicate that he also has a history of animal abuse, and most psychologists regard animal abuse as a marker for severe mental distrubance.
Secondly, Cullen got away with his murders for years because again and again medical facilities hired him, unaware of his background. In fact, Cullen was dismissed from several hospitals and nursing homes under the suspicion of having harmed his patients. Although reporting laws have been strengthened since Cullen’s conviction in 2004, it remains remarkable how easily a healthcare professional can move from job to job despite a very poor work record, or even suspicion of malfeasance.
Which brings us to Cullen and the kidney. We usually think of organ donation as the most altruistic of actions – giving up a part or our own bodies and taking a health risk (surgery) to do it, all for the benefit of another. Here is a man who killed at least 29 people and yet wants to help save a man’s life.
Is Cullen just irrational? Or does he think he was doing a kindness by ending the lives of chronically ill people, and thus, the kidney donation is simply an extension of his desire to decrease suffering? One thing is for certain. If Cullen does have some sense of ethics he certainly has them out of order. It is not important simply to have values. A person must have the right priority of values. For instance, it may be ethical to be patriotic. But if a government asks a person to torture an innocent person because it is patriotic to do so, a moral person should at least pause. What is more important, patriotism or the right of an innocent person not to be tortured?
Values do not exist in a vacuum. They sometimes come into conflict (and this is often the case in medicine), and when they do, the people involved have to consider not just what their values are, but also which values take precidence in a given situation.
In the case of Mr. Cullen, perhaps he understood the value of not prolonging unnecessary suffering. But he missed the value of a patient’s right to live, even in suffering, if the patient wants to. It is a conflict of values that a balanced mind would not be likely to miss.
Aside from simply pointing out this very peculiar case, I would venture an observation. It is easy for us to see that Cullen, in his effort to relieve suffering, was doing the wrong thing. He, in his mentally ill state, stumbled over the conflict in values between relieving suffering and respecting a patient’s right to live. The fact that he would want to donate a kidney tells me that he really does have values, albeit very warped by his mental illness.
It is easy for us to see the faults in Cullen’s thinking. But there are tougher moral choices out there than the ones Cullen made. I wonder if our society is warped in its thinking, if we are making terrible moral choices but cannot see them, just as Cullen cannot see his. Our society once condoned slavery, and wife-beating, and lynching, because our ancestors stumbled over value conflicts our modern eyes now see as easily as we can see Cullen’s mistakes. There is no reason to think, having cast aside a few errors of the past, that we are now perfect, though it may be perfectly satisfying for us to be so kind to ourselves.