The case of Stephen Dawson, a seven-year-old boy with severe mental disabilities, discusses many difficult ethical issues. The influence of this case impacts other cases with severely mentally ill patients, but additionally impacts larger cases including different moral principles. The first issue the case discusses is who is responsible for making the health care decisions of those who are not competent to make the decisions themselves. Secondly, it discusses the difference between withdrawing and withholding treatment. Lastly, and the issue that I want to discuss, is the moral status of those with disabilities.
In the case of Stephen Dawson, I believe that the state was morally correct in usurping parental control over the child and performing the life-sustaining surgery. Despite Stephen’s severe physical issues, he is still a human to whom, dependent on which theory you subscribe to, the principles of moral status apply. He has sentience and therefore feels physical and emotional pain. He has human properties, including human DNA and being of the human species. But, because of his disability, the suffering of others overpowers his ability to be treated as someone who is not disabled.
By electing to not complete the surgery on their son, the Dawsons are dismissing the value in the life of their son. In the case discussion, the Supreme Court Justice of British Columbia, Justice Lloyd McKenzie, stated the life of a severely handicapped child had been placed above a healthy child. All throughout this case, Stephen’s welfare was often not the priority, and his life was viewed as disposable. Many of the statements from Judge Bryne, who ruled that the Dawsons should “allow their son die”, discuss the great burden placed on parents of Stephen as evidence for his ruling. The needs of his parents were placed above the needs of Stephen. Additionally, when Stephen was removed Sunny Hill (the home for physically disabled children), he was placed into foster care, and not the care of his parents. The case does not explicitly state the reasoning for this placement, however, I suspect that it was to not burden the family of Stephen again after they had acclimated to having him outside the household, especially the life of their other, healthy child. Overall, this case displays that the welfare of Stephen was not a priority to his parents and their lives, and the life of their other child was placed above their physically disabled son. Luckily for Stephen, the government of British Columbia fought for what the moral just ruling.
While this case in British Columbia eventually ruled in the favor of Stephen’s welfare, I question if the logic of Stephen’s parents and Judge Bryne, would have held in the United States. The trend of placing the life of a healthy child over the right of a mentally or physically disabled child has been shown in the decreasing birth rates of Down Syndrome Children in the United States. Dr. Brian Skotoko, a pediatric geneticist at Children’s Hospital Boston showed a fifteen percent decreases in Down Syndrome children born in the United States between 1989 and 2005. This decrease may be attributed to the larger increase in women choosing to terminate their pregnancies with Down Syndrome Children. Without even discussing the dilemma of abortion, terminating a pregnancy with a Down Syndrome child that you would not have terminated otherwise, is a clear invalidation of the lives of disabled children. Based on this data, would this case have been ruled different here in the United States?
Sources:
Beauchamp, Tom L and James F. Childress, Principles of Biomedical Ethics (Oxford, Seventh Edition).
James, Susan Donaldson. “Down Syndrome Births Are Down in U.S.” ABC News. ABC News Network, 02 Nov. 2009. Web. 21 Feb. 2015. <http://abcnews.go.com/Health/w_ParentingResource/down-syndrome-births-drop-us-women-abort/story?id=8960803&page=2>.
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I admit that I was appalled by the title of the case given by the textbook; of course a person with disabilities has the right to be treated just as any other person does, per your arguments. While there might be some cases where withholding treatment (for either a disabled or non-disabled patient) might be the better option done with the right intentions, I agree that this is not the case here. I too was under the impression that the parents did not necessarily want what was best for Stephen, but the emphasis was placed on how much of a responsibility it was to raise him. The surgery was described as “simple and routine,” but the parents still did not want to go through with it (Thomas 231). It felt like the parents were pleading under the guise of beneficence to let him die with dignity and not suffer any longer when really, they were looking out more for themselves and their other (presumably) healthy children.
Thomas, John E. 1926-. Well and Good. a Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. Print.
Honestly, it’s utterly deplorable that this is even a topic in question or one for discussion. This is all personal belief but I cannot even begin to imagine valuing one child’s life over another’s, especially when the reason is that one of those two children have a physical disability or mental impairment. Every child conceived deserved a right to life. You can’t just simply place more value on one child because they are healthier. In this case the parents, to me, are not acting the best interest of their disabled child, they are acting selfishly and are making a decision based on what would be easier and more convenient for them. It is no doubt that the responsibilities of taking care of a physically or mentally impaired child far surpass those of a healthy one, but does that really mean that you would just let them die if given the chance? Having a child, healthy or not, is not a “burden,” it is a responsibility, and one that you cannot simply opt out of without some sort of legitimate, moral reason. These parents want to let their child die in fear of what it would cost them (monetarily, physically, and emotionally) to keep the child. And that, is the farthest thing from moral.
In this case I think that what ought to happen is clear. If ethics is to answer what ought to be, then it is clear that every person regardless of age, gender, sexuality, etc… should be given the most help possible. In an ideal world Stephen should be given ever possible surgery and the most health care. However the world we live in is not perfect and the biggest question for ethics is often not what ought to be, but how much of this perfect ideal that we compromise. In this case given to how far this child’s disabilities are and the fact that he is disabled to such a degree then I do believe it would better if he were not given the surgery. The problem in this case is that there are two conflicting descriptions of the level of pain and quality of life for Stephen. If you were to believe the parents story of him being in constant pain, then like a terminally ill cancer patient he should be allowed to rest. Yes, dying does cause harm, but in terms of non-maleficence sometimes when the pain is so bad then dying becomes a better option. Especially when there is no future of improvement. To met his case could be solved by finding a third professional opinion, someone trained to measure and diagnosis the child’s condition. Based on that persons opinion they could break the tie between the nursing home and the parents and thus clarify the case more. If the child is in pain and does not expect to get better then letting him rest would be the more ethical and humane choice as forcing someone to live in pain and dragging out there life is cruel and unusual punishment. However should he have a chance of improvement like the nursing care home states then I would say the state was correct in taking the child into custody.