During August 2005, the Gulf Coast experienced the most expensive natural disaster in history. The remarkable devastation would be painfully remembered simply as Hurricane Katrina. Amidst the hue and cry of lives lost, levees that failed—and alleged FEMA incompetence—Hurricane Katrina’s darkest moments, especially for medicine, continue to reverberate. It must never be forgotten that after the initial shock from the powerful storm had dissipated, forty-five corpses were retrieved from one New Orleans hospital under suspicious circumstances.[1] A subsequent article reporting the events was trenchant enough to receive a Pulitzer Prize.[2] At the time, it was alleged that some of these forty-five individuals were injected with sedatives such as morphine to relieve either their suffering or to deliberately hasten their deaths.[3] Therein lays the rub of the principle of double effect. The Louisiana Attorney General and prominent forensic scientists labeled what happened homicide.[4] The local coroner later testified in agreement with this claim and provided evidence of the drug levels to demonstrate what should have been a lethal cause and effect. Also critical to the ensuing debate, several of these persons whose death may have been hastened did not have a Do Not Resuscitate order. There was no evidence that any of the individuals consented to assisted suicide. One case study may provide insight.[5]

GATTACA is just one of the examples from literature and popular culture that entice us to slow down and think about some of the most serious ethical questions facing us today. Hollywood has given us The Sixth Day on human cloning, The Island on involuntary organ donors, John Q on organ transplantation, and Minority Report on neuroethics, to name just a few. These are joined in literature by works such as C.S. Lewis’ That Hideous Strength and, of course, Aldous Huxley’s Brave New World.

Sometimes there is an eerie immediacy to the sci-fi futuristic scenarios depicted in these works. Scripts have had to be altered when real-day science threatened to overtake the in-the-future premise of the plot. Meanwhile, the moral conversation, the bioethical reflection, has struggled to keep up. Law and policy lag even farther behind, often feebly attempting to regulate only after a catastrophe or dispute.