In “Is it ethical to hire sherpas when climbing Mount Everest?,” a short piece out today in the British Medical Journal, I suggest that the question of whether it is ethical to pay sherpas to assume risks for the benefit of relatively affluent Western climbers is a variant of cases–common in medical ethics–where compensation and assumption of risk coincide. Consider offers of payment to research subjects, organ sales, and paid surrogacy. As a result, medical ethics can offer helpful frameworks for evaluating the acceptability of payment and, perhaps, suggest protections for sherpas as we look forward to the next climbing season on Everest.
I owe particular thanks to Nir Eyal, Harvard Medical School Center for Bioethics and Harvard School of Public Health Department of Global Health and Population; Richard Salisbury, University of Michigan (retired); and Paul Firth, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital.
Take a look and let me know what you think.
Nice article, EL. Other instances of this same general phenomenon:
Is it ethical to hire construction workers to work at the top of tall scaffolding, or alongside speeding traffic?
Is it ethical to pay football players to smash heads for our entertainment?
Is it ethical to pay healthcare workers to expose themselves to needle pricks or pandemic influenza?
I think that counterfactual reasoning is key to understand the consequences of the hire/don’t decision (i.e., are they better off without the job). Then, I think that the most important questions are about how we can make their jobs reasonably safe. Rarely is the best option — for the worker or the society — to eliminate the job.