The authors relate a story regarding a physician in Cracow Poland under Nazi occupation choosing whether or not to "inject cyanide into four immobile patients or abandon them to the SS, who were at that moment emptying the ghetto and had already demonstrated that they would brutally torture and kill captives and patients." The doctor ultimately decides to euthanize the patients without their consent. The authors imply that they do not believe the physician murdered his four patients and, in fact, label him a "moral hero." The libertarian bioethicist, on the contrary, immediately recognizes the doctor committed 4 murders , for murder is defined as aggression against another human that intentionally leads to the death of that human. The libertarian bioethicist makes no judgment regarding the heroic status of the physician because this type of judgment is outside the purview of libertarian bioethics. Yet, the context of the doctor's decision would be taken into account if a libertarian justice system became involved in this scenario, for the aggrieved parties (family, next-of-kin, or friends or others designated by the deceased) could easily, and rightly in the estimation of the LIBERTARIAN BIOETHICS BLOGger, seek no punishment for the 4 murders and laud the physician as a "moral hero" for killing their loved ones in a humane way rather than abandoning them to be killed in an inhumane way by the Nazis.
The authors also comment on conscientious objections by health care professionals. They specifically cite "a physician's refusal to honor a patient's valid advance directive to withdraw artificial nutrition and hydration under certain circumstances, a nurse's refusal to participate in an abortion or sterilization procedure, and a pharmacist's refusal to fill a woman's prescription for an emergency contraception." They mention the ethical duty of these health care professionals to inform potential future employers of their relevant objections and "public policy" implications but do not discuss the more common scenario of health care professionals refusing to perform certain work duties after employed. The libertarian answer is the recognition that these health care professionals are probably violating their contracts (and thus private-property rights of their employers) by declining to perform contract-designated duties and, thus, are subject to disciplinary procedures by their employers, including termination of employment.
The authors also discuss organ and tissue donations from living donors. They assert that transplant teams can "decline some heroic offers of organs for moral reasons - even when the donors are competent, their decisions informed and voluntary, and their moral excellence beyond question." I agree with the authors for the key libertarian point in this scenario is that physicians are not slaves and thus, as long as they are not violating the terms of their employment contracts, do not have to provide any medical services to anyone for any reason.
The next chapter in this textbook analyzes the concept of moral status.