Case 26: Minor Refusing Life-Sustaining Treatment CLOSED
Class,
Follow-up to the case we read and discussed in class (Case 26 p. 208 in your text). Anything else you'd like to say? Something you thought of later?
Hello, everyone! I would like to comment on Case 26 a little further. In class, my group had the Utilitarian perspective of the case. In this perspective we stated that Jimmy should have an opinion, as well as his parents, but the oncologist should merely state the facts since he/she acts as an authority on the subject. Overall, I agree with each of these statements but I would like to add a little more. I agree with these statements not because the Utilitarian POV states to do whatever is best for the group; I agree with these statements because I think that Jimmy, even though he is only eleven, should have a say about his future if he knows that facts. In the end Jimmy's parents should have the overall say because he is only eleven, which taps into the Virtue perspective of the case.
Jimmy, as an eleven-year-old boy, may not have the mental facilities to weigh every option and think through the different scenarios like his parents do, due to their life experiences as adults. Jimmy may decide he wants to let himself die out of pure fear. Likewise, his parents may only base their decision on their love for their son and not based on the gruesome facts. Purely basing a decision on one ethical perspective seems impossible based on human insticts of protection and survival. Parents are going to protect their children and should be willing to do whatever it takes for their offspring to live. The Utilitarian perspective is a rule-based process, and when it's a matter of life and death, family should be willing to toss rules aside to protect one's own.
I think that it is important to focus on the individual cirmstances that influence the decision. If the child has delt with a disease his entire life he is probably more educated than many 11 year olds. I have seen young kids know more about their own diseases than even some of the resident doctors because they have delt with it so long. I think that as healthcare providers we should be aware of this and not try to make the 11 year old feel that he isn't important in a decision about his life.
The utilitarian standpoint for this case is very conflicting. This theory strives to promote happiness and minimize pain for the greatest number. But whose point of view do you take? The parents? If so, the answer is to keep Jimmy alive. This way, the family stays together and the parents do not have to deal with the immense hardship of losing a child. But what if you take Jimmy's point of view? If so, allowing himself to end his life would be the path to maximize happiness for the greatest number. For Jimmy, he will no longer be in pain and confined to a hospital. His parents will no longer live in fear of not knowing if their child was going to die that day, their days won't be consumed with chemotherapy and doctor visits. Their lives can return to "normal." So from his point of view, honoring his wishes would be for the greatest benefit. So, whose viewpoint do you take?
In class, I was also in the utilitarian group. It is hard for me to think about an issue like this from a certain ethical perspective. Many different things have to go into a decision like this as others have stated before. The utilitarian perspective is all about the big group. Sometimes these decisions have to be made by only half the group. The doctor should be involved merely as a professional telling the family the facts about both sides. He or she should not be involved in making the final decision since he has no emotional attachment to Jimmy. From personal experience, I find it intimidating to have the doctor in the room when I am making a medical decision, but I have never had any life threatening diseases like cancer.
From the virtue ethics point of view, the decision should be made by an adult. The child may be the center of the situation but he has not had the time to develop his character or matured enough to make such an important decision. His parents can listen to his point of view and what he would like to happen, but ultimately it would be the parents decision to make.
I agree with this point of view. I understand that the child is the one living with the disease, but at age 11, he definitely isn't mature enough to make such a life-altering decision. His parents have gone through this disease with him and are the ones that should decide how to treat their child
That is an interesting point about utilitarianism being conflicting. We have been looking at it from the perspective of an 11 year old child and I believe mostly agreed he was too young to make such a decision, but what if we consider this view for the man with LGS from the movie? Clearly, he wants to forfeit his life at the time he feels is appropriate, but say the majority of his family was against this, whether for religious, emotion, etc. reasons.
I would like to comment on Dana's post. Utilitarianism is maximizing happiness and minimizing pain, but I don't think it has a point of view. It is a general statement from an outside opinion of happiness and pain. Every person in the situation has pain and every person in the situation has potential happiness. However, I do believe that utiliatarianism needs a scale of happiness and pain in order to provide the most clear assessment. Can we say that Jimmy's physical pain is or will be more than the parents' pain upon his death? Can we say that Jimmy's happiness after death will be more or less than the parents' happiness to prolong his life? We must look at the situation standing outside the situation in order to agree on the best decision.
A boy who is 11 years old should not be allowed to make this kind of decision entirely on his own, but he does have the right to participate in the decision by voicing his concerns.
Children understand a lot more than we give them credit for, and some kids are much more mature than some adults that I know.
This particular case is difficult because the child is expected to die in the next several months regardless of if treatment is given or not. As a mother of two girls, 14 & 4, I would give a great deal of thought to carrying out my 14 year olds wishes if I was confronted with this situation.
My group was the Kant point of view and in short, it is based on duty as opposed to consequences (good or bad). It has to do with performing actions out of pure goodness and not because it benefits us and brings us good consequences. In this particular point of view this would mean that the family and doctors would be following their duties and doing them for good and pure purposes for Jimmy instead of what is best for themselves. Therefore, the doctor would have to give him the chemotherapy because it is his duty as a doctor to provide care for the sick. However, the parents duty is to do what’s best for their son Jimmy which I believe would be a difficult decision because I think they could look at it as having two options: 1. Decide to do the chemotherapy on the basis that it could work and it could make him better and prolong his life. 2. Honor their sons wishes and refuse the treatment because of his suffering and let him live the last few months as normal as possible for him. So the parents would have to take into consideration that deciding to do the treatment would have to be based on the hope that it will work for him and make him better and not because doing treatment would keep him around a few extra months so they could be with him longer.
In class I was in the Kant group and we said that while Jimmy should be allowed to have a say in his treatment the final say lies with his parents. Because Jimmy is a minor he is not seen as responsible enough to make a major decision like this. According to Kant JImmy's parents would have the final say as to wether or not life sustaining treatments would be carried out. When it comes to the oncologist Kant says that it is his duty to do good. He says that we have a duty to do good and as a doctor Kant would say that he has a duty to do good and to do the right thing. So in this case the oncologist should listen to the parents and should do what they want even if it is not what Jimmy wants. In my opinion it is a hard situation and not one theory has the best solution for this problem. If I were involved in this situation I would tell the family all of their options and I would give them a time frame on how long JImmy is likely to live and to let them know that it could be longer or it could be shorter because there is no real definitive way to give an exact amount of time that someone has left. I would also try to leave my opinion out of it becuase what I would do would not necessarily be what they want to do. In this situation it is best to give unbiased information and then let the family talk it out and come to a decision that works for all members of the family and that all members of the family are comfortable with.
Hello, everyone! I would like to comment on Case 26 a little further. In class, my group had the Utilitarian perspective of the case. In this perspective we stated that Jimmy should have an opinion, as well as his parents, but the oncologist should merely state the facts since he/she acts as an authority on the subject. Overall, I agree with each of these statements but I would like to add a little more. I agree with these statements not because the Utilitarian POV states to do whatever is best for the group; I agree with these statements because I think that Jimmy, even though he is only eleven, should have a say about his future if he knows that facts. In the end Jimmy's parents should have the overall say because he is only eleven, which taps into the Virtue perspective of the case.
ReplyDeleteJimmy, as an eleven-year-old boy, may not have the mental facilities to weigh every option and think through the different scenarios like his parents do, due to their life experiences as adults. Jimmy may decide he wants to let himself die out of pure fear. Likewise, his parents may only base their decision on their love for their son and not based on the gruesome facts. Purely basing a decision on one ethical perspective seems impossible based on human insticts of protection and survival. Parents are going to protect their children and should be willing to do whatever it takes for their offspring to live. The Utilitarian perspective is a rule-based process, and when it's a matter of life and death, family should be willing to toss rules aside to protect one's own.
Thanks for listening!
I think that it is important to focus on the individual cirmstances that influence the decision. If the child has delt with a disease his entire life he is probably more educated than many 11 year olds. I have seen young kids know more about their own diseases than even some of the resident doctors because they have delt with it so long. I think that as healthcare providers we should be aware of this and not try to make the 11 year old feel that he isn't important in a decision about his life.
ReplyDeleteThe utilitarian standpoint for this case is very conflicting. This theory strives to promote happiness and minimize pain for the greatest number. But whose point of view do you take? The parents? If so, the answer is to keep Jimmy alive. This way, the family stays together and the parents do not have to deal with the immense hardship of losing a child. But what if you take Jimmy's point of view? If so, allowing himself to end his life would be the path to maximize happiness for the greatest number. For Jimmy, he will no longer be in pain and confined to a hospital. His parents will no longer live in fear of not knowing if their child was going to die that day, their days won't be consumed with chemotherapy and doctor visits. Their lives can return to "normal." So from his point of view, honoring his wishes would be for the greatest benefit. So, whose viewpoint do you take?
ReplyDeleteIn class, I was also in the utilitarian group. It is hard for me to think about an issue like this from a certain ethical perspective. Many different things have to go into a decision like this as others have stated before. The utilitarian perspective is all about the big group. Sometimes these decisions have to be made by only half the group. The doctor should be involved merely as a professional telling the family the facts about both sides. He or she should not be involved in making the final decision since he has no emotional attachment to Jimmy. From personal experience, I find it intimidating to have the doctor in the room when I am making a medical decision, but I have never had any life threatening diseases like cancer.
ReplyDeleteFrom the virtue ethics point of view, the decision should be made by an adult. The child may be the center of the situation but he has not had the time to develop his character or matured enough to make such an important decision. His parents can listen to his point of view and what he would like to happen, but ultimately it would be the parents decision to make.
ReplyDeleteI agree with this point of view. I understand that the child is the one living with the disease, but at age 11, he definitely isn't mature enough to make such a life-altering decision. His parents have gone through this disease with him and are the ones that should decide how to treat their child
That is an interesting point about utilitarianism being conflicting. We have been looking at it from the perspective of an 11 year old child and I believe mostly agreed he was too young to make such a decision, but what if we consider this view for the man with LGS from the movie? Clearly, he wants to forfeit his life at the time he feels is appropriate, but say the majority of his family was against this, whether for religious, emotion, etc. reasons.
ReplyDeleteI would like to comment on Dana's post. Utilitarianism is maximizing happiness and minimizing pain, but I don't think it has a point of view. It is a general statement from an outside opinion of happiness and pain. Every person in the situation has pain and every person in the situation has potential happiness. However, I do believe that utiliatarianism needs a scale of happiness and pain in order to provide the most clear assessment. Can we say that Jimmy's physical pain is or will be more than the parents' pain upon his death? Can we say that Jimmy's happiness after death will be more or less than the parents' happiness to prolong his life? We must look at the situation standing outside the situation in order to agree on the best decision.
ReplyDeleteA boy who is 11 years old should not be allowed to make this kind of decision entirely on his own, but he does have the right to participate in the decision by voicing his concerns.
ReplyDeleteChildren understand a lot more than we give them credit for, and some kids are much more mature than some adults that I know.
This particular case is difficult because the child is expected to die in the next several months regardless of if treatment is given or not. As a mother of two girls, 14 & 4, I would give a great deal of thought to carrying out my 14 year olds wishes if I was confronted with this situation.
My group was the Kant point of view and in short, it is based on duty as opposed to consequences (good or bad). It has to do with performing actions out of pure goodness and not because it benefits us and brings us good consequences. In this particular point of view this would mean that the family and doctors would be following their duties and doing them for good and pure purposes for Jimmy instead of what is best for themselves. Therefore, the doctor would have to give him the chemotherapy because it is his duty as a doctor to provide care for the sick. However, the parents duty is to do what’s best for their son Jimmy which I believe would be a difficult decision because I think they could look at it as having two options: 1. Decide to do the chemotherapy on the basis that it could work and it could make him better and prolong his life. 2. Honor their sons wishes and refuse the treatment because of his suffering and let him live the last few months as normal as possible for him. So the parents would have to take into consideration that deciding to do the treatment would have to be based on the hope that it will work for him and make him better and not because doing treatment would keep him around a few extra months so they could be with him longer.
ReplyDeleteIn class I was in the Kant group and we said that while Jimmy should be allowed to have a say in his treatment the final say lies with his parents. Because Jimmy is a minor he is not seen as responsible enough to make a major decision like this. According to Kant JImmy's parents would have the final say as to wether or not life sustaining treatments would be carried out. When it comes to the oncologist Kant says that it is his duty to do good. He says that we have a duty to do good and as a doctor Kant would say that he has a duty to do good and to do the right thing. So in this case the oncologist should listen to the parents and should do what they want even if it is not what Jimmy wants.
ReplyDeleteIn my opinion it is a hard situation and not one theory has the best solution for this problem. If I were involved in this situation I would tell the family all of their options and I would give them a time frame on how long JImmy is likely to live and to let them know that it could be longer or it could be shorter because there is no real definitive way to give an exact amount of time that someone has left. I would also try to leave my opinion out of it becuase what I would do would not necessarily be what they want to do. In this situation it is best to give unbiased information and then let the family talk it out and come to a decision that works for all members of the family and that all members of the family are comfortable with.