Introduction
Religious and medical ethics sometimes conflict. An example of such a conflict is Jehovah's witnesses' beliefs about blood transfusion and the need for medical personnel to save lives. There was a case in the Midwest where a child whose parents were Jehovah's witnesses was on the verge of dying. According to the doctors, the parents wanted their child to be saved but with no blood transfusion; only a blood transfusion would help them. A force made a blood transfusion to save the child, and the parents forcefully removed from the ward with the father facing trial (Catlin, 1996). The case can be viewed from the utilitarianism, duty theory, and social contract theory ethical perspectives. If arguments are developed about the ethical theories mentioned above, all the approaches have their strengths and weaknesses, posing a challenge to selecting the theory to employ. However, an analysis of all the theories and arguments can help develop the best approach to follow.
Utilitarianism
Utilitarianism is an example of normative ethics that focuses on actions that promote happiness. According to utilitarianism, steps are good as long as they promote happiness, while wrong activities promote unhappiness (Savulesku et al. 2020). Act utilitarianism refers to the results of one act, while rule-based utilitarianism asserts that an action is right if it conforms to a rule that leads to the greatest good. A utilitarian argument to support the hospital would be that the hospital promotes the child's happiness. Only the blood transfusion would have helped to revert the situation, and it was in the child's best interest to save his life. Maybe the parents did not understand the criticality of the matter, and hence doctors took the best option to save a life that would please the parents and the child. For the parents' belief in preserving the spiritual life, they had a right to stick to their religion. The parents thought that what mattered in work is the getting of eternal life in the end.
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The arguments by the doctors to save the physical life and that of the parents to save spiritual life are valid. However, the view by the doctors carries more weight as it entails an aspect of social utility. The parents want their child's life to be saved because that brought them to the hospital. However, they don't have a clear understanding of what sickle cell anemia entails and the corrective measures when it gets worse. When the doctors give them an option of consulting an alternative treatment, they decide to bring many people's happiness. Despite the parents sticking to their religious beliefs, they are desperate to save their child's life. The parents' beliefs entail more individual utility as they do not think of the transfusion results. Although not told, when the child gets better, one can easily conclude that they were happy to restore their child's health.
The Duty Theory
The duty theory asserts that all human beings must be viewed as worth of respect and dignity. The theory further says that individuals have rational duties regarding each other (Misselbrook, 2013). From the hospital perspective, it can be argued the child was considered. The hospital must ensure that lives are saved, and in cases where consent is hard to obtain, hospitals work for the best good of the patient and the society. The legal team at the hospital may have evaluated the situation and noticed that the child would die if the blood transfusion were not conducted. The death would lead to a loss to the parents and the community. The parents had their religious beliefs, and they were right to be respected by the hospital. Besides, they were in the custody of their child and had a right to listen. Kant and Ross bring the aspect of action in the maxim that an individual has and per the universal law. A consideration of the two duty theorists puts the move by the hospital to question.
According to the duty theory and the Kantian assertion, the argument by the hospital is stronger. The second formulation by Kant and Ross insists on acting in ways that treat humans. The formulation goes further to argue that every case should be treated as an end to itself (Misselbrook, 2013). With these guidelines and formulations, a hospital setup would act in the best way to give the necessary treatment to a patient. The overall goal of a hospital setup is to save lives, and health practitioners take a vow to act in ways that will ensure the survival of their patients. While one may argue that parents have to take care of their child, the case in question is extreme. According to their religion, Jehova's witness parents want their child's life saved without sinning. If the blood transfusion is not administered, then the parent's duty to treat humanity with dignity will have failed to give the hospital only one option; to administer the transfusion.
The Social Contract Theory
The social contract theory proposes that an individual's morality or political obligations depend on the agreement or contract between the individuals and their society (Wrenn, 2020). For the case at hand, the hospital and the healthcare providers are mandated by the state and the constitution to provide quality health services that will ensure reduced mortality. The community also expects that when they visit the hospitals, they receive better healthcare. Medical practitioners have made a vow with their respective boards to work with diligence to ensure sustainable healthcare systems leading to a decision by the hospital to transfuse blood to the child despite what his parents think. On the other hand, the parents belong to a religious group with an assertion that blood transfusion is a sin and would make one lose eternal life. The moral behavior of the parents is justified as they have a right to stay loyal to the beliefs of their community and protect the spiritual life.
The hospital's argument to carry out blood transfusion even without the consent of the parents is superior. The factors contributing to superiority are the justification of the step taken by the hospital by the state and the health board. One of the significant roles of a government is to protect the lives of its citizens, and constitutions stipulate that the government always puts measures to cushion the citizens against occurrences that may cause death through the provision of better healthcare services. The doctors and nurses acted according to what is expected of them by the government and board members. While the parents may argue that they had a right to believe, according to Jehova's witness community society, they did not have an option of a facility that would save the child's life. The hospital was willing to allow the parents to take the child to another facility where the life would have been saved without a blood transfusion.
Strengths and Weaknesses of the Theories
The utilitarianism theory approach as a solution has strengths and weaknesses. The approach represents a more extensive community giving a representation of many people. Besides, the theory is centered on humanity hance can help to remove imbalances in religious and scientific beliefs (Savulesku et al. 2020). Implementation of utilitarianism is easy since the satisfaction of the community is considered. However, a significant weakness of utilitarianism is the infringement of the good to the minority. The case in question represents an example where the sick child's parents believe the good is not considered. For the parents, saving spiritual life is essential instead of saving the physical life as viewed by the hospital and the government.
Deontological theory approaches have an emphasis on doing what is right as it is a duty. Besides, the approach emphasizes rationality, and there is a minimal contradiction (Misselbrook, 2013). The set rules apply in the case at the hospital since the hospital works according to stipulated guidelines to ensure that the child's life is saved. Besides, the duty of the hospital to ensure survival is achieved when the transfusion is done. However, a weakness of the duty theory is the strictness of the rules. According to the approach, individuals only act in a particular way as suggested by the rules. The theory does not offer room for individuals to adjust the rules and act otherwise. The instructions that doctors must save lives are the guiding factors to the hospital's decision, neglecting the parents' views to save spiritual life.
The social contract theory justifies the power of the sovereign. With the theory, the rule of law is followed, and community members know how to handle given situations (Wrenn, 2020). Constitutions are part of the social contract theory since they stipulate the rules governing a given country. There is the justification of moral rules such as the one taken by the hospital in giving the transfusion. However, the theory has a contradiction between religious and scientific morals. The parents to the child belong to a community with its set of beliefs bringing the conflict of choosing a solution to the problem. The issue ends forceful removal of the parents from the ward, making them feel outstared. All the theories lack the aspect consensus as they conflict between the major and the minor groups.
Conclusion
Conclusively, religious and medical ethics sometimes conflict. The conflicts can be solved through an examination using utilitarianism, duty, and social contract approaches. The case of the Jehavs witness parents refusing the transfusion of blood to their child while it was the only option to save the child offers a case where there confliction of ethics. The utilitarianism approach emphasizes the good for the many; the duty theory approach asserts that human beings have the duty to act rationally in a given way by protecting the dignity of others. In contrast, the social contract theory emphasizes that individuals act according to the agreement made with the society that they exist. While all the approaches may be applicable, the utilitarianism approach sounds better as actions are good if they are in the interest of the many. The theory represents a majority's view and can therefore be used while looking for solutions in conflicts.
References
Catlin, A. The dilemma of Jehovah's Witness children who need blood to survive. HEC Forum 8, 195–207 (1996). https://doi.org/10.1007/BF00056549
Misselbrook, D. (2013, April). Duty, Kant, and deontology. Retrieved April 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609464/
Savulescu, J., Persson, I., & Wilkinson, D. (2020). Utilitarianism and the pandemic. Bioethics , 34 (6), 620-632.
Wrenn, C. (2020). Internet Encyclopedia of Philosophy. Retrieved April 27, 2021, from https://iep.utm.edu/soc-cont/
