I. Identification
The central ethical issue in the presented case study is Edward and Susan’s intention to conceive for the sake of looking for a hematopoietic stem cell donor. The couple fear that the second child will be psychologically disturbed if he or she realizes the reason for being born. There are high chances that Edward and Susan may end up not loving the second child in the same way that they love Mitchell who is their first born. The couple is not ready to discriminate their own second blood child. Seeing their second child uncomfortable will hurt them.
The physician’s failure to detect Mitchell’s problem while still in an embryo is the second ethical issue because it allowed a child with defect to be born. Typically, embryos that have been identified to have some defects are not supposed to be allowed to be born. The life of such embryos is supposed to be terminated so as to avoid subjecting children into prolonged suffering. It is considered to be more beneficial in the long run to terminate the life of an embryo that has been identified to have a defect. The suffering of a child also inflicts pain on parents and so benefits the parents when the embryo’s life is terminated.
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The third ethical issue in the presented case study is Mitchell’s possible death in any case there will be no donor in time. Should Edward and Susan avoid conceiving another child and instead opt to continue looking for a person that matches the genetic make of their daughter, there are high chances that the daughter might end up dying. Staying for long time without getting the hematopoietic stem cells being transplanted will make the health of the daughter to begin deteriorating. Some of the body’s vital functions will get compromised. Mitchell will begin to experience complications which will lead to her death.
Elimination of embryos identified to have defects through in vitro fertilization is the fourth ethical issue because it appears to be a special type of killing. Existing laws prohibit any person from infringing the rights of other people. Even though embryos are not considered to be people, it is assumed that they are individuals who are in the process of developing. Laws of this nature assume that life begins the moment when the sperm fertilizes the ovum. Fertilization of the Ovum leads to the formation of the zygote which then leads to the formation of the embryo. The physician’s action of terminating the lives of the embryos therefore is unethical.
Another ethical issue in the presented case study is asking for student’s private health information during school admission. The only people allowed by law to know the health information of a patient include the physician, and the guardian of the patient. Information about illnesses is supposed to be kept a secret. The aim here is to prevent third parties from using health information to discriminate the patient. A teacher may for instance develop negative attitude towards a student known to suffer from certain lifelong illness such as in the case of Mitchell. Such discrimination makes the students to be psychologically distressed.
II. Research
Mody, R. J., Prensner, J. R., Everett, J., Parsons, D. W., & Chinnaiyan, A. M. (2017). Precision medicine in pediatric oncology: Lessons learned and next steps. Pediatric blood & cancer , 64 (3), e26288.
Mody and Chinnaiyan ’s 2016 published article talks about pediatric cancer. Its relevance to the main moral issue in the case is that this piece highlights the challenges that children suffering from blood cancer experience. One of the challenges that has been pointed out in the article is the lack of perfect matches. According to the article, children that experience the challenge of not having a perfect match are those that come from families that have chosen to have one child. The authors of the articles suggest that it is advisable for a family to have more than one child.
Weaver, M. S., Heinze, K. E., Kelly, K. P., Wiener, L., Casey, R. L., Bell, C. J., ... & Hinds, P. S. (2015). Palliative care as a standard of care in pediatric oncology. Pediatric blood & cancer , 62 (S5), S829-S833.
Authors Weaver and Kelly present standards that physicians have to adhere to when delivering medical services to children suffering from blood cancer. The relevance of Weaver and Kelly’s article is that it provides a guideline that all physicians are supposed to follow when treating children with blood cancer. The guidelines are aimed at reducing the chances of committing medical errors during treatment. The two authors emphasize that committing medical errors when treating children with blood cancer is dangerous due to the fact that their health condition is delicate. Being delicate here means that the children can easily lose their lives if care is not taken.
Pizzo, P. A., & Poplack, D. G. (2015). Principles and practice of pediatric oncology . Lippincott Williams & Wilkins.
This piece of writing is related to the main moral issue in the presented case study in the sense that it highlights the extent to which physicians go just to save the life of a child that is suffering from a severe illness. The article for instance explains that physicians never get tired attending to a child that is waiting to get a perfect match for the extraction of hematopoietic stem cell. As stated in the article, physicians are dedicated to ensuring that children under their care are able to recover from the illness that they are suffering from.
III. Analysis
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Stakeholders |
Options |
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| Conceive another Child to get a hematopoietic stem cell donor | Continue looking for a matching hematopoietic stem cell donor | Allow Mitchell to die | Continue having Mitchell on life support machine | ||
| Mitchell | Mitchell’s life will be saved | Mitchell’s condition will last for a very long time | Mitchell will lose her life | Mitchell’s condition will deteriorate | |
| Edward and Susan | Edward and Susan will get a second born | Edward and Susan will take a long time looking for the right donor | Edward and Susan will be childless | Edward and Susan will incur high costs | |
| Physician | Physician will conduct screening to identify and eliminate embryos with defects | Physician will be forced to monitor Mitchell for a very long time | Physician will be guilty for terminating Mitchell’s life | Physician will spend a lot of time taking care of Mitchell | |
IV. Application
1. Consequential Ethical Theory
A consequential ethical theory that best suits the presented scenario is rule utilitarianism. Key concepts of this theory include conformity to the existing rules and greatest good. In the presented case study, Edward and Susan are trying to conform to the societal rule of saving a life. Typically, all people are required to do all that they can so as to save the life of a person that is in danger. The couple are trying to do this since it is the option that will bring Mitchell the greatest good. The only ethical dilemma confronting Edward and Susan is the reason for which to conceive another child. The couple view that conceiving another child so to act as a donor for another child is not a good reason enough. The awkward reason has scared them which is why the physician has advised them to go and see the counselor. The role of the counselor in this case will be to give them an advice that makes them be peaceful with the decision.
Applying the rule utilitarianism to the presented case study, the action of choosing to get another child so as to save the life of Mitchell will be aligned to the existing rules and regulations. In any case the couple will choose to get another child, Mitchell will get a perfect donor. The physician will be able to extract the hematopoietic stem cells from the child that will be born and then transplant them in Mitchell. Her body will respond positively due to the matching leading to her recovery. The recovery from illness will give Mitchell an opportunity to be happy. Being happy once again in this case will be aligned to the existing purpose of life which is to be happy. Happiness is an ultimate goal for everyone in the society and so Mitchell like any other person deserves it.
2. Non-Consequential Ethical Theory
A non-consequential ethical theory that best suits the presented scenario is natural right. Important concepts of this theory include inherent entitlements and privilege. All individuals are naturally entitled to the right to life. It is wrong for one person to prevent another individuals from enjoying the right to life. Referring to the presented case study, the physician has no right to terminate Mitchel’s life just because a donor has not been found. The role of the physician is to administer medical care to Mitchell so as to keep her alive as she is waiting for a perfect donor to be found. Edward and Susan too will not have the right to have the life of their daughter terminated just because they have not found a person whose genetic make-up matches that of their daughter or are not willing to get another baby. Both the physician and the couple have an obligation to save Mitchel’s life.
Applying the natural right theory key terms Mitchell is entitled to the right to life. The only way available for her to enjoy this right is by having a matching donor donate her hematopoietic stem cell. The right to life is Mitchell’s privilege. As things stand right now, there is nobody who has been found to match her genetic make-up. Even though the physician feels that it is possible to get a person that matches her genetic make-up, the chances of getting this person are minimal. It could take many years to get the right person that matches Mitchell’s genetic make-up. The consequence of taking long here is that it will reduce the chances of Mitchell’s survival. There are high chances that Mitchell might die if the perfect match being looked for will take a long time. Typically, the conditions of patients in similar situations deteriorate after spending a lot of time without treatment.
V. Decision Making
The best solution to the presented case study is for Edward and Susan to get a second child who will then donate hematopoietic stem cell. There are few chances that a perfect match will ever be gotten. In any case the couple will embark on searching for an individual that has the same genetic makeup as that of their children, they will end up spending a lot of money and time. It is important to note here that the search for a perfect can take so many years and so it is more convenient to get a child who will only take a period of one year to be born.
The other reason as to why choosing to get a second child is a better option is that there are improved screening machines. Mitchell’s defect was not detected at the embryo stage because the screening machines during that time were not effective enough. Technological developments have led to the creation of more effective machines that are capable of detecting underlying birth defects. Improved screening machines imply that the second child that will be born will have no defects. It means that Edward and Susan will not face the same problem that they are currently experiencing with their first born.
VI. Evaluation
The first possible argument against the decision to get a second born who will act as a hematopoietic stem cell donor is that the motive will make the parents show little love to the second born thereby making the child to be psychologically distressed. The negative impact of being psychologically stressed is that the child will underperform all activities that he or she will participate in. underperformance will be as a result of lack of concentration. The child will constantly think that he or she is a mistake which is more likely to contribute to low self-esteem.
The second argument against the selected decision is that there is possibility that the second born will have defects since the machines that will be used to screen embryos with defects do not 100% guarantee that the exercise will be perfectly conducted. Even if the machines were to offer a 100% guarantee, there could still be a medical error.
The third argument against the selected decision is that Edward and Susan only wanted one child in their whole life and so will be disturbed raising two children. The couple may be financially unprepared to cater for the second born that will be born to save the life of the first born.
The counterargument to the above claims is that the bond between the second born and the parents will increase from birth making the new born to be loved jus the same way as Mitchell is loved. A good example that best exemplifies this argument is a case where parents that have adopted a child end up bonding with this child as though they were the real parents. In a case where parents have adopted a child, the love for the child tends to be minimum at early stages. As the parents continue to live with the child, the love for the child begins to grow slowly. Edward and Susan will not accord the second born much love but as they continue to stay together, love will increase.
VI. Reflection
A few of the lessons learned from this particular assignment and the critical thinking process include the lesson that thorough evaluation of available information leads to better understanding and also that reasoning contributes to better analysis results. The critical thinking process could be improved through such steps as gathering more information and also taking time to synthesize the information that has been obtained. Caution should be taken to ensure that the information gathered is relevant. Handling relevant information will prevent the wastage of time and financial resources. Effective time management will prevent possible deployment of goals and objectives.
References
Mody, R. J., Prensner, J. R., Everett, J., Parsons, D. W., & Chinnaiyan, A. M. (2017). Precision medicine in pediatric oncology: Lessons learned and next steps. Pediatric blood & cancer , 64 (3), e26288.
Pizzo, P. A., & Poplack, D. G. (2015). Principles and practice of pediatric oncology . Lippincott Williams & Wilkins.
Weaver, M. S., Heinze, K. E., Kelly, K. P., Wiener, L., Casey, R. L., Bell, C. J., ... & Hinds, P. S. (2015). Palliative care as a standard of care in pediatric oncology. Pediatric blood & cancer , 62 (S5), S829-S833.
