Medical Ethics.
http://www.cnn.com/2007/HEALTH/conditions/01/04/ashley.treatment.ap/index.htmlI have many thoughts concerning the case that I was sent discussing a young girl named Ashley and the recent procedures and surgeries she went through by her parents decision. I have many thoughts in different areas that go beyond ethics but are still related to ethics such as autonomy, freedom of choice, social roles and responsibilities, and individuality which very closely relates to autonomy.
I don’t know where to start and I am going to do my best to not to get off topic. Parents have responsibilities and obligations to the children that they bring into this world to provide what they believe is the best and most comfortable situation based on the circumstances in which they live. The circumstances of course being income, debt, job status, residence et cetera. The best and most comfortable situation might vary from parent to parent in small detail but can be probably be admitted that most intelligent, good parents have the same foundation of beliefs concerning this. The biggest question with this case is are the parents justified in having these surgeries done to there daughter. And sadly, and this will probably come off as a cop out, I really can not answer that question. I am not a doctor and I am not familiar enough with her disabilities or the consequences of the surgeries that are being done. However, it is important to address both sides of the issue nonetheless even if not fully aware of the medical knowledge needed to evaluate the knitty gritty of the case.
There are many problems that a slew of different people could state that stem from the parents decisions to go through with these drastic surgeries. Are the parents seriously looking out for the well-being of the child or are these surgeries just easier ways for the parents to deal with there disabled child? Does this really lead to a slippery-slope or a snowball type effect? How reliable and how much should we actually question the type of health-care we have access to and the tools and procedures that doctors have access to? A big one that the article does not address at is the status of handicapped and disabled people in our society, do they not have as much of right to freedom of choice and to pursue what makes him/her the happiest.
In these types of cases it can be very difficult to evaluate what was occurring in the individuals heads. This case is certainly not the exception, where there are going to be two sides who make judgements based on there intuitions and how they interpret the information on hand. And we really do not have that much information on hand to make a solid decision either way, but in this case I am leaning towards the idea that the parents do have good intentions for there daughter. I know the procedures are drastic, and there will be things that this girl will never be able to experience, but so long as the consequences of not having her period, having her breasts removed or anything else that might have to be done outweighs the consequences of her having her period or possibly getting breast cancer and all the discomforts that go it then we have done the right thing. And anybody who knows me knows I hate to resolve an issue like this based on principles of utility but sadly this case is mostly a matter of utility. Categorical imperatives aren’t going to do any good in this case because they are so global it becomes difficult to associate those types of rules to something as specific as this. And as far as good character qualities go I believe that the parents have good intentions and are actually being brave in the sense that imagine how difficult it is to see your daughter go through all of this, I don’t care who you are any parent with a heart never wants to see there child go through a serious surgery, let alone several more on top of that. They have her well-being in consideration as well there own, and they are doing there best to still keep the child involved in all of the family activities.
There are another group of people who say that the surgeries are drastic, and that the parents should accept there child for who she is and tough it out. Unless the medical procedure directly betters the patient then the procedure should be questioned in some degree. I don’t think it has been established that the treatment does not directly benefit her; I know it appears that the procedures also make the parents job a little bit easier but that seems a bit cold and counter-intuitive. I can’t imagine how this job can get any easier, and really at this point what I would tell these group of people that unless they actually have a handicapped child that they have to raise, then I can’t see how they can even begin to theorize what it is like. At this point I am going to reference contractualism, this is a principle that states that one should not make assertions about a situation unless they themselves have actually been in a situation and can accept the consequences of there actions in that situation. I guess it questions how these ethicist’ can really question the entire situation being that they have not been through it, but I suppose many people are not actually advocates of contractualism.
The slippery slope argument holds some ground here but the fascinating part is that this case in my opinion is not a contributor of the slippery slope. I have read all too many cases of parents that have hormones injected into there child to help them grow more, and more and more people are concerned about aesthetics and there appearances in this world. And this makes procedures like hormone injections more readily available, and we have already seen that so many people abuse these procedures all for the wrong reasons. And I suppose the slippery slope problems relates more to the fact that the procedures and tools doctors and hospitals have available to them does not readily equip them to deal with situations like this. And situations like this aren’t just rare examples, I am sure that a lot of parents have to face these types of situations and many doctors honestly don’t know how to handle it. As far as parents stunting there child’s growth to make him/her easier to deal with does not make sense to me. I know parents always say that they grow up so fast and I wish you would be my baby forever, but I do believe that a parents happiness with there child while always there grows into full peek after seeing there son or daughter grow up to be this intelligent, successful individual. It’s probably idealistic to think this way, but I don’t think most parents want to solve there children’s problems and there own by keeping them trapped in childhood forever.
The problem here is that the idea of what defines our actions being right or wrong is based on too many things; and while each of these things are an important part of defining what is right or wrong there have been some serious word twisting involved to make these things compatible with the amount of ever-growing questions concerning morality. Most agree that the consequences of our actions and the intentions involved when deciding a certain course of action is the heart and soul of defining what our morality is. I believe whole-heartedly however that we have to get a good grasp of what is involved when defining our intentions. Why a good person has good intentions or a bad or selfish person has intentions respective to the type of persona they have. These are our character values, and should be taken into serious consideration when discussing right or wrong actions, because our values are going to go hand-in-hand with our intentions. And it is important to discuss in great detail what defines our intentions, it has to go beyond the scope of character values. The idea of a character value is very open-ended, and we are at the point in our society where the ancient ideas of character values, while important in how we act in our society today is not enough to create an ethical theory that can apply to our modern world. The best way to wrap this up is to say that if categorical imperatives and consequences are important then understanding why we act in certain ways leads us to the actions in which the consequences then follow. If we understand what precedes these things then discussing the latter parts will be easier. It just so happens that character identity and what motivates an individual is far too complicated to go into detail here, I’ve always believed that the problem with most arguments dealing with philosophy are tunnel-visioned. We’re not really concerned with actually solving problems and looking towards the future, we’re looking to deal with the issues now and just “one-over” the other arguments. Specifically in the applied medical ethics world this is not sound, issues will constantly be arising with many situations being similar enough with only minute differences where the minutes differences could very well sway individuals from one type of mentality to another. The other big issue here is solving the problem at hand, we get so focused on the problem at hand that we forget to even think that the problem could have very well arisen from a past theory that has assumed to be accurate for so long. Surprisingly, while most readers can think of philosophers who made the big leaps of knowledge and tested more than what they could handle, most philosophers careers are started by a predecessors theories. There is some advantage to this type of mentality though, you certainly get closer to a more solid theory inch by inch, but there just reaches a peak point where nothing else can really be said until something revolutionary happens, and I’m not sure when the next occurrence will be...
For those who are going to read this in it’s entirety, I am sorry but this was written over a two week period and hence jumps all over the place. More so than what’s even normal for me, but I hope you get something out of this and if anybody ever wants to discuss any of the issues at hand, feel free to get a hold of me...
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