Medical Ethics PHIL 148 @ Binghamton University, Sum 11


Patient-Professional Relationship Debate

Debate Question: If a young deaf child (5-years-old) expresses a desire for a cochlear implant (which has a chance of allowing her to hear), but the deaf mother of the child decides not to let her go through with the procedure, would it be morally wrong for the doctor to get a court order to allow him to perform the surgery?

Position Post:

To deny service to those in need while one is knowingly capable of providing aide is morally wrong. Doctors, before they received their license as medical professional recited an oath in which they pledged to uphold the priorities of their patient’s care above all else in their practicing field. These individuals promised to care for their patients to the upmost of their ability and in stating so the doctor presented in this case must submit to these orders. Now I understand that this particular case may break/destroy or even contradict some relationship principles but one must understand that when dealing with the sick, patients care stand above all. Proposing to receive a court order before the surgical procedure may even contradict a national law, but on ethical and moral grounds such rules fail to apply, as will be explained.

Let’s take a look at why this act of seeking a court order is morally correct based on the theories of certain philosophical principles, with the first being care ethics. Defined by the mere principles of virtue ethics in the placement of patient care at upmost priority, care ethics embodies the importance of empathy and sensitivity in the field of medicine. Proposing to get a court order against the wishes of the mother exemplifies this definition.  Note that the physician going against the mothers wishes is sure to break relationship ties between him/her and the parent. But disregarding this fact and continuing to declare one anyway demonstrates clear empathy for it takes true compassion and willpower to be able to commit such an act. It would also morally correct because not only does it embrace the principles of care and virtue ethics but also it satisfied the needs of the patient in having received an implant and a chance at a normal life.

Another ethical standpoint that stands in support of this moral action is utilitarianism. Derived into two forms (act utilitarianism and rule utilitarianism), utilitarianism states that an act or action must be only be performed when it is in good standing with the general body at hand. Meaning that the good (the pros) must outweigh the bad (the cons) in terms of its effect on the people in question. The people in question in this case would be the doctor, the parent and the child. Should the physician be granted the opportunity to possibly restore the child’s hearing both the child and the parent will benefit; and not to mention the physician as well. How this affects the child is obvious; he or she will be granted a chance at a normal life and will also be able to hear again. The parent will benefit in the sense that she is also deaf and will have a personal translator should she ever need one. In the end the physician will be content knowing that he/she upheld his/her promise of the Hippocratic oath and that both parties were satisfied with the procedure. In terms of rule-utilitarianism, the physician will be conforming to a set of rules (the Hippocratic Oath) that leads to the greatest good for everyone.

A counterargument that may be proposed against this moral action of seeking a court order may be that of a national law. Within the United States, children are said to be lawfully under the care and supervision of their parents until their legal age of adulthood at 18 years old. This means that the child may not receive treatment without direct consent from the mother.  From a legal perspective this may suggest that seeking a court order stands in clear violation of this law. I, however, propose that such violation does not exist. Courts pass judgments on “broken laws” so if they were to issue permission to the doctor then technically no law will “broken”  and it would be legally okay for the surgeon  perform the surgery.  Regardless of a legal aspect, the act of seeking a court order should not be denied anyway because it would be morally incorrect to do so.  To disregard the need of court consent is to disregard the practice of optimal care and to do that according to the theories of care and virtue ethics it is morally wrong.

Yes, it’s immoral to go against the wishes of the mother concerning the child but one must not neglect the needs of the child either. So what happens when you take both wants into consideration? Which side does one choose? Does one uphold the morals of the mother or that of the child? I say that of the child because of the many reasons presented above. At the end of the day, the child is the patient and not the mother. The needs and feelings of the patient are what should be considered and not that of the mother; even if she does have a say in the care of her child. Every mother should want the best for their child. If the mother fails to acknowledge this, the doctor should not and should therefore do everything humanely and morally possible to provide the optimal care.

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