The movie John Q is filled with ethical and

moral dilemmas throughout its course. It gives us a

clear notion of the duties of public servants, and
private administrators with regards to ethical decision
they face in the daily execution of duties in
communities they represent. In this analysis, I will
explore the ethical and moral values of the main
characters in the movie in performing their various
official capacities. I will also elaborate on health
insurance coverage by defining and reviewing the
difference and similarities of PPO and HMO. Below is
an ethical analysis of the characters in the movie John
Q.:
First of all let me explain what the movie is
about before touching on the moral and ethical
dilemmas of the characters. The director of this movie
Nick Cassavetes reveals a social issue in the health
care industry. He explains the ordeals of John
Archibald, whose son has a serious cardiac condition
that requires urgent surgery. John did not have an
appropriate health insurance policy to cover the cost of
the operation; the hospital chooses not to take the
Good Samaritan route, and refuse to proceed with the
operation.
Therefore, John Q is confronted with a moral
dilemma to accept fate and prepare for his sons
funeral as the Hope Memorial Hospital administrator,
Rebecca Payne have suggested, or raise funds for the
cardiac operation, which is a daunting task considering
the time and emergency nature of the situation his son
is in. John decided to take the hospital staff and other
patients at the emergency room hostage. In the
Geuras, Dean, and Charles Garoralo text for this course
have discussed the four sub groups of absolutism
which will be discussed in this analysis. It talks about
philosophers like Aristotle, Kant, and Mills who have
developed their ethical opinions and philosophies. By
reviewing events throughout the movie, we can
compare them as to how they would be viewed under
these different philosophies to determine if they were
morally right, or wrong in relation to Public
Administration.
One would wonder why a hospital will refuse to
offer free operation to save the life of a twelve year old
boy. Well the answer is simple, unlike public
administrations, Hope Memorial Hospital (HMH) is a
private entity, and private cooperations were
established to make a profit. This what academicians
described as the real world or functional world? A
world of budget, deadlines to meet, accountability, and
compliance (Garofalo and Gueras p, 1.) Rebecca Payne
acted in a utilitarian way; by thinking that assisting
John Qs son for free treatment will not do society any
good due to millions of HIV patients facing the same
problem. John Qs son is only a modicum of the health
care problem faced by many. Utilitarian believes that
the outcome of any action has to be for the happiness
of many. Rebecca Payne may be a pariah to her
community for refusing to offer free treatment to Johns
son, but her action may be justified by a utilitarian.
While John is espousing the emergency room
(ER) with his hostages, he was also faced with an
ethical dilemma; he has a pregnant woman who needs
treatment at another facility and another lady who
cant speak English in the ER. When Lieutenant Frank
ask him to release some of the hostages during the
negotiation, Johns dilemma tears him between leaving
the women in the ER where they will die and giving in

to the police by releasing the women. One outcome

emphasizes his desire to find a heart for his son while
the other saves the lives of hostages and expose his
weakness. In the end, he shows his reverence for
humanity and releases the hostages that need serious
help to save them.
This act of John Q will resonate well to a jury
that has passion with the virtue theory of Aristotle
which focuses on good intents of an action. By
releasing the most vulnerable patients during the
hostage negotiation for their own good, divulge a good
side of John. John Q may have portray a poor character
traits for using the gun to commandeer the hospital
staff, but for the very fact that he was brandishing an
empty gun on his victims, and his consistency in
freeing hostages as promise, is a clear indication of
being a man of integrity. Since virtual theory is
concern with the significance of the whole person,
(Garofalo and Gueras p, 59.) Johns actions, his ran
some demand and the treatment of his hostages shows
his frivolous intensions of hurting no one, rather than
an attempt to save his sons life after everything else
saves. His case brings awareness to his community
who can relate to its plight, of part time employment,
and lack of health insurance. This fact makes his
actions very virtuous and utilitarian despite his action
initially gear towards his sons well being, its
magnitude after being publicized has a theme of
struggle to achieve happiness beyond his
community. His slogan, sick! Help! Is welcome by
sympathizers, and that is a remuneration for his
virtues.
Furthermore, the movie also brings to mind the
question of loyalty which is one of the six pillars of
characters. How much can one be loyal to his
employer or organization? One has a moral duty to
protect his organization, but when a persons moral
standards are being threaten, they usually resigns, or
stay and become whistle blowers.[1] The whistle
blowers often fall under intuitionism, a pragmatic
theory which indicates that our intuition can determine
if an action or act is good or evil. There are certain
individuals in the ER whose morals conflict with those
of the Hope MemorialHospital. For instance one of
the nurses gives John Q several options for funding of
his sons operation including an altruistic statement of
just dont take no for an answer. A statement which
John Q reminded her of when she asks him what he
thinks he is doing. John answer that, I am doing what
you advise me, not to take no for an answer. During
the course of the hostage taking in the ER, both John
and the hospital staff were discussing insurance
coverage for Health Maintenance Organization (HMO.)
[2] HMO Merriam- Websters Medical
Dictionary. Merriam- Webster, Inc. 21
Aug.2011.
<
Dictionary.com http://dictionary.reference.com/brouse/
HMO>.
One of the ER male nurses reveals that HMO
physicians receives annual Christmas bonus for not
checking their patients for costly illness to avoid paying
hospitals for costly procedures. This is reveal after
John asks why his sons physicians didnt find out about
his illness earlier during their visits. The heart surgeon
amongst the hostage is reluctant in accepting this
claim which I think is the exercise of his loyalty to the
hospital. The candor this male nurse in further
attacking the surgeon by revealing that in their

hospital, they tend to get around the law by stabilizing

the patients, and then send them home to die if they
do not have a good health insurance carrier to cover
the cost of the treatment.
The male nurses claims sounds infallible, but
the question is what is the ethics in whistle blowing? In
their analyses of whistle blowing, both Bowie (1982)
and Bok (1980) indicate that an employee has a
significant obligation of loyalty to the organization they
belong. Bok, for example, comment that the
whistleblower hopes to stop the game; but since he is
neither referee nor coach, and since he blows the
whistle on his own team, his act is seen as a violation
of loyalty. For both, however, the duty of loyalty is not
absolute; it is a prima facie duty that can be overridden
in certain circumstances.
However, Duska (1997) reject this theory in
which whistle blowing is categorize as an act of sell
out, one needs justification or can be pursued only
under special circumstances. Duska says it is as if
the act of a good Samaritan is being condemn as an
act of interference, as if the prevention of a suicide
needs to be justified (p.355). The flaw, for Duska, is
found in the notion that individuals should be loyal to a
company. Simply put, a company is not a person and
not, therefore, deserving of loyalty. While a company
typically consists of people, it is not a group of people
with a purpose that transcends self-interest. Loyalty,
according to Duska, exists in the context of human
relationships and entails a readiness to engage in
sacrificial behavior. A company is...an instrument with
a specific purpose, the making of profit. To treat an
instrument as an end in itself...does give the
instrument a moral status it does not deserve (p.
338). Thus whistle blowing is a prominent instrument
in virtue theory, intuitionism and teleology.
Another ethical aspect that comes to light in
the movie is dishonesty. The human resource (HR)
department change John Qs insurance from PPO
(Preferred Provider Organization)[3] PPO MerriamWebsters Medical Dictionary. Merriam- Webster, Inc.
21 Aug.2011.< Dictionary.com
http://dictionary.reference.com/brouse/PPO> to HMO
without explaining the implication of the change to his
health benefits. Not until the day he visits the HR to
discuss his health benefits that he is aware of the kind
of coverage his has. Health insurance and other
employee benefits are very esoteric, and should be
thoroughly explained to employees before making
changes in their plan.
Another aspect of dishonesty is portrayed by
Rebecca Payne, Hope Hospital Senior Supervisor in
lying to John Qs wife that her sons name has been
added to the donor list. This unethical lie would have
cost John Q his life as he is made to believe that his
sons name has been added to the organ recipient
list. As he is talking on the phone with his wife, a
conspiracy to murder him during the act is
unsuccessful, as the sniper misses his target (John
Q). As John Q lie inanimate after the shot is fired faking
to be decease to play his move. He rise up and
overpower his assassin to fulfill his moral obligations to
his wife and son whom he promised to do something,
and to find his son a new heart.
This action of John Q, to deceive the sniper,
and the entire police force in his locale on live
television also resonates with the six pillars of
character (W& B p.13, 14) of reliability and

responsibility. John Q is reliable due to his

determination to keep the promises he made to both
his wife and son. West and Evan write that when we
make promises or other commitments which creates a
legitimate basis for another person to rely on us to
perform the task (p.13). They further write that people
with ethics should avoid bad faith excuses. This clause
reveals the dishonesty of the hospital administration,
and the HR department of John Qs employer, who uses
cover up to conceal their motives of murder, and
paying less health coverage for their employees
respectively without explaining benefits and cost to
their employees for them to make an informed
decision.
The reliability character pillar also warns
individuals to avoid unwise commitments, and also to
avoid unclear commitments. These two clauses put
John Q in a moral dilemma for promising his loved ones
to get things done by taking the law into his own hands
as a vigilante to fulfill his promise at all cost to save his
sons life. As he put it I will not bury my son, my son
will bury me. This brings another pillar of character
to mind, responsibility. As the economists says,
human wants are many, but the need to satisfy them
are limited (Adam Smith- wealth of a nation) which
brings to scarcity and choice. John has chosen to
threaten the hospital to save his son which is
considering as a moral responsibility for every
parent. He is aware of the consequences of his action,
as West and Berman indicates beyond having the
responsibility to be trustworthy, respectful, fair and
caring, ethical people show responsibility by being
accountable, pursuing excellence, and exercising self
restraints (W & B p, 14). All this traits can be trace in
John Qs actions and decision making throughout the
movie, on to the end when he decided to sacrifice his
heart for his son when he has explore all means, but
his sons condition keeps deteriorating by the hour.
Despite this colorful picture I have painted on
John Qs to morally, and ethical justify his actions, I will
be unjust to discredit Rebecca Payne for lying to John
Qs wife. In fact, she is not the one that suggested
initially lying to John Qs wife about their sons name
being added to the organ recipient list, it is Sergeant
Moodys idea. Regardless, a deontologist would argue
in her favor due to the principle nature of the
situation. A deontological ethical theory celebrates an
action not base on its outcome, but on a remarkable
feature of the act itself (G& G p.53). Most popular of
these views are followers of Emanuel Kant (1959), the
father of Kantianism. They believe in consistency and
in this case, they will support Hope Memorial Hospitals
stand of continue its policy of cash case for all
patient without health coverage. Any action contrary
to the hospitals billing tradition with creates
contradiction, and lying to Johns wife is ethical. This is
because, deontologist believes any true statement
meant to deceive others would not be a lie (G& G
p,53).
Another example of lying can be justified by
deontologist and Utilitarians alike is doing undercover
work by police officers. They often dress in plain
clothes and change their identity to get information
from the public. Such action can be consider as
unethical by some, but since such disguise is for the
general good to create a happy society, the utilitarian
would support such an act, and so is the
deontologist. For the very fact that Rebecca Payne lie

to end the hostage ordeals in her organization to save

the hostages, her organization, and cooperation with
authorities, makes her decision ethical.
In the final analysis, we will examine the role of
the Police Officials and the media in the movie, and the
impact of their involvement ethically. Unlike private
organization that operates for profit, public officials
such as police officers operate to provide public safety
to maximize happiness for people to roam freely in

their communities without fear for their lives or

properties. They are empowered with the moral and
ethical powers to carry out their duties without fear
and favor. On the other hand, the new outlets that are
considered by political scientists as the fourth arm of
the government encourage transparency and
accountability and exposes corrupt practices in the
community.