Randy Cohen

From 1999–2011, the New York Times Magazine published a column called "The Ethicist," in which Randy Cohen or occasionally a guest writer responded to a reader's letter that poses an ethical question. Some of these letters and responses have been collected in a book called The Good, the Bad, and the Difference (2002). Cohen is also the author, most recently, of ?Be Good: How to Navigate the Ethics of Everything. The letters have posed such questions as these:

Below, we give three letters on other topics, with Cohen's responses.

DYING WISH

Recently at the hospice where I work, the family of an African-American patient requested an African-American nursing assistant rather than the Latino we had planned to assign. I feel uncomfortable when a white patient requests a white care provider, but this seems different. After all, the requests of female patients for female nursing assistants seem reasonable on the basis of modesty. What should I do here?—Anonymous

Your proclivity to accede to any request of a dying patient does you credit. Yet, though your intentions are benign, you should not assign jobs simply on the basis of race. If the former segregationist Strom Thurmond demanded a white nurse's aide, few hospices would comply. And while the victims of racism confront different circumstances than its beneficiaries do, that is not sufficient reason to establish a race-based jobs policy. To do so would be to discriminate against members of your staff, and that rejected Latino aide would have grounds to complain if you did.

You could honor a request for a particular aide: I want Rosa. She's capable and kind, and I love beating her at gin. And going further, a hospice can consider race as one of many factors—age, experience, geographic background, temperament, sense of humor—when deciding which aide would be a great match for a particular patient. Indeed, given America's history, how could race not be a factor in such decisions? This is akin to what some university admissions officers do, treating race as one of many factors that inform them about prospective students. Thus, after considering all criteria, you may well decide to grant the request of your African-American patient.

As for sex and health care, here too we meet some demands but not others. Most of us would consent to a woman's request for a female gynecologist, deferring to her sense of sexual modesty. But few would honor her request for a female heart surgeon. And while a nurse's aide does perform intimate tasks—bathing a patient, for example—the analogy of race and sex has only limited application here, given the essential similarity of all human bodies.

Follow up: Anonymous later learned that an episode in the patient's past had instilled in her a fear of white faces. This new information makes assigning her an African-American aide not racism but compassion, an honorable response to her individual circumstances.

SUFFER THE LITTLE CHILDREN

I am a university researcher using magnetic resonance imaging to study how children learn to speak and read. All such work is monitored by a review board to assess its safety. Our board has given me permission to study children as young as 7. There is as yet no evidence at all that M.R.I. is harmful, but I worry about later discoveries, and so I may not let my own 7-year-old participate. Can I run other children in this study if I wouldn't run my own?—Anonymous

Different people accept different levels of risk. That this study entails more than you find palatable does not mean others will concur. Some let their kids drive dirt bikes; others don't. (Although few would allow their 7-year-old to drive a motorcycle through an M.R.I.) Forbidding your child to be a research subject does not make you a hypocrite. Your duty as a researcher is to be a responsible scientist, not a model father.

It is your obligation to make sure that potential participants understand the current risks as well as the dangers that might be confirmed in the future—not just statistical possibilities, but information meaningful to a lay person. You must be alert to the deference we civilians sometimes show doctors and scientists, which inhibits us from asking pertinent questions. And your volunteers must be truly that: you must avoid offering, for example, the sort of payments to participants that exploit the desperation of the financially hard pressed.

After that, it is up to other parents to decide. If anyone asks if you'd allow your child to participate, you must of course answer calmly and honestly. That is, you should not shriek, unprompted: "I'd never let my kid within 50 feet of an M.R.I. Those things could blow sky high!" By appealing to parents' emotions rather than to their reasoned judgment, by manipulating their regard for you as an authority figure, you would undermine not only this valuable research but your respect for science itself.

COLLEGE PARKING

At the public university where I used to work, it was first-arrive, first-park. (The later you came to work, the more likely you had to park in the satellite lot and ride the shuttle.) Recently, just before I left, a number of closer spots were reserved for particular deans and vice presidents. I then had fewer spots to choose from, even when I arrived before them. Is it ethical for them to get preferred parking?—Andrew Feldman, Long Island

Sure, rank has its privileges. I've even heard of cases in which some high-ranking people make more money than we hoi polloi—and talk about scarce resources.

But while this policy is not unethical, it is unwise. To elevate administrators to a privileged class is contrary to the American ideal of an egalitarian society. Why bestow parking perks on a dean rather than a math professor or a grad student or, for that matter, a cafeteria worker? What's more—or perhaps less—it will not improve a dean's ability to do his job if his experience of campus life has little in common with the people who work and study there.

However, if your university is eager to create a petty aristocracy, it could instead force students with lower than a C average to carry administrators around the campus in sedan chairs, providing both an incentive to excel academically and a public display of the university's values.