Ok, this is gonna be a long-ish one, so strap in. I am just completely and utterly delighted with Paladin's Hope taking a hard left into medical ethics, resurrection men, and the intersection of my nerdy medical humanities interests. Because Piper is over here being HELLA unethical by allowing a local...I'm gonna go ahead and use the term cunning woman...cunning woman practice techniques to repair vaginal fistulas anytime an appropriate body crosses his morgue slab. This is done without the permission of either the person whose body it is OR their family.
Piper comes right out and says this is unethical:
"It's not ethical, and I know it, and god help me, it genuinely is a slippery slope. Start thinking you have the right to do things to people's bodies in a good cause, and you're halfway to hell and picking up speed. But I also don't know what I could have done differently. [...] I've asked the Bishop about how we could do it, if we could offer financial compensation in return, but that ends up with poor families selling their loved one's cadavers or even more people selling them for money, and it's just...really not a good idea."
And for context, this has happened historically. The closest examples to what Piper is actively doing are probably King Louis XIV's doctor experimenting on 75 live butts that almost certainly did not consent to it before treating the king's anal fistula and the long, storied history of North American gynecological research, which has its roots in J. Marion Sims's stupidly unethical experimentation on enslaved women. Piper KNOWS this could be the reality. He knows he's on the slippery slope to literally these realities.
And yet. He's doing it, because women's reproductive healthcare MATTERS. It is important to be able to help women and improve their quality of life and health. The messiness of this is one of my favorite parts of this book, and frankly, as long as Piper isn't being a resurrection man, and isn't starting the World of the White Rat version of the 1788 Doctor's Riot, then I'd say he still comes out on top, ethically speaking. It's not good, and Piper himself will tell you that. But I think he's still a net good in the world, and he's concretely helping people, even if it is on a small scale.
The thing that Piper is SUPER aware of and what I think the reason is that he's willing to take ethical liberties with dead bodies is that if he does, people will live. There will be a concrete reduction in suffering and a concrete increase in people's quality of life.
He is also not violating the bodily autonomy of anyone who is still alive. We see him advising a woman where to go for help. He's making sure it won't cost her anything if she does go. There is no financial coercion there, there is no force or pressure on the woman to go to this cunning woman. It's her choice if she goes, she can give or withdraw consent at any time. I don't always feel like I have that choice or the financial freedom to make it in MODERN medicine. Piper is doing his level goddamn best in a nightmare scenario, and I respect the hell out of him for that. I love that this is messy, and I love that it has real consequences in the world.
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