A Choice of Lifestyle

Eric Lis

Does the village cleric have a moral duty to stop your level 1 character from running off to become an adventurer?

The life of the adventurer is a risky one, as we all know. Nobody has ever collected something approximating statistics, but I think that we all imagine that most kids who go out into a dragon-filled world don't live to reach level 10. Granted, the kids who take up professional adventuring have the advantage of living in a world where magical healing is commonplace and resurrection from the dead may be a very reliable possibility, but if a body is eaten by an owlbear or goblins leave a corpse in the bottom of their warren, odds are good that no one is ever going to reanimate it... not with sentience, anyway. In a previous post, I discussed how low-level characters are presumably adolescent and probably not-uncommonly pre-pubescent, so we would expect them to have a very unrealistic view of the risks of their lifestyle and their odds of surviving it; just as teenagers in the real world tend to be psychologically built to believe in their own immortality, I think we can safely assume that the beardless kid who picks up his grandfather's sword and sets off to find adventure doesn't really believe his story could possibly end badly. The question becomes, if we assume that becoming an adventurer in a fantasy world is, in some respects, tantamount to suicide, do the people around that young fool have a duty to stop him or her?

In the emergency department, I'm often called upon to assess people who've been brought to hospital because, in one way or another, they've made a very dangerous decision. This can include a range of interesting stories, from the adolescent making a tenth lifetime low-risk suicide attempt in response to a romantic rupture to the overtly psychotic person who refuses to wash or take out the garbage because of paranoia. Most commonly, though, these stories are related to substance abuse. It's by no means unusual for me to be asked to see a fifty year-old man who has no desire to stop drinking in spite of recurrent pancreatitis, or a teenager who doesn't see why her parents want her to cut back to smoking only two joints per day, or a mother with bipolar disorder who knows perfectly well that she's become psychotic every time she's taken cocaine before but is convinced that it won't happen next time. All of these people share one important characteristic with most of our PCs: they have a longstanding pattern of making very questionable decisions. The question that routinely gets put to me by the patients' family members and other doctors is, what can we do to stop people from making decisions that we believe are unwise. I, in turn, have to ask a couple of related questions: do we have a moral obligation to stop someone from making a bad decision, and, wholly independent of that, do we have any legal right to stop them.

One could choose to look at this from the point of view adopted in medicine, i.e., that of "informed consent." Informed consent is the principle that people have the right to make their own decisions, assuming that they're mentally competent (which can be a tough call to make) and have all the facts that they need to reach an informed conclusion. This usually becomes an issue when a patient has the temerity to refuse to do what their doctor thinks they should do... physicians hate that, and we tend to make a fuss over it, which is sometimes the right thing to do and sometimes not. As a rule, we consider that a person has the right to refuse medical care, be it invasive surgery or a referral to a drug detox program, if 1) they understand their medical problem, 2) they understand what intervention the doctor suggests, and 3) they understand the consequences of refusal. According to the current thinking in bioethics, someone usually has to be very impaired for a doctor to force treatment on them, and rightly so! Even in most cases of mental disorder, where the individual's thinking may be grossly disordered and illogical, a patient is often still felt to be capable of deciding for themselves whether or not they want the recommended treatment.

According to the principles of medical ethics, everybody has the right to make dumb choices as long as they're competent at the time that they make it. One of the landmark judicial decisions on this topic came out of the Supreme Court here in Canada about ten years back, and it's so wonderfully written that I'd like to share it with you. In the case of Starson v. Swayze, a justice wrote,

"...a competent patient has the absolute entitlement to make decisions that any reasonable person would deem foolish... The right knowingly to be foolish is not unimportant; the right to voluntarily assume risks is to be respected. The State has no business meddling with either."

Technically, some of that was the justice quoting a prior judgment by someone else, so I'm not being fair by attributing the quote the way I am, but if you're a real stickler for detail you can read more about it yourself.

The point is, although this case specifically related to whether or not a psychotic patient could or should be forced to accept injectable antipsychotic medications and so much of the argument around the case doesn't particularly apply to our characters (if only because nobody's invented haloperidol or paliperidone in our game worlds), the basic logic holds true. The young man or woman setting out to become an adventurer armed with nothing more than an old sword or three magic missiles per day is making a tremendously stupid and potentially imminently life-threatening decision, but the local cleric, at least, has no business stopping them after trying and failing to talk them out of going.

Everybody has the right to make bloody stupid decisions so long as those decisions affect only themselves, and a good thing that is, because otherwise none of our characters would have jobs. 

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on February 15, 2014. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system