Groups form around whichever theory you pick but no more than 4 of you on any one theory.
- Utilitarianism
- Kant
- Virtue Ethics
- Ethics of Care / Feminist Ethics
- Principles of Biomedical Ethics
Sunday, January 24, 2016
Case 3 (1 & 5 Feb)
In groups, use the following theories to answer the questions at the end and generally assess the case.
Groups form around whichever theory you pick but no more than 4 of you on any one theory.
Groups form around whichever theory you pick but no more than 4 of you on any one theory.
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Case 3, Ethics of care.
ReplyDeleteIn this theory empathy and emotions are the focus. Dr, H would not do the vasectomy if he was looking at the future wife from this stand point, in my opinion. This explains the doubts of the provider to consider his future wife's wants and dreams.
I think the moral ramifications come in to play on the part of the provider, not the patient. The patient is not asking out of spite or revenge; he simply cannot picture how his life may change and his feeling along with it.
On the other hand, Dr. H has an ethical obligation to ensure the patient has considered all of the options and thought it through. I do feel it is the dr.'s obligation to provide the service despite the reservations if the Patient is still requesting after being informed.
One of the things I do think people forget and you can refuse to treat someone if it is an elective non life threating procedure. So by not treating him you have a mad patient but it may be the ethical thing to do.
DeleteI don 't like ant theory that takes the power over my life and places it into someone else. The theory of Ethics of Care places someone's opinion over mine. This allows them to make choices for me. I don't like the theory because it is not hard science. It is a theory. At age 24 he is well an adult and allowed to make his decision. To refuse because one day he may marry someone who wants kids is not an option. He may have someone who already has kids, or maybe he does not want the financial burden and recognizes he may not be a good parent.
DeletePrinciples Of Biomedical Ethics as applied to Case 3:
ReplyDeleteI think in this case, Dr. H has to apply the theory of The Principles of Biomedical Ethics. Birth control is considered questionable ethically period, as evidenced by the Catholic Church's take on it (it isn't up to us to medically prevent procreation, procreation is God's decision) versus the belief that it is that individual's choice as to whether they become parents or not. Putting those contrasting beliefs, and my own beliefs aside, I think the theory best applied is The Principles of Biomedical Ethics.
To look at this case from the belief in The Principles of Biomedical Ethics theory: Dr. H must put his personal beliefs aside and apply this to the request of the patient. He is there, being paid to provide a service for someone who has decided that he does not want children.
Evaluate respect for:
Autonomy: he must respect Gregory X and his ability to make his own decision
Beneficence: This procedure will do good for Gregory X assuring he does not have unwanted children
Non-maleficence: This procedure will do not harm to Gregory X
Justice: He must be fair when making his decision and remember that this ultimately affects Gregory X's life, not his own, and if he does not do the procedure, Gregory X cannot afford to have it done elsewhere.
When taking Gregory X's future wife into consideration: that is something that Gregory X and his potential mates will have to discuss down the road. They will go into the relationship knowing they cannot have a child with Gregory X, and they are able to make their own decision to not be with him and search for someone else who wanted to have children. Just because a potential mate down the road might want children should not nullify Gregory X's wishes and dictate what he can or cannot choose for himself. (Ultimately, though, we know in today's medical world, this can be reversed if he changes his mind and wants children if he meets someone who convinces him.... However, that raises the ethical question, who should foot the bill for the costs of people playing God changing their minds again and again...)
Very well said Shelly! I had not considered using that theory to apply to this case but it makes perfect sense. I like how you broke it down by the four principals. You also raise a valid question of who will pay the bill for those individuals who constantly change their minds.
DeleteVery well said Shelly! I had not considered using that theory to apply to this case but it makes perfect sense. I like how you broke it down by the four principals. You also raise a valid question of who will pay the bill for those individuals who constantly change their minds.
DeleteCase 3: Ethics of Care
ReplyDeleteWhile considering all aspects of this case study I believe that the Ethics of Care applies. This theory focuses on the emotions and empathy as the source of morality in relationships.
1. To the question of whether Dr. H should accede to Gregory X's request for a vasectomy despite his reservations I believe the answer is yes. Gregory X is coming to the clinic for a procedure that although it may involve some pain, it does him no harm. He has been properly informed of risks and benefits and can give informed consent. Dr. H works for a urology group that routinely performs this procedure so it is not out of the ordinary. Dr. H shows empathy to Gregory H's future wife, hence him asking Gregory to consider how this could impact his future relationships. I do believe he is also furthering the informed consent and making sure Gregory X has thought this decision through.
2. There are only 2 things I can think of that might make Gregory's decision morally problematic:
a. If hes Catholic then that goes against the belief of no birth control
b. If he does meet a woman in the future and he lies about his vasectomy leading the woman to believe he can still have children then that is morally wrong.
Jocelyn,
DeleteI had wondered too if he would be honest with women he met in the future. I would like to think he would be. If he is honest with them, I see no issue, they can choose to accept that course or move on to find someone with the same family plans they have. If he lies, that is an unfortunate immoral situation.
I agree I feel that if he was not honest with the woman about this it could be considered morally wrong.
Deletehowever it is not like is saying that he had a vasectomy and really did not leaving the woman to think she cannot have kids and therefore not use protection and then getting pregnant because of his lying.. which I believe is much more morally wrong in that aspect.
But I think he would be honest given the fact he has come to this decision at such an early age.
This situation would fall into early discussions of relationship 101. Ethically and morally important for him to discuss this. It may be something he lives to regret and he will have to live with the ramifications. It may be a deal breaker for her, and may not be the relationship for her.
DeleteCase 3. Ethic of Care.
ReplyDeleteThis focuses on the empathy and emotions as the source of morality.
In this case Dr. H has expected reservations about performing the procedure. A procedure, typically performed on an older male who has already had children and feels his family is complete; becomes a thought-provoking issue to the physician asked to do this on a 25 year old whom has not had children yet. The thing here to consider is: Assuming the patient is capable of making his own decisions, all options must be reiterated to him regarding his future. Also, if he currently does not have a wife, and one is considering a 'future wife', you must ask; how do you know if he will ever get married? And, if he does, then it is Gregory's responsibility thereafter, to be honest about his inability to have children, and other such relationship issues. This is not the doctor's responsiblity whatsoever. After having discussed future ramifications and all options, it is the doctors' responsibility to perform the procedure as the patient request. As far as any morally problematic issues of Gregory's request, only would be if he has certain religious beliefs that are against this.
I don't feel like the future wife here is the issue. I think that everyone knows going into a relationship that these are things you discuss. you discuss your future and if only if he was honest which he seems to be if he is already come to make this decision he would be that the future wife or potential would know this progressing in the relationship. So I think at that point that would be on her. That she could make a decision on her own that if she didn't want to be with someone that could give her children, then she could leave.
DeleteI agree with you regarding the the morally problematic issues that it would only be if he had some religious tie to something which there was not enough information provided in the case study to make that assumption
1. According to Kant’s ethical theory, yes. The doctor should perform the surgery despite his own thoughts or personal feelings. He is helping his patient because it is his job and vasectomies are part of the services that he offers. If the doctor refuses to do the surgery, then he is being disrespectful of this patient’s beliefs and is acting only on his own personal feelings which goes against Kant’s theory and idea of “treat others as you want to be treated.” This consenting patient, who had given his decision several years of thought, came to him for his service. The doctor needs to honor what the patient wants because it is his job. Not refuse the surgery because he doesn’t agree.
ReplyDelete2. I don’t feel as if there are any moral problems with the patient’s request related to Kant’s theory given the assumption that he will be open and honest about the surgery and the fact that he does not want to be a parent. If that were the case, his actions would be going against the morals of Kant’s theory which is based on categorical imperative where lying is wrong. Kant’s theory implies everyone has a duty to tell the truth.
In the doctors case, I feel as though he completed his moral responsibility by explaining the risks involved including discussing the possibility of a future wife wanting children.
Erin, If the doctor truly has moral issue with doing this mans vasectomy I don't believe he should be forced to do it. I'm sure there are other doctors there capable of performing this procedure. Just as we as nurses should not be forced to perform something that we feel is morally wrong. Now if the doctor routinely feels this way and refused multiple times to perform vasectomies, then perhaps he should consider a new line of work. :) But I do agree that there was no moral problem with the mans request. He did thoroughly think about his choice and did not rush into a decision.
DeleteI am not sure what would be the MD moral issue is. He is an adult and 24 years old. I would have been frustrated and went to another MD. If the MD has these views than he is practicing the wrong medicine.
DeleteI had considered the idea of him going to a different doctor, however I think that is why the problem specifically states that this particular doctor was the only one he could afford, so as to eliminate that option. In a perfect world, I completely agree that medical professionals should not be forced to perform something that goes against our own personal morals but I don't feel that is being realistic. I think we should honor our patient's feelings and beliefs and do what they feel is best for them not what we feel is best.
DeleteVirtue Ethics
ReplyDeleteI feel that based this particular theory he should turn the patient away because Virtue ethics is about the moral character of the Doctor. The doctor himself isn't forcing the patient to have children there are other forms of contraception. The patient is very young as well and that is very atypical to have something like that done at the age of 25 and sometime you don't always make a good decisions and your heart could change if you were to meet a woman. I would also say that this is an elective procedure so ask the patient to attend counseling and come back and see him in six months and see if still feels the same way then maybe you could revisit this. Also this doctor would be making a decision for any potential wife or mate he may have in the future and I believe based on virtue ethics this would not be something the doctor should preform.
I think the counseling is a good idea and should be required any time someone is choosing something like this. Because if they do change their minds, suddenly they are rushing to get it reversed which includes risks and costs that would not have happened if they had been forced to think about it harder.
DeleteTo play the other side: As far as the moral aspect, I think as healthcare workers we have to put our personal beliefs aside, which is hard when someone lives such child-centered lives as we do. I am perplexed as to how everyone thinks a decision about his body and his desires is up to a "future wife", an unknown that he hasn't met yet.
Shelley, I agree that the "future wife" shouldn't be a huge issue here. Many women are on various types of birth control and no one ever counseled me to think about my future husband and his desire for children. I know that birth control is not a permanent contraceptive, but neither is the vasectomy. Men don't have the same choices as women have when it comes to deciding if he has children or not. Abstinence or condoms are the only options. Condoms aren't 100% and I doubt a young 25 year old man would like to be abstinent.
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DeleteI don't like the theory. What happens in the future is unknown. What if he never gets married but dates. It is his right not to have to worry about getting his romantic partner pregnant. He does need to notify them that he has undergone the procedure and children are off the table. It seems like more and more people in todays society do not want children.
DeleteUtilitarianism is a theory in normative ethics holding that the best moral action is the one that maximizes utility. Utility can be defined in various ways, but is usually related to the well-being of the sentient entities.
ReplyDeleteSo based with this the cause of him having a sterilization procedure is because he just does not want kids that he has decided that he does not want to be a parent. It isn't that he needs to have a vasectomy due to medical reasons giving you the effect of better health, the only effect in this situation if he were to have the procedure done is that he will not be able to have children.
So I believe that applying it to the utilitarianism theory that this is not maximizing the effect. This is not to maximize his health this is just an elective thing.
I personally do not feel that this is morally wrong for a 25 year old to want to have this procedure done. 1. he is of age to consent and has been for 6 years. He can make this decision and not have any issues with it. His future mates are all on him this isn't something the doctor would have to worry about. I mean what if he was already sterile with out the procedure he would have to let his future mates know that anyway.
If the doctor did not want to do the procedure there would be no morally wrong reasoning in his decision either. This is strictly an elective procedure and not a medical necessity.
I feel that this case is all about the Dr. and nothing to do with the patient. I said in my response I think the patient should maybe attend counseling before making a life decision. He may feel differently after he really explores his feelings.
DeleteI agree with you Kourtney. It is a choice we not make ourselves but should not deny him of what he wants. Of course with proper education. It is difficult to make such a choice so early in life that will affect many aspects of his future life. I also agree with Alex, extra exploration with his feelings may be needed given his age.
DeleteI agree with Kourtney that the patient can decide if he wants to have children. His reasons for this decision are not known. It may be his belief that he knows that there are many children waiting to be adopted, and with the overpopulation problem in this world, why not give homes to the children that need one instead of bringing more children into this world. Knowing his reasons or his goals for his life, may change the doctor's thoughts on this. I think that the Doctor would also do well to explore his reasoning, but give him ample time to be educated and revisit this before proceeding.
DeleteI agree with Kourtney that the patient can decide if he wants to have children. His reasons for this decision are not known. It may be his belief that he knows that there are many children waiting to be adopted, and with the overpopulation problem in this world, why not give homes to the children that need one instead of bringing more children into this world. Knowing his reasons or his goals for his life, may change the doctor's thoughts on this. I think that the Doctor would also do well to explore his reasoning, but give him ample time to be educated and revisit this before proceeding.
DeleteUsing Kant theory of Kantian deontology, the MD must preform the procedure for the patient. With his respectful rights we must acknowledge the respect of his rightful authority over himself. He may choose what happens to himself. Is this decision any greater than any long term decision we make. Going to college, joining the military, or becoming a tradesman, all affect our lives drastically but no one questions those. His theory allows a rationale person to make their own choices.
ReplyDeleteI believe the MD should perform the procedure if that is what Gregory wants. He is of legal age and allowed to make decisions for himself. I know by law after the initial consultation they must wait 24 hours to perform the procedure. This allows the MD to throw out his opinions and how the procedure is done. In 24 hours if he still wants the vasectomy he should be allowed. The MD should not be able to choose for the patient.
Yes, I agree. The physician can explore all sides of the procedure but should not be able to choose for the patient. The patient has a right to make informed consent regarding his health.
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ReplyDeleteCase #3
ReplyDeleteI have to base my thoughts on the case with the principles of biomedical ethics.
1. Dr. H should consider Gregory's right to autonomy. He is of age to consent to surgery and seems to have put much thought into his decision. Dr. H also is a practicing urologist who preforms the surgery regularly. Justice would come in to play here also. Gregory can't pay for the surgery, however, Dr. X must be fair to all of his patient's. Dr. X must give Gregory all the information necessary to make an informed decision. Once he has provided the information, he would not be doing harm to Gregory because he has made an informed decision.
2. According to many religions, elective sterilization goes against the belief of protecting human life from conception to natural death. Is Gregory denying the future life of children by having the elective surgery. Morality in this case would weigh heavily on the decision of surgery if he or Dr. X practiced in one of these religions.
Using Kant theory I do believe the doctor should preform the surgery. Granted it may not be a choice that the doctor agrees with but ultimately the patient is there for a service and not an opinion of personal choices based on the doctors private beliefs. I do believe the doctor is responsible for the patient to be fully informed regarding all aspects of this procedure and discussed the pros and cons to ensure the patient has explored all of his feelings regarding a drastic life choice. Given all that has been done and some time allowed for the patient to allow the information to settle. If he still wants the procedure done then it is his right to have it done.
ReplyDelete