Case Study on "Active Euthanasia With Parental Consent"

Quoted Instructions for "Active Euthanasia With Parental Consent" Assignment:

How to begin

You should begin by considering a number of things. First, read through the case and decide what the major issue(s) is. In other words, what is at stake in this case? Is this an issue of confidentiality? Autonomy? Are there broader themes or issues such as the patient-physician relationship or distributive justice? After making these general observations, move on to the specifics of the case.

Generally, the point of a case is that something must be done. Specifically, there are multiple options, and we must decide which is preferable. You should identify and consider various possible solutions/actions. Also feel free to fill in hypothetical details. Often we will not know all the details of a case. What these details are can affect your decision about what you think should be done. If there is a relevant detail missing, discuss how this detail (potentially) effects your conclusion. Or, if necessary, state your assumptions up front. For example, *****In this case, I will assume the physician has discussed X with the patient."

Note: sometimes the facts of a case will be important, but do not let emphasis on these distract you form the ethical issues of the case. Your argument should focus on the ethical conflict.

Remember to bring up possible objections to your point of view. Sometimes, this will come out in your discussion of possible options. For example, you may pose one option as something certain people would propose and then discuss why you disagree with it. However, if this is not clear in your general discussion, then make it clear.

Finally, be clear about which option(s) you support and why. Again, this will usually be clear from your general discussion. However, if not, make it clear.

What I will look for when grading your case study

Overall moral argument/position

You will notice that some of the commentaries we read are more ambiguous or disorganized. However, for your analysis, you need to take a clear position and defend it. To do this, avoid *****back and forth***** discussions (especially within the same paragraph). Also, always make sure it is clear when you are presenting your view and when you are considering another viewpoint. A good way to clue the reader into your overall argument is to state it in your introduction along with a summary or suggestion of how you will defend it.

Also, make sure to stay focused on the moral issues of the case. Yes, what is legal or suggested by professional codes will often be relevant and useful for your case, but it does not always coincide exactly with the moral argument. For example, in most states physician-assisted-suicide is illegal; however, many argue that this is morally acceptable when practiced with consenting, competent adults.

Use of moral theories, concepts, and readings when appropriate

One goal of this course is to learn to see the connections between abstract moral theories and everyday, practical issues. When making your arguments consider whether they relate to any of the theories or concepts discussed in the readings. If so, make this connection explicit. However, do not feel like you have to cram as many theories as possible into your case analysis. This can actually detract from your argument if they are not relevant or you spend too little time on each point. Best to focus on the few that are most relevant or useful. (Also consider this connection when considering an objection to your position.)

Objection and response

A common philosophical tool in constructing an argument is to consider the position of those who disagree with you. This shows that you understand why reasonable people would disagree, but also gives you the chance to explain why your position is still better. When considering an objection to your argument, make sure it is clear to the reader this is what you are doing (otherwise, it will appear you are contradicting yourself). Also be sure to give your opponent the credit/time they deserve. You will usually need a few sentences to a paragraph to adequately explain your opponent*****s position (remember the point is to acknowledge this is a reasonable view, not just something we can dismiss out of hand). Then, after you explain the objection, go on to refute it. You can do this either by showing a flaw in your opponents position or providing an argument that you think is stronger than the one presented by your opponent.

Case Study:

Active Euthanasia with Parental Consent

Andrea was a nine-year-old girl who had been diagnosed as having cystic fibrosis at the age of thirteen months. Since then she had been hospitalized twelve times, eight times during the last year.

When admitted for the last time she was already receiving an experimental antibiotic, which was being administered in an attempt to control a resistant pneumonia superimposed on severely damaged lungs, a result of her underlying disease. She was at that time a severely ill, emaciated child with moderately labored breathing. She seemed to have no interest in her environment and refused to communicate with anyone but her mother.

Because of the severity of the child*****s illness and because the parents had accurately perceived that the experimental antibiotic was a *****last ditch***** attempt to control her pulmonary infection, the physicians discussed with the parents their perception of *****extreme medical measure***** and the significance of a *****No Code***** order. The parents indicated that in the event of a cardiac or respiratory arrest, they did not want their child to be resuscitated and the appropriate *****No Code***** order was written. The child was not involved in these conversations or subsequent decision making, nor had the mother previously been able to answer her daughter*****s questions about death and dying.

As the child*****s condition continued to decline, the parents asked how much longer she would live and how she would die. At one point the father said: *****Watching your own child die is worse than dying yourself.***** This comment led to a discussion of active euthanasia utilizing intravenous potassium chloride or a similar drug. The physicians pointed out that no matter how hopeless a situation or the amount of suffering that the patient and family were enduring, the law prohibits the active taking of a patient*****s life. They refused to consider this option.

The following day Andrea*****s heart began to fail. Her condition became progressively worse, and she died approximately 48 hours later. During these last two days her parents were appalled by her grotesque appearance, with *****eyes bulged out like a frog,***** and were in great despair because of her steadily deteriorating condition. They felt helpless and impotent to alleviate their daughter*****s distress. Medical treatment was continued to the end, and no measures were taken to hasten Andrea*****s death.

Approximately two months after her death, the mother was asked if she would still have given permission for active euthanasia if she had been offered that option. She replied, *****Yes.*****

Should active euthanasia be permitted to spare the patient and family from suffering when death is inevitable?

[Reference information = Levine and Veatch, eds. 1984. Cases in Bioethics. Hastings-on-Hudson, NY: The Hastings Center, 50.]