Evolutionary Ethics and Medical Ethics in Enterprise’s “Dear Doctor” and Voyager’s “Nothing Human”
In “Dear Doctor” (2002), Dr. Phlox hopes and aspires to not cure a global population suffering from a spreading disease that is killing them by the millions. Dr. Phlox would prefer not to find a cure. Such a harsh dialectic tone coming from the doctor invades our sense of ethics while turning our senses inward. Much like how Captain Archer responded when he told Dr. Phlox that he had reconsidered his position. Previously Archer insisted that Phlox discover a cure for the Valakians. Phlox, however, articulated that curing this dying race would not be ethical. Their illness was not a virus or pathogen, but biological, an evolutionary trait that coincided with evolutionary advances of the Menk, the other humanoid species that shared the planet. Upon asking Archer to reconsider, he states,
I have reconsidered. I spent the whole night reconsidering, and what I’ve decided goes against all my principles. Someday my people are going to come up with some sort of a doctrine, something that tells us what we can and can’t do out here, should and shouldn’t do. But until somebody tells me that they’ve drafted that directive I’m going to have to remind myself every day that we didn’t come out here to play God.
With that the seeds of the Prime Directive were born. It is noteworthy that the Prime Directive is being fleshed out while in the background other species have already visited the Valakians, though did not assist them for completely different reasons:
This episode establishes the basis of what would become the Prime Directive. In this episode there is a clear contrast in moral authority between the Ferengi, who do not help the Valakians because there are no financial gains to be made, and humans, who must make the very difficult decision not only to not share warp technology, but not even a cure for the genetic mutation in the interest of the greater scheme of evolutionary blueprints and architecture.
Though not a scientist in the manner that Dr. Phlox is, Archer still comes to agree with Phlox’s insights that though he had indeed discovered a cure, they would be altering, invading the biological and evolutionary sentencing of the planet. I argue that, despite being as argumentative as it is, this is not the real pushback being given in this scene.
What is really happening is the arc of the human story. Ethics of evolutionary biology, most often referred to as evolutionary ethics, states that natural selection acts upon ethical sensibilities just as it does for any other fitness. What is being contemplated in this episode is the advancement of the human species. When Archer decides not to give the Valakians the cure, he is symbolizing a humanity that plays an accelerated ethical roles matching its scientific progress that allows us to navigate to distant planets. Phlox directly refers to trusting humanity to make the right decisions, the ethical and difficult, “If I hadn’t trusted him [Archer] to make the right choice I’d have been no better than the Vulcan diplomats who held your species back because they felt you couldn’t make proper decisions on your own.” In many ways the Valakians mirrors what humanity could have been.
At one point Archer brings up the possibility of staying with the Valakians and teaching them how to build a warp capable spacecraft, to which T’Pol states, “The Vulcans stayed to help Earth ninety years ago. We’re still there.” There was also foreshadowing in the episode of the nuances of the Prime Directive. When they discover the drifting Valakian ship Archer questions T’Pol regarding the ability to interfere, to which T’Pol articulates that they have already been in contact with two warp capable species, therefore, the risk for adverse overexposure to technology and outer planetary life was low. Through these experiences, with the Valakians and the Menk, humanity is actively composing what will be their guiding laws in the cosmos, to rest and refrain from harsh interference in the natural course of events; guiding laws that will be exercised and explored even further in the series with the Temporal Prime Directive.
However, Star Trek does not abate more direct and actionable laws and guidances. Years after the Prime Directive as been firmly established, there are still the tremors of the echoes of even older ethical boundaries that have been declared not to be crossed circumventing the lived realities of crew of Voyager. In “Nothing Human” (1998) a seemingly more active doctrine is exposed as testing the humanity of Voyager and its ethical disposition while in the distant Delta Quadrant.
I have previously discussed “Nothing Human.” The Doctor was forced to rely on the experience and insights of Cardassian exobiologist, Dr. Crell Moset, in hologram form, to assist in releasing B’Elanna from the grasp of a parasitic alien.
Dr. Crell Moset possessed the skill and knowledge to save B’Lenna’s life, but only due to the experience he gained through grotesque experiments and tortures committed against the Bajoran people. Are we to save and preserve life with knowledge gained through mass atrocity? The evolution of medical sciences in the 18th and 19th centuries did just that. James Marion Sims performed painful experiments on enslaved Black women which led to him being credited as the “father of modern gynecology.” The source of preservation for some comes at the cost of extinguishing the lives of others. The violence-narratives of cyclical familial trauma creates a tension of permanence and retreat from that permanence to an earlier state is not what makes us whole, but is derivative of sequestered lies and intoxicated moments of release.
This episode cements the tenets of The Nuremberg Code’s first action, that “The voluntary consent of the human subject is absolutely essential.” Further adding the Declaration of Helsinki, which the fourth general principle states, “It is the duty of the physician to promote and safeguard the health, well-being and rights of patients, including those who are involved in medical research.” Though at first arguing for the Moset’s usefulness, The Doctor comes to confirm members of the crew’s stance of the ethics of retaining a holoprogram that was gifted only by its degrees of torture, stating “It is my judgment that the Medical Consultant Programme and all the algorithms contained therein shall be deleted from the database. In light of recent evidence I cannot in good conscience utilise research that was derived from such inhuman practices.” Interestingly, it took time for The Doctor, a hologram himself, to reach the same conclusion that B’Elanna and Tabor had instinctively.
Tabor, having lost his brother and grandfather to Moset’s experiments, was a humanoid witness to a holographic computer simulation on a ship where Chief Medical Officer was a simulation himself. Clearly, the repose of the Bajoran testimony is never actually at rest, but such guidances are always needed as we face more and more conflation between our humanoid commanding officers and decision makers and reliance on AI and computer technologies. Without doubt, The Doctor would not have so easily come to see Tabor’s and B’Ellana’s perspective, or the tenets of The Nuremberg Code and Declaration of Helsinki without persuasion in the humanoid form.
The Doctor trusted too much in his own innate gifts just as be initially trusted in the gifts of Dr. Crell Moset. The echo chamber was only disrupted through the testimony of Bajoran suffering, a testimony not sought out or easily accepted by the simulation of the holder and possessor of medical ethics programming and databases. The Doctor is not completely to blame. Captain Janeway commanded that The Doctor allow Moset to assist him to save B’Ellana’s life and, furthermore, that all consequences from that rested with her. It is interesting to contemplate how ethical boundaries are consistent when Archer makes a choice that permits the deaths of millions while Janeway makes a choice that saves the life of just one.