More ethical problems

[Xantar]

Note to mods: please award doubloons for thoughtful replies to this thread.

We here in the Black Project Forum are by definition veteran forum members and hopefully more intelligent than the average bunch of internet people. So, here's an opportunity to earn your keep. With your replies to this thread, you can earn part of your payment for another month of access to this forum. I'm going to try to create issues like this every once in a while for you to discuss.

Here's a hypothetical situation that also occurs in real life: you are on the ethics committee for a hospital. That means your job is to determine what doctors should do for their patients based on what is ethical. Most people on ethics committees at hospitals are doctors and nurses, but that's not necessary. All you need is inteligence and a sense of morality.

A baby is born three months premature in your hospital. It has a strange growth on its back, and its legs are turning blue from lack of oxygen. The doctors realize that this baby has spina bifida. To put it simply, spina bifida is a split in the spine that means that below a certain point on the spine, messages from the brain won't be carried. The spina bifida on this baby is placed in such a way that it has some upper body movement and its vital organs work properly. However, it has no leg function or bladder function. So it won't be able to walk, and when it eats, somebody will actively have to drain its bladder because it can't urinate.

There's more. The nature of this particular spina bifida means that the baby is severely mentally retarded. It has no higher thinking. Not only is it unable to walk, it is unable to conceive of the idea of walking. Its senses are so impaired that it barely meets the definition of "conscious." It will go through life simply lying in place, not thinking or perceiving the world.

You have two choices. You can direct doctors to treat the baby aggressively. It just might improve to the point where it can perceive the world in a limited way and perhaps even talk. That has happened in cases like this before. Also, the case is medically very easy to treat. It won't cost a lot of money, and there is relatively little surgery aside from the initial operation to drain fluid from its spine.

Or you can take the conservative approach which is to make it comfortable. It will most likely die in a few weeks if you do this.

Keep in mind that the baby is not suffering. Your hospital is capable of letting a patient die, but the guidelines are that you can only do that if the patient is a hopeless case and is suffering to the extent that it is better to let him or her pass away. This baby is not a hopeless case. He is capable of breathing and eating although not urinating. Moreover, as I said before he is not suffering.

But what kind of life are you granting him? The chances of improvement are almost nonexistent despite the fact that it sometimes happens. What is thousands of times more likely is that he will be vegetative. Is that a life worth living? Moreover, what about his parents? They love him and will do whatever is best for him. If you decide that what's best for him is to keep him alive, they will abide by that. If you decide that what's best for him is to let nature take its course, the parents will abide by that, too.

But can you in good conscience perform allow the initial operation to take place whereupon the baby is placed as a burden on the parents to take care of for the rest of his life?

On the other hand, is letting him die tantamount to killing him?

You work at a hospital. Some would say that your job is to preserve life. Others would say that your job is to provide care. Which is it?

[BlueFire]

Wow. That's deep. I can't wait to see some of the replies.

[Joeiss]

Wow Xantar. I was going to do my homework today, but this is very interesting, and now I have to write about it. So, on Monday, I guess I'll have to tell my teachers that Xantar wouldn't let my do my homework.

I'll post my answer to this question as soon as I am done writing it...

[BreakABone]

wow that is a tough question.. We actually have a class in my school where we discuss this type of stuff.. Biomedical Ethnics

Anyhow onto the subject on hand.

As a doctor, you are responsible for life and death, but at the same time you are only human which means you have a sense of mortality. The simple fact is not only are you responsible for life and death but you are also responsible for doing what you think is ethnically correct. You can only give someone so much care, but what is it worth if their life was nothing more than suffering.

This case would be very hard to call. On one hand, you have the choice to preserve someone's life. It won't be the grandest of lifes and you know it will be an extreme burden on the parents. I mean the parents (hopefully) will love it the same as if it was a normal kid, and will probably have some of the same problems.

Then, you have the fact that if you do preserve this life. It will be full of ridicule. Do you want to be responsible for creating a mental unstable child. I mean this is a cruel, cruel world we live in. No matter what, there will always be someone to make fun of those less fortunate then them (I myself could be accused of this on occassions). As a doctor, you may think it right to preserve the life, but as a human being with a sense of deceny would you really want to be the one who allows someone to go through life like this? There is also the point that the person will be no more than a shell of a real human. I mean it won't be able to do much, won't be able to teach much, urinate or even have much mobility skills. Is it really important to allow such a thing to happen.

On the flip side of that all, you can kill the baby and much like allowing it to live there are some factors that are both good and bad. The simple fact is if you kill it when it's an infant you will somewhat better it's life. For it could have lived for as very little as it could, life to the best of it's abilities and not seem to be that different.When you are a kid, not much is expected of you. Yet this kid with all his abnormalties would be consider almost normal in behavior at his age. You also eliminate that burning desire to live life with a little bit of hope. There isn't wrong with living life with hope. We all do it in some way or another, but the simple fact is it begins to tear you apart when you know that you hope, your goal, your desire is further and further then you expected.

Then, we have the ethnic reasons. Is this baby beyond help? No there is a way to allow the child to live, it won't have a normal life but it will live. So a doctor should do his best to preserve the life if they are able to even if the results in the long run aren't too beneficial. You also have the parents. You could say if they had a child and it was killed that it "was better to love and lost then to never have loved before." But like it's been said time and time again, "Parents shouldn't have to bury their kids. Kids should bury their parents." I know a couple of families who have had infants die a little after birth and no matter what happens in their life the image, the memory of the child is never gone. No parents whether rich or poor, good or evil, mean or nice or anything else should go through this. And how should the doctor feel.. Going through life knowing that he didn't give it his all... That he could have saved the child.

Like you said this would be a tough decision, but I would have to say I would make the kid live. I know it is a somewhat cruel thing to do, but it is better for everyone around him then just killing him without giving him a chance to live.

[Bond]

Originally posted by Xantar
Note to mods: please award doubloons for thoughtful replies to this thread.

We here in the Black Project Forum are by definition veteran forum members and hopefully more intelligent than the average bunch of internet people. So, here's an opportunity to earn your keep. With your replies to this thread, you can earn part of your payment for another month of access to this forum. I'm going to try to create issues like this every once in a while for you to discuss.

Here's a hypothetical situation that also occurs in real life: you are on the ethics committee for a hospital. That means your job is to determine what doctors should do for their patients based on what is ethical. Most people on ethics committees at hospitals are doctors and nurses, but that's not necessary. All you need is inteligence and a sense of morality.

A baby is born three months premature in your hospital. It has a strange growth on its back, and its legs are turning blue from lack of oxygen. The doctors realize that this baby has spina bifida. To put it simply, spina bifida is a split in the spine that means that below a certain point on the spine, messages from the brain won't be carried. The spina bifida on this baby is placed in such a way that it has some upper body movement and its vital organs work properly. However, it has no leg function or bladder function. So it won't be able to walk, and when it eats, somebody will actively have to drain its bladder because it can't urinate.

There's more. The nature of this particular spina bifida means that the baby is severely mentally retarded. It has no higher thinking. Not only is it unable to walk, it is unable to conceive of the idea of walking. Its senses are so impaired that it barely meets the definition of "conscious." It will go through life simply lying in place, not thinking or perceiving the world.

You have two choices. You can direct doctors to treat the baby aggressively. It just might improve to the point where it can perceive the world in a limited way and perhaps even talk. That has happened in cases like this before. Also, the case is medically very easy to treat. It won't cost a lot of money, and there is relatively little surgery aside from the initial operation to drain fluid from its spine.

Or you can take the conservative approach which is to make it comfortable. It will most likely die in a few weeks if you do this.

Keep in mind that the baby is not suffering. Your hospital is capable of letting a patient die, but the guidelines are that you can only do that if the patient is a hopeless case and is suffering to the extent that it is better to let him or her pass away. This baby is not a hopeless case. He is capable of breathing and eating although not urinating. Moreover, as I said before he is not suffering.

But what kind of life are you granting him? The chances of improvement are almost nonexistent despite the fact that it sometimes happens. What is thousands of times more likely is that he will be vegetative. Is that a life worth living? Moreover, what about his parents? They love him and will do whatever is best for him. If you decide that what's best for him is to keep him alive, they will abide by that. If you decide that what's best for him is to let nature take its course, the parents will abide by that, too.

But can you in good conscience perform allow the initial operation to take place whereupon the baby is placed as a burden on the parents to take care of for the rest of his life?

On the other hand, is letting him die tantamount to killing him?

You work at a hospital. Some would say that your job is to preserve life. Others would say that your job is to provide care. Which is it?
It really doesn't matter which option you choose. Considering there is nothing to judge it by. Whichever results in goods and bads, pros and cons.

[Joeiss]

This question will probably get many different answers, and many different reasons for those answers. One must look down deep inside of them self to provide a logical answer to a question like this. This is what I plan to do today. As of right now, I do not know what my answer will be, but by the end of this writing, my answer will be judged upon the points that I am about to make.

The growth on the baby's back and its legs that are turning blue are things that only a loved one can look over. People in this world will not see this person as a human like you or me, but as a person who is mutated, a person who is different. I wouldn't want to my patient grow up being taunted by other people, that is if he is able to go out. We all have to admit, we live in a cruel world. If my patient ever has enough strength (both physically and emotionally) to get outside to go on a car ride or something of that nature, people will look at him in pity. Pity is something that my patient should not be getting. My patient will think that he is living a regular life, a life of an uncontrollable body. I do not want to give people the opportunity to feel proud of themselves because they felt pity for him. Score one for death.

Since there is a chance that the patient will live and progressively get better (although patient still will not be totally better), we should try to make that so. We should do whatever we can to help this person live, so we should treat the baby aggressively. After all, there is a chance that the baby will get better. I think that things should only be looked upon as positive. If there is a chance that my patient can live and maybe get better, then we will try as hard as we can to make that so. Things can get better, so we might as well try, rather than give up so quickly. We are talking about a person's life here. Score one for living.

"Not only is it unable to walk, it is unable to conceive of the idea of walking. Its senses are so impaired that it barely meets the definition of "conscious." It will go through life simply lying in place, not thinking or perceiving the world." A life is a life. We should always cherish it. Even though this baby's life will amount to nothing and the person will accomplish nothing by himself in his lifetime, this baby should still live. There is a chance that the baby can learn to talk, so we have to look forward to this. Hope is all we need here. We cannot abandon hope, because in this case, it is all we have. If we let this person die, we will never know if this person can fully recuperate from spina difiba. New tests can be performed on this patient, and who knows, maybe a breakthrough discovery can occur. Score one for living.

Since there are ways to treat this case, why not treat it? It will not even cost a lot of money for the parents of the patient, so I say that we should care for this child and hope for the best. A "conservative way" of care should not be in the picture. Why make the patient comfortable for a couple of weeks when you know that the patient will pass on before your eyes? We should not just stand by the patient's body and watch it die. We should try to do anything that we possibly can to help this patient get better, after all, this is what we do as doctors. Score one for living.

Well, the score is four to one, in favour of letting the child live and be cared for. There is no reason that we should let somebody die because of any disease. Since treating this child is inexpensive, I am sure that the parents would not mind paying the bills for as long as their child lives. We should cherish all lives and we should not make the decisions that are ultimately God's.

[Xantar]

Originally posted by Bond

It really doesn't matter which option you choose. Considering there is nothing to judge it by. Whichever results in goods and bads, pros and cons.

That's kind of why I created this topic. Not only to get some discussion going but also to let some of the members here know that decisions like this exist in real life. And one option or the other has to be picked. And moreover, the consequences of that decision have to be lived with. Because, after all, there was a case in an actual hospital exactly like what I described.

I'm not saying that you're suggesting this, but this decision can't be taken lightly. I don't think we will reach a consensus here (the actual hospital committee didn't), but the more we think about these things, the better off we are.

[Blackmane]

This kind of question is hard to decide, but ultimately, I don't think it should be the ethics committee that tells the doctors what they should do for the baby. It is and should always be the parents decision.

The parent is the one responcible for the baby, and the parent can have very different ethics than the hospital. Lets say they have been trying to get a baby for many years and this is there first. Even if the child is heavily handicapped and has a high possibility of being permanently in a "vegetable" state, they may prefer to keep him alive and have a child of there own. They may be willing to cope with the trouble of taking care of the child all there life. On the other hand, they may not have the heart to let the kid live a completely empty world unable to perceive or understand life to its fullest. In that case, the doctors should do what the parents say and the parents have to live with their decision.

This same problem arises when someone is seriously hurt and ends up living, but only in as a "vegetable", not able to talk, see, or interact with anyone or anything. This person has to be on constant life support to live. The doctors can either keep him on life support and maintain that machinery at high cost or pull the plug. In that case, the doctors still should have no voice in the decision making process. That should be left up to family.

Doctors are the tools that we use to heal us and give us life and watch over us while we're ill, but that doesn't mean they should decide whether to take life or not. The decisions are left up to someone else and doctors should simply do it as long as it is plausible.

[Xantar]

That would be all well and good, Blackmane, except the parents don't know what to do. That's why the ethics committee got involved. The parents have decided to go with what the ethics committee decides.

Moreover, let me just throw you a not-so-hypothetical example. The parents have a premature baby that will grow up to be retarded. It will have an IQ of 60 which means they will have to take care of it for the rest of their lives since it won't be able to get a good paying job. They don't feel capable of handling this. The kid also has a disease that will kill him if not treated, and the parents decide not to treat in order to avoid the responsibility of raising him. Are you going to go along with that?

What if it's a perfectly healthy kid who gets an infected leg and the parents refuse to give it antibiotics? Are you similarly going to withhold antibiotics which means the kid will lose a leg if not life altogether?

We cannot rely on patient autonomy in all cases. Sometimes, they are clearly not capable of making the decision. They may be stupid, but more often, they are just so emotionally wrung out that they can't be rational. It was a good idea to try asking the parents, but unfortunately, I already told you what they would say.

[Gamer]

I have mixed feelings about this topic. I feel that every being has the right to live, with a certain extent. I think that every child, that has a possibility of being a human, not a vegie their whole life, should live. I think that i know that if i was unable to do anything for my entire life and someone had to drain my pee and ****, that i wouldnt want to live.

It is my feeling that as long as the parents agree to it, the child should be conforted and maybe not live. I think that it would be better for the child to feel confort as long as it is living then to feel pain and have to suffer the stupidity he would have. I dont think that it would be good for the parents either, just think, once that kid gets to be thirty, they will be, lets say 70 and they will have to still take care of it and feed, "drain" and do all that other dirty work to it.

I think that it would be best for everyone, the baby and the parents if they let go of the child and let it have a few weeks of comport and then let it go. There is next to no sense to keep it in its condition, they should let it run its course with nature.

Thats what i think anyways.

[Perfect Stu]

I'm digging deep for this one.

I have a little cousin. She's, oh...about 8 now. She was born with a rare disease, I'll call it an extreme case of mental retardation. She doesn't know what's right or wrong, she can't really talk (mama, dada, and some goos and gaas)...she can't walk, she can barely sit up. She doesn't understand the concept of using the washroom. It doesn't compute. But damn, when I see a smile on that child's face, it sometimes brings me to tears. I can even make her laugh sometimes. It makes me appreciate life when I'm going through tough times. That little girl means more to me than my other cousins. Thankfully, she has the best mom and dad you could possibly ask for. She was blessed to have them as her parents. I think that my aunt and uncle are some of the best people on the planet.

My point is, I wouldn't care if that child couldn't see me, couldn't hear me, or couldn't think at all. I would care that that child is alive. That it has a soul. Because I know, that even if a little baby couldn't see me, hear me, or have any concious thoughts of me or anything else, I would still love that baby. It makes me think badly of myself for thinking that I'm not the best looking guy around. Or that maybe my parents can't afford a nice car. It really puts things in perspective for me. And I need that type of kick in the ass now and again.

What would I choose in Xantar's scenario? I would want to make that baby's life as long and as peaceful as possible. No matter what it took. No matter what obstacles would lie ahead for the child. The question is so subjective, but my answer is simple. Preserve that life as best as humanly possible.