Managing in the Gray
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For example, what were Mullen’s duties to patients taking
Tysabri? Was he obligated, legally or ethically, to immedi-
ately inform their doctors about the PML cases? Did he have
a duty to inform the patients right away? Or did he have an
obligation to first get to the root of the problem? Perhaps his
duty was to withdraw Tysabri immediately. Or did patients
have the right to decide whether to keep taking the drug and
run the risk of PML, once they had been informed about the
problem?
Mullen’s problem with a multiplicity of duties is hardly
unique. Put the Tysabri case aside for a moment and think
about the many rights that people frequently assert. Lists of
these rights go on and on. One list included, “A right to life,
a right to choose; a right to vote, to work, to strike; a right to
one phone call, to dissolve parliament, to operate a forklift,
to asylum, to equal treatment before the law, to feel proud of
what one has done; a right to exist, to sentence an offender to
death, to launch a nuclear first strike, to castle kingside, to a
distinct genetic identity; a right to believe one’s eyes, to pro-
nounce the couple husband and wife, to be left alone, to go to
hell in one’s own way.”
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All of these rights create duties for
others. Like insects in a rain forest, duties and duty-generating
rights swarm all around us.
The further complication is that these duties come in all
different forms. Some are legal and regulatory; some are
familiar, others esoteric; some seem inconsequential, and oth-
ers shape our lives. So do some duties or types of duty have
priority over others? And what about situations in which
duties conflict? An everyday example is the conflict between
telling the truth and being kind to our friends. In short, the
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