Star Trek: The Next Generation: Ethics   Rewatch 
May 10, 2021 9:24 AM - Season 5, Episode 16 - Subscribe

After Worf is paralyzed by a freak accident, his only hope may be a visiting doctor with questionable medical ethics.

Maybe it's time you stopped lying here worrying about your honor and started thinking about someone else, like Memory Alpha.

Story and script
  • Ronald D. Moore found writing the episode difficult. He remembered, "I wasn't a big fan of doing medical shows to begin with, and that particular one had a ton of medical jargon and technology and medical ethics." (Star Trek: The Next Generation 365, p. 245)
  • Herbert J. Wright suggested that the experimental procedure be more grotesque, with small creatures released into Worf's bloodstream, eating away damage to his body. The idea was rejected so that science fiction elements did not distract from the drama. (Captains' Logs: The Unauthorized Complete Trek Voyages, p. 240)
  • There were internal debates among the production staff about how to handle the issues of euthanasia and living with a disability. To Moore, Worf's position was obvious. He argued, "That wouldn't matter to Worf. He wouldn't want to live like that. He's a Klingon, and a Klingon would want to be killed." (Star Trek: The Next Generation 365, p. 245) However, for both Worf's dilemma and the conflict between the two doctors, he endeavored to show the different positions fairly. He commented, "The balancing act was to make sure both sides of the argument had validity, were compelling and real positions." (Captains' Logs: The Unauthorized Complete Trek Voyages, p. 239)
  • Michael Piller remarked, "I love grays. I don't love black and whites. I don't like answering questions so easily for the audience […] with 'Ethics,' again, we went out of our way not to make it easy for the audience to know what the right thing to do was." (Captains' Logs: The Unauthorized Complete Trek Voyages, p. 239)
  • Director Chip Chalmers revealed that the scene where Riker and Worf argue was originally even more heated, with the two actors yelling "nose to nose". At the last minute, this was cut, as it was felt that it had gone too far. (Captains' Logs: The Unauthorized Complete Trek Voyages, p. 239)
  • During most of the surgery, Worf was played by Al Foster, the photo double for Michael Dorn. (Star Trek: The Next Generation Companion (2nd ed., p. 193))
  • The containers which fell onto Dorn's stunt double Rusty McClennon were made of styrofoam. (Call sheet)
  • While describing his disdain for the hegh'bat ritual, Riker makes mention of the deaths of Marla Aster (TNG: "The Bonding") and Natasha Yar (TNG: "Skin of Evil").
  • In an alternate reality shown in the 7th season episode "Parallels", Worf and Deanna Troi fall in love after his operation, and the couple soon marry.
  • Unlike DS9: "Sons of Mogh", it was not clarified if this form of ritual Klingon assisted suicide would allow a Klingon soul to enter Sto-vo-kor (though it can perhaps be inferred as such, from the fact that it is an accepted ritual of the Klingon culture).
  • While Commander Riker was encouraged by Captain Picard to carry out the ritual of hegh'bat, Worf himself was arrested by Odo and berated by Sisko for attempting a similar ritual on his brother Kurn in DS9: "Sons of Mogh".
  • When asking Riker to help him by performing the hegh'bat ceremony, Worf says "help me end my life as I have lived it". Seven years later, Kor repeats that phrase to Worf, word for word, when asking him to help him undertake his final mission in "Once More Unto the Breach".
  • During this episode, it is revealed that Klingons have visible ridges on their spines and feet as well as their foreheads.
Poster's Log:

Worf has no survival sense at all, does he? Dodging seems more Klingon-like than turning your back and cowering. One wonders if his shame at that reaction fed his desire for the Hegh'bat ceremony.

Russell lampshading her "objectivity" in the first five minutes she's on-board really sets up the later conflict with Crusher well.

Oh, right, this is another "Riker's human sensitivities are more important than multiculturalism" episode.

Alexander's seriousness while Worf talks about the dangers of the surgery may be an acting highlight for little Brian Bonsall. He sold it here better than he has before.

We'll get back to the future implied by Worf's request that Troi take care of Alexander a couple of times, especially in "Parallels" and "All Good Things...".

"Ten to the ninth base pairs per second". Worf's Klingon, so we don't know just how many base pairs his DNA holds, but that shouldn't take TOO long to sequence the entire structure. Humans have about 3.2 billion base pairs - that's three seconds worth of work for the sequencer. It can sequence three and a half trillion base pairs an hour and they have over three hours to complete the process.

Klingon nervous systems apparently have a nictating membrane.

Poster's Log, Supplemental:

I went into this one with a lot of trepidation, fearing a schmaltzy take on assisted suicide. In reality, this episode is a little bolder than I remembered.

Assisted suicide was quite a hot topic when this aired. Jack Kevorkian, known as "Dr. Death", had been in the news for losing his license to practice medicine in Michigan less than three weeks before final script acceptance and filming. I don't recall if she was in the news much, yet, but Terry Schiavo had been on a ventilator for over a year by this point. People were starting to confront the moral decisions around ending one's own life or assisting others in ending theirs, and TNG confronted it head-on.
posted by hanov3r (17 comments total) 3 users marked this as a favorite
This got kind of long! Sorry.

Dr. Russell has her replicator device to grow new organs and all. Her preliminary results show promise, but her success rate is still very low. "I can't allow this on Worf." And then Crusher's delivers her trademark smile a few times that says so much: Sorry, hun, my way or the highway. But keep working.

Riker goes from having his hair perfectly combed on the Bridge to having that lock hanging down, indicating emotional distress! Oh! He doesn't want to help Worf; Picard though seems quite aware of what this kind of injury means for a Klingon. Maybe Picard should take the weight off Riker's shoulders and offer his services? Or maybe he is so firm in his thoughts on the situation precisely because things are on Riker's shoulders: "Your tough luck he asked you first, Number One."

I get where they try to go here with Riker and honoring Worf's beliefs, but we never ever get to see the other side of the coin. What about honoring Riker's beliefs?

Crusher is so oblivious to her patients' state of mind. Worf isn't buying what she's selling, but she's all, "You'll get used to it." Then Dr. Russell offers her treatment while Crusher is frowning in the background. Jump to the two doctors talking where we learn Worf has made it known he would rather self-terminate than wear Crusher's implants, but Crusher dismisses Worf as simply grasping at straws.

The mass casualty incident scene where Crusher and Russell have it out after Russell uses one of her pet treatments on one of the injured is a bit heavy handed. The writers talk about being fair to both sides of the issue, but Worf hasn't even had his surgery yet and they're turning Russell into some kind of monster.

Picard comes down to Beverly's office to talk to her about maybe allowing Russell to do her thing with Worf because he will definitely suicide without a full recovery. Crusher would keep him a prisoner to prevent it! She's not very into respecting the beliefs of her fellow Starfleet members. Picard is the voice of reason yet again.

Good scene with Worf and Troi. Good scene with Riker and Picard; I like the close-ups as they ask if they've had any word yet. Crusher in surgery looks intense and concerned for her patient.

Of course, Crusher and Russell get a final scene in Crusher's office! Surgery worked, but it's bad medicine. It's interesting to think about how Russell got there in the first place. She's a specialist who must have been requested by Crusher. Does Beverly not vet these people first?

There are times I love Gates, but this an episode that didn't serve her or Crusher well. I hate when they go overboard with making Crusher as some kind of paragon. She's just sanctimonious.
posted by Fukiyama at 9:53 AM on May 10, 2021 [4 favorites]

I'm 99% sure that this is well before Shiavo was a household name, but good call on the Kevorkian connection, which I'd forgotten about.

The big moment in this one has gotta be Riker's speech. Its powerful delivery notwithstanding, I felt there was a bit of retroactive continuity at work there, in that we are told Riker and Worf are really close friends, but it's a relationship that hasn't been too thoroughly established prior to this, at least not nearly as vividly as Riker and Troi, Data and Geordi, or even Picard and Troi.

Why didn't Crusher—the former head of Starfleet Medical—pull some rank to formally censure Dr. Russell for the fatal experiment on Rando McVictim in the cargo bay? Her final Kirk Speech might've had a bit more oomph if it had ended with something along the lines of "Expect a hearing, at minimum." Plus then Russell doesn't get to flounce out of there with that "Omigod I'm so sure" expression on her face. (And on that topic, props to the writing and performance of that role. You start out liking Dr. Russell and you end up intensely disliking her; kind of a neat arc.)

Good scene with Riker and Picard; I like the close-ups as they ask if they've had any word yet.

Yes, that moment is really striking. I'd been trying to remember which TNG it was in for literally years.
posted by CheesesOfBrazil at 9:57 AM on May 10, 2021 [1 favorite]

So this week's two-fer is Ethics in SPAAAAACE, and this one is a doozy. I'd remembered it as TNG's take on the play (and eventual movie starring Richard Dreyfuss) Whose Life Is It Anyway?, and there's quite a bit of that in there, but I'd forgotten about the parallel story with Crusher and Russell (it's a bit too involved to put it in the category of a B story, I think), which is also very much a thing. We got a bit of the concept of the right to die in "Half a Life", although things are significantly different as Worf's situation seems hopeless and of course he's one of the E-D's own. Of course there's a ritual for it, and Riker deciding to rules-lawyer his way out of helping (and into reminding Worf of how he's about to orphan Alexander, as he himself was) was pretty neat.

But, yeah, this was not a good Crusher episode.

Of course, Crusher and Russell get a final scene in Crusher's office! Surgery worked, but it's bad medicine. It's interesting to think about how Russell got there in the first place. She's a specialist who must have been requested by Crusher. Does Beverly not vet these people first?

Why didn't Crusher—the former head of Starfleet Medical—pull some rank to formally censure Dr. Russell for the fatal experiment on Rando McVictim in the cargo bay? Her final Kirk Speech might've had a bit more oomph if it had ended with something along the lines of "Expect a hearing, at minimum." Plus then Russell doesn't get to flounce out of there with that "Omigod I'm so sure" expression on her face.

Yeahhhh. The writers nailed Worf and Riker (and Alexander and Troi) very well, but totally whiffed on the whole how-to-do-medical-ethics-from-the-doctors'-perspective. I mean, there are actual rules in real life about how medicine advances the art and science while still putting the patient first. Medical ethics is a deep, and deeply fascinating, subject, and there's only so much that they can put into part of a single episode, but the ep seems to want to put the two doctors in easy categories--this doctor plays by the rules, but this doctor makes her own rules--and stacks the deck against Russell by having her actually kill a patient. In a way, the ep bites off way more than it can chew; having a doctor make a snap judgment in a crisis situation that turns out to be the wrong decision is absolutely a thing that happens IRL, and Crusher deciding that a course of treatment that is at odds with Worf's personal and cultural preferences is OK is also a thing that happens (although against current best medical practices), but neither is really resolved satisfactorily IMO.
posted by Halloween Jack at 10:58 AM on May 10, 2021 [2 favorites]

I always avoid looking at titles when I start, so I can play "how long does it take to recognize an episode?", and this one is my all-time best--they open up with a shot of big ole barrel high up on a shelf, and so what else could it be?

Are all Worf episodes from here on out also Alexander episodes?

In the last scene, Crusher literally refuses to acknowledge Dr. Russell or even make eye contact when she walks into her office. I think this is the same office, with the scene shot pretty much the same way, as in The Host, where Crusher also gives a former friend an awkward, dismissive farewell. Russell's reaction is "jeez, no pleasing some people" and walks off, doesn't seem to really care, which is a strange note to end on.

Anyway, better than I remembered, thought I'd really dislike it.

posted by skewed at 11:00 AM on May 10, 2021 [1 favorite]

What about honoring Riker's beliefs?

I mean, I agree with this sentiment, but we don't know what Riker's beliefs *are*. We only know that they're not the same as Worf's. The closest we get is "I will not help a friend commit suicide".

Also, this Riker quote:
I've been studying this ritual of yours. Do you know what I've decided? I think it's despicable. I hate everything about it. The casual disregard for life, the way it tries to cloak suicide in some glorious notion of honour. I may have to respect your beliefs, but I don't have to like them.
That's not "respect", Will. There are lots of ways to express respect for someone's beliefs without agreeing with them yourself, but this isn't one of them.

I'm also a little salty about the emotional appeal in the "well, how will this hurt all your friends?" approach. Many people contemplating suicide (and, probably, ESPECIALLY a Klingon like Worf) feel like a burden to those around them; he's quite probably thinking "at least they won't have to take care of me any more".

This is one of the few instances where Worf's overly-Klingon Klingon-ness is "normal", as we'll see when his brither Kurn asks for the same ritual in DS9's "Sons of Mogh".
posted by hanov3r at 11:05 AM on May 10, 2021 [3 favorites]

Are all Worf episodes from here on out also Alexander episodes?

Nah, there really aren't that many more Alexander episodes, and some really good Worf episodes are still to come ("Parallels" and the less-good "Birthright" 2-parter come to mind).
posted by hanov3r at 11:08 AM on May 10, 2021

"Ronald D. Moore ... wasn't a big fan of doing medical shows to begin with"

I find this a bit amusing considering one of the worst episodes of Battlestar Galactica was about an even more unethical doctor than this one.
posted by Mr.Encyclopedia at 12:05 PM on May 10, 2021

I mean, I agree with this sentiment, but we don't know what Riker's beliefs *are*.

Yeah, there really no "human" culture as portrayed in TNG aside from stuff like Picard quoting Shakespeare or Gilgamesh. It's almost like since humans don't have much of a culture of their own anymore, they have taken on the idea of just respecting everyone else's stuff. But when that stuff is morally repugnant, we have situations like we see here with Riker who obviously has strong feelings about Worf's request, but has no personal belief system to really back up his own thinking on the subject.
posted by Fukiyama at 12:12 PM on May 10, 2021

The conflict with Riker in this episode feels 100% fake/astroturfy/plot-ecnomical, to me. They needed someone to nuh uh Worf's desire to end his life, and beard man has a contract so let's make him do it. Contrast this with his conflicts with Shelby and Ro, where he's also being kind of a hardass, but it reflects something about who he was at the start of the series and who he's become. He's settled down, they haven't, you can see why he'd resent that. In contrast, this storyline essentially contradicts anything he may have learned about Klingon culture in his calisthenics sessions with Worf, or in serving on a Klingon ship, etc. Phooey.

It also kinda seems like BS that Starfleet Medical doesn't have any ethical proscription against experimenting on patients without their consent. A similar flavor of 'wat, really?' to the Federation not having any laws against telepathic attacks...

Cards of the episode in the Star Trek CCG, all from Premiere:
Alexander Rozhenko has a great image pull, even if the card itself wouldn't be used much. At least he can do the Ooby Dooby.

Toby Russell is depicted in the improbably-red Federation surgical smock, I've seen it so many times I have trouble recognizing her in the civvies she sported in the rest of the episode. I'd have her at 4 integrity and add Treachery. Not much call for a Physics mission specialist...

Genetronic Replicator
is a bit overpowered, and seems to be more effective than it was on the show, as Worf would have been toast if not for his redundant systems. Eventually, this highly effective means of keeping your personnel alive received a hard counter in Panel Overload.
posted by StarkRoads at 1:17 PM on May 10, 2021 [3 favorites]

Riker has no foundation. We're talking about a character who's said to have planned to make captain by age thirty-five and yet passed on more than one command to spend seven-plus years at Picard's side out of "enlightened self-interest," as if a three-hour tour /s on the Enterprise is the key to Starfleet nirvana. So its no surprise that Riker is hostile toward's Worf's choice to end his life even after Riker had no compunction about choosing to "abort" the clones in Up The Long Ladder. Riker isn't Picard or even Worf, whose character concepts lend them strong, in-universe foundations. The only thing Riker firmly believes in is that he gets to go on the away missions and the captain doesn't.
posted by Stuka at 1:55 PM on May 10, 2021 [4 favorites]

It definitely seems like someone had been watching Whose Life Is It Anyway? and 'night, Mother.

CheesesOfBrazil, it's interesting that you bring up the Riker and Worf relationship, because a long time ago here, I'd mentioned that one of my favorite things about the rewatch was discovering how much I liked the Riker/Worf bromance. But it seems as though they abandoned a lot of the interactions between them, the way they played off of one another, along the way, and it kind of bummed me out.

LOL at Beverly once again sitting in her '90s Taco Bell-interior office (the mauve blinds! the forest green carpet sections! the puttty colored plastic desk!) and giving someone the silent treatment like she's 13. I can't even with her. Maybe there's something wrong with me, but I didn't end up disliking Russell. I remember that feeling of desperation with my mom's illness and having this sense of "I don't care if it's experimental, do whatever it takes" and with Worf this tiny sliver of hope is being cut off by Beverly playing god, when one way or another, he'll die. Not saying it's great that Russell experimented on that one rando, but I didn't feel like I could begrudge her pushing to try something that might still fail but is the only shot Worf has.
posted by kitten kaboodle at 1:58 PM on May 10, 2021 [1 favorite]

Every single time I see this episode or even think of it, I get a shock: "wait, how is Crusher here, isn't it Polanski who does the surgery!?!"

Every. Single. Time.
posted by meese at 6:57 AM on May 14, 2021

Pulaski drank that lethal, psychedelic tea with Worf, putting complete faith in her antidote. She experienced the Klingon romantic poetry in its purest form. She gets it. She wouldn't have wrung her hands about letting him have the experimental surgery.
posted by polecat at 10:02 AM on May 14, 2021

Oh no, let me clarify! I always think it's Polanski who does the procedure. It's totally something she would do.
posted by meese at 12:29 PM on May 14, 2021

I guess I meant to say that it makes sense that you imagine Pulaski doing it. :)
posted by polecat at 4:05 PM on May 14, 2021

I was a bit surprised to have Picard be so pro-suicide, but I guess he had been Roddenberry's mouthpiece about progressing beyond the fear of death earlier.
posted by ckape at 7:21 PM on May 23, 2021

I still remember watching this the first time it aired. My sister had just arrived from out of state for a visit with the family. Apparently, the syndication affiliate in her local market aired TNG on a different day of the week than ours did, because she had already seen the episode. She chose to let me know this by walking in the room, observing, "Oh, this is the one where Worf dies," and then walking back out.
posted by radwolf76 at 9:33 AM on June 18, 2021

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