Talk About Ethics

Should a journalist ever step out of his professional role to help others in need? If so, why and when? What if a life is on the line? What if the journalist has a unique skill that can make a big difference?

Those questions are at the heart of Sanjay Gupta's intriguing case. Gupta is a CNN medical correspondent covering the war in Iraq. He has been embedded for several weeks with a U.S. Navy Medical Corps unit called the "devil docs." They operate a mobile operating room near the front lines in support of the Marines.

Gupta also happens to be Dr. Gupta, as in medical doctor. He is a practicing neurosurgeon at Emory University in Atlanta who also has been working for CNN for over a year.

On April 3rd, war correspondent Gupta was asked by the medical team he is covering to perform emergency brain surgery on a 2-year-old Iraqi boy who had been critically wounded when hit in the head with shrapnel. The boy did not survive.

As the Associated Press reported, "As the only neurosurgeon available to treat a patient with a severe head injury, Gupta said it was his moral duty to help."

In his own CNN report about the incident, Gupta told his viewers, "I did not hesitate at all. … It was the right thing to do … to give this child a chance to live. Medically and morally I thought it was the right thing to do."

Gupta said that the "Devil Docs" had earlier told him they had no neurosurgical capabilities, and they asked him if he would help out if needed.

The CNN network position

His bosses supported him. CNN spokeswoman Christa Robinson told the Boston Globe that "CNN has no specific rules about Gupta’s role there. 'If the same situation arose, I’m sure he would do it again,’ she said. 'We fully support it.'"

Another CNN news executive, who spoke to me on-the-record but with conditions of confidentiality, said Gupta's "situation was an extraordinary circumstance. … His obligation as a doctor took precedence in that situation. In two weeks [with the medical unit in Iraq], this is the first time that something like that has happened.

"[Gupta] hasn't participated in any other way with surgery since he was with that unit. We think it's important for somebody with his expertise to be with that type of unit.

"If Sanjay was needed to save a life and he was the only person available, I don’t think it would matter whether he was in Iraq, Kuwait, or Seattle."

I don’t argue with that logic. Saving a life is a moral imperative. A journalist -- be he a neurosurgeon or not -- has a personal duty to step forth and help if someone's life is at profound risk.

Gupta did what he felt was morally and professionally right in that situation with the gravely wounded child, and I accept his decision and honor his commitment.

Beyond the moment

But this situation with Sanjay Gupta the physician and Sanjay Gupta the journalist is not as black and white as it might appear.

What about in other circumstances? How often should Gupta "help out" this medical unit that he is responsible for covering as a journalist? What is the threshold for the type of case where he puts aside his reporting duties and becomes the medical practitioner? What if the military docs just need an extra hand in a non-life threatening case?

How does Gupta the reporter and Gupta the doctor reconcile his competing roles and competing obligations? Does the Hippocratic oath duty always trump the journalistic responsibility to gather information and report stories?

I asked that question of Dr. Art Caplan, Chairman of the Department of Medical Ethics at the University of Pennsylvania. Caplan was familiar with Dr. Gupta's case.

"Yes, his medical duty always trumps his journalistic role. There would be some gray areas when there are non-life threatening [cases]. … Diagnostic and chronic ailments are different. You can say someone can wait."

But Caplan says that when it comes to serious injuries, "If you are the only one available to help, you’ve got to put down the pen and pick up the scalpel, so to speak. If you are stuck with no one else to help, you've got to go to the Hippocratic oath first."

An informed reporter

Gupta's medical background certainly gives him a unique lens to cover this medical unit.

Caplan says that it's important to have someone of Sanjay Gupta's qualifications in the role of a war correspondent. "I think that the good news is we've got some informed eyeballs out there to evaluate medical care. It was a good thing to send him into the field. … The fact that he stepped in and looked a bit heroic doesn't bother me."

The CNN News executive I talked with said CNN has been "very proud of all the work [Gupta] has done conveying stories. … His work has been terrific."

"Should he help out in other situations?" this CNN news executive asked rhetorically. "I wouldn't want to advise him before we talked to him. I don't want to speculate on what we would do about something that would happen yet."

Says Caplan: The Hippocratic Oath does not distinguish among patients in need. "The Hippocratic Oath applies to the enemy, as well. It says we treat them. We don't care whether they are hostiles or not."