Medical Ethics through the Star Trek Lens

Science fiction, which started out on the edges of literature and pulp fiction, has become more than mainstream; it is now an essential way of interpreting the world.

--Eric P. Nash ¹

Throughout the twentieth century, science fiction has been deeply entwined in the popular moral imagination about the future. Novels, stories, and movies about science, technology, and moral decisions have shaped the way we think about people and the choices they make. From Mary Shelley's Frankenstein or Aldous Huxley's Brave New World through George Orwell's 1984, I. R. Levin's The Boys from Brazil, or Michael Crichton's Jurassic Park, technology and the scientists who develop and deploy it represent both our scariest nightmares and our deepest hopes and aspirations. We want to make a better world, but we are unsure of our abilities or the purity of our motivations.

Over the past thirty years, the Star Trek series of movies and television shows have brought the ethical dilemmas of modern science and technology, and the ethical conflicts that arise in a vast, pluralistic universe, to a huge popular audience in a sensitive and accessible way. The "texts" of Star Trek often take the form of philosophic dialogues, in which the freedom offered by the science-fiction genre allows the authors to pose pointed moral questions in succinctly dramatic ways.

As a vehicle for communicating debate and discussion about these issues, it would be hard to overestimate the success or the reach of Star Trek. Since its first episode aired on 8 September 1966, the Star Trek universe has been one of the most popular and often cited science-fiction creations of any kind. There have been more books, television shows, and movies set in the Star Trek universe than in any other science-fictional universe. Beginning in 1987, Star Trek: The Next Generation ran for seven seasons as the highest-rated syndicated show in television history, followed by a reasonable success for Star Trek: Deep Space Nine, another top syndicated drama, and Star Trek: Voyager, the continuation of the franchise, which is now finishing its fifth and final year. ² The Star Trek films have grossed more than one billion dollars, and are among the most popular of all video rentals. Hundreds of millions of copies of Star Trek books are in print, and dozens of new titles are published each year. There are hundreds of clubs and web sites devoted to the series, and scholarly attention has grown slowly since the 1970s. By the time this essay appears in print, the book The Ethics of Star Trek will be in bookstores, joining The Physics of Star Trek, Life Signs: The Biology of Star Trek, The Metaphysics of Star Trek, and Star Trek on the Brain, a book on the neurological and psychological science of the series. ³

Part of the appeal of the Star Trek universe has been its explicitly humanistic ethos established by its creator, Gene Roddenberry. The original seventy-nine episodes addressed topics of racism, war, and humanity's relationship to machines. The Star Trek universe is populated with hundreds of exotic races and cultures, as well as many devices operating at the interface between the machine world and the life world. Thus, it provides opportunities to explore the moral dilemmas associated with cultural diversity and pluralism in a universe without a single moral code. In that sense, the ethics of Star Trek is the ethics of multiculturalism. ⁴

Star Trek scripts have often grappled with dilemmas of medical ethics. The most explicitly medical-ethics-oriented Star Trek episode is named, aptly enough, "Ethics." The script was written by Sara Charno and Stuart Charno, authors of two other Star Trek episodes. "Ethics" first aired on 2 March 1992. In the fall of 1992, we began to use this "Ethics" episode to motivate discussions in our first-year medical students' course on medical ethics and the...