Class Note for PHIL 164 at UMass(7)
Class Note for PHIL 164 at UMass(7)
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This 2 page Class Notes was uploaded by an elite notetaker on Friday February 6, 2015. The Class Notes belongs to a course at University of Massachusetts taught by a professor in Fall. Since its upload, it has received 22 views.
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Date Created: 02/06/15
Medical Ethics 022609 Phil 1643 Spring 09 l Instructor Kiistoffer Ahlstrom leayrtmpyzarumamedu l httppeopleumassedukahlstro164 TIEE BABY DOE GUIDELINES One of the most famous cases ofinfanticidegor the killing of an infantiis that of Baby Doe Baby Doe Suffered from Down syndrome typically associated with lower levels ofIQ Baby Doe also suffered from an unformed esophagus the passage from the mouth to the stomach In other words food put in the mouth did not reach the stomach The doctors recommended not going ahead with the operation to restore the esophagus but to instead let him die while giving him drugs ensuring that he would be in no pain The parents consented and the baby died within a couple of days Public reactions however were hostile to the decision made and to the parents The Reagan administrationgofficially a strong defender of the proilife movementiquickly put in effect what came to be known as 73 balk doeghidez39nex The guidelines were framed in terms of an attempt to protect the disabled Squads of lawyers doctors and government officials were set up for the purpose ofbeing dispatched to locations of complaints within an hour s notice No investigation revealed violation of the guidelines Still the guidelines were later struck down since they had been developed without consulting those affected The De partment of Health and Human Services HHS developed a new guideline which suggested that the law does not require the imposition of futile therapies which merely temporarily prolong the process of dying of an infant terminally ill such as a child born with anencephaly or intraicranial bleeding Singer Any concession to the effect that life sometimes should not be maintained amounts to a departure from the idea of the sanctity oflife In other words what is notable is that in attempting to defend the sanctity oflife in law the Reagan administration ended up defending a qua2y oflife ethic on which all lives need not be maintained However the new guidelines were not accepted by those asked to comment on it For this reason HHS issued its Final Rule which exchanged talk of futile treatments with treatments that are not medically beneficial Singer This is if anything an even clearer example ofa quality oflife ethic Not even this guideline was accepted however The Reagan administration appealed to the Supreme Court but without any success Supporters of the guidelines in congress tried a new tack They appended a clause to a bill reauthorizing a federal government program against child abuse However even this clause accepted treatments that would merely prolong dying or that would be virtually futile in terms of the survival of the infant and the treatment itself under such circumstances would be inhumane It came into effect in 1984 DR LORBER ON SPINA BIFIDA One condition that people arguing that infanticide is sometimes morally permissible usually bring up is spina bi da Spina bi da Literally means divided spine Involves a complete paralysis of the legs and a complete inability to control the bowel or bladder The spine may also be deformed The condition sometimes but not always involves intellectual disability Before the 1950 s almost all infants that suffered from spina bifida died either due to infection or because doctors and midwifes made sure that they didn t live However after the 1950 s antibiotics became available to deal with the infec7 tions and new surgical procedures became available that would handle the many physical defects involved Dr John Lorber was a pediatrician in Sheffield He initially argued that all babies suffering from spina bifida should be operated on However after a decade of practicing he began to have his doubts and analyzed the records of 848 of the children he had treated Here is what he found Half had died most of these during the first year oflife Of those who had survived only six had no handicap and seventyithree were only moderately handicapped More than 80 percent were severely handicapped that is they had at least two but usually more of the following conditions no bowel and bladder control or a urinary by pass with frequent kidney infections and progressive chronic kidney damage which sometimes led to kidney fail ure paralysis to such a degree that they were unable to walk without caliper splints crutches or other appliances and that do rely on wheelchair for part of the day pressure sores on feet knees or buttocks hydrocephalus uid accumulation in the brain which was treated by a drainage tube requiring new operations to deal with frequent complications In addition to these physical problems approximately oneithird of the surviving children were in tellectually disabled Singer 1994 p 117 In light of this Lorber called for a reassessment of priorities and for selective treatment He found that the size and location of the opening of the spine were good predictors of the severity of disability that the child would have He suggested that those predicted to suffer from severe disabilities should be kept comfortable and free from pain while treated to die HARD CASES AND HARDER CASES This clearly amounts to a qualify oflife ethic on part ofLorberga consequence that Singer naturally welcomes However it remains to be specified exactly how such an ethic is to be applied Consider the following cases Re Re B ohn Pearson A brainidaniaged premature baby At Similar to Baby Doe Suffered from Suffered from Downs Syndrome but five months he still had difficulty Downs Syndrome and a blockage of had no other abnormalities breathing without a ventilator was the intestine which could have been paralyzed appeared to be blind and removed by way of a fairly simple likely to become deaf In addition it procedure The effect of not opera was unlikely that he would ever be tion was starvation able to sit up or hold his head up In all these cases doctors were able to perform passive infanticide without any legal repercussions They were all brought before courts but led to no convictions However it seems that the question whether it is morally permissible to perform infanticide becomes less and less straightforward as we move from the leftmost case to the rightmost case FOR DISCUSSION The Article A contemporary commentary from the British newspaper the Guardian on the John Pearson case and the doctor that was responsible for his care Dr Leonard Arthur Questions 7 Under what conditions does the Commission say that it might be morally permissible to perform infanticide 7 Going by the Commission s view was it right to killJohn Pearson
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