Dilemma: Stephen Dawson was premature and suffers from extensive brain damage and lowered mental and physical capacities due to meningitis. He cannot be left alone and his parents have described his life as being “painful and unhappy.” It was found that he needed an operation to repair a blockage in his brain shunt and without this operation, he would die. Should Stephen undergo the operation or should he be allowed to “die with dignity” and avoid future suffering according to his parent’s wishes?
Discussion:
This is a very conflicting case in my opinion; however, I believe that Stephen Dawson should be allowed to pass away as his quality of life is very low and his chances of ever improving or being able to live on his own without constant care are low as well.
In cases such as this one, I believe that Stephen’s present and future quality of life must be considered. While the case study states that he has not officially consented to refusing treatment, he is also not competent to do so. Because he is incompetent, it is fair for his parent’s, who have spent much time caring for him and observing the struggles he has had to undergo, to decide whether it is worth allowing him to undergo the operation. If it were an operation to help him gain some of his mental and physical capacities, then I would agree that the surgery should take place. However, this surgery does not hold that promise and would simply serve to “prolong a life inflicted with an incurable condition (Thomas, et al. 229-235).”
Simultaneously, this does bring up the issue of the value of the life of a disabled person. Do they not have rights as well? While this is a serious question, I believe that in this case, the value of Stephen’s is not being questioned or determined but simply his quality of life. Stephen would continue to live with great difficulty and would never achieve independence or be able to fully enjoy life. Involuntary passive euthanasia is appropriate in this case. This form of euthanasia occurs when the patient is unable to consent and life sustaining treatments are withheld (Nordqvist).” There are many reasons why passive euthanasia would be utilized. In this case, Stephen’s medical situation would progressively get worse and his “expected quality of life is so poor that life will be worse… than death (Garrard).” Stephen cannot feed himself and he has the capabilities of an eight-week-old infant according to the case study. I am not arguing that because of these disabilities, Stephen is not worth preserving; however, I do believe that it is within his best interests to not suffer any longer than he has to. The surgery would not cure him but would only serve to keep him alive. He would still have to face these challenges and most likely many more as he gets older.
Works Cited
Thomas, John E, et al. “Case 6.4 Stephen Dawson: Should Severely Mentally Challenged Patients Be Treated?” Well and Good: A Case Study Approach to Health Care Ethics, 4th ed., Broadview P, 2014, pp. 229-235.
Garrard E, Wilkinson S Passive Euthanasia Journal of Medical Ethics 2005;31:64-68.
Nordqvist, Christian. “Euthanasia and Assisted Suicide.” Medical News Today, 8 Apr. 2016, www.medicalnewstoday.com/articles/182951.php.
I agree with this decision. As you noted, the decision to allow him to pass away is very difficult. As someone who is very well acquainted with disability culture and advocacy for the rights of the disabled, I can say that there would be a debate, even within this group, over whether or not is right for the parents to allow his death.
In my opinion, continuing his treatments and forcing him to stay alive would “be inhumane or even cruel. Even for an incompetent patient, the burdens can so outweigh the benefits that the treatment is wrong, not merely optional” (Beauchamp et. al 169). I say this because I would side with the parents; the reason being that they spent a lot of time with him, and if they were as exhausted as they said, then he would be in even more agony and way more exhausted than they were, because they weren’t feeling the effects of his disabilities first-hand. It wouldn’t surprise me if the caregivers were overstating his abilities, competency, and happiness either because they wanted to overstate their own care, or because they saw the parents’ decision as wrong. Even if their assessment is accurate, it’s likely that there are several caregivers, and none of them individually have an appreciation for the difficulties he’s facing like the parents do.
I would be interested to hear more arguments from others on the other side, especially if they have any direct experience with patients who are facing similar disabilities.
Citation:
Beauchamp, Tom L., and James F. Childress. Principles of biomedical ethics. New York, NY: Oxford U Press, 2001. Print.
Ki Kianna,
I think your evaluation of this is case is very interesting and super relevant! I feel like you tied in the idea of non-malfeasance really well. It is a hard to many doctors to allow their patients to undergo intentional harm. However, I feel it is a crucial choice that should be available for people who’s situation are dire.
In the case of Stephen Dawson, it is very important that he is in a position where he has a zero to no chance of a better life, which you noted. I too believe that if there is not chance of survival or no real benefit to the patient, an operation can be forgone.
But, this case is fascinating in that way that it is not entirely Dawson’s choice, rather it’s his parents.
Because his parents are his primary caretakers, it is very much their decision as it is Stephen’s to see if the surgery should take place. Since Stephen’s autonomy is at question, his parents making the call to ultimately ‘save his life’ directly impacts them. I feel that the opposing sides to this argument should consider that emotional, physical, and financial toll it will take on his parents if Stephen continues to live against his wishes.
I feel like another medical controversy similar to this would be the idea of euthanasia. In this case, Dawson and his family is forfeiting a surgery that will knowingly kill him in the future. But for people who aren’t in the same position. For people who have terminal illnesses that also cause intense pain, should they be allowed assisted death if they were fully consensual to it. I feel like they should for the same reasons presented in this case.
Span, Paula. “Physician Aid in Dying Gains Acceptance in the U.S.” Nytimes.com. N.p., 16 Jan. 2017. Web.
“Palliative Care / Hospice Care Pain / Anesthetics Euthanasia and Assisted Suicide.” Medical News Today. MediLexicon International, 8 Apr. 2016. Web.
Hello Kiana!
Thanks for such a well-structured blog post and clear opinions on the case. This comment applies to your post as well as Jack’s and Arianna’s comments. I agree with you and Jack in the sense that this is a very difficult situation to be in, with many contributing factors from a variety of fields. I would also agree with you that she surgery could be forgone if the above was true, but I agree with Judge McKenzie’s ruling in this case mainly because of issues involving primary caregivers. While Stephen’s parents testified the details of Stephen’s situation including physical and mental disabilities as well as issues of time, Stephen spent much of his time at the Sunny Hill care center, so much that those caregivers became his primary ones. The testimony from the Sunny Hill workers described Stephen “‘to be a happy little fellow despite his handicaps'(McKenzie)” (Case 6.4), responsive, and with potential. There is no way to be absolutely sure of how Stephen will progress after receiving the surgery. Because of this testimony, I am hesitant to agree with the forgoing of surgery. I would like more information in this case on the relationships of Stephen to his caregivers to further develop an opinion, but as it stands, I would not rule out the surgery.
Thanks again!
Elisabeth Crusey
Works Cited
Thomas, John, Wilfrid J. Waluchow, and Elisabeth Gedge. “Case 6.4: Stephen Dawson: Should Severely Mentally Challenged Patients Be Treated?” Well and Good: A Case Study Approach to Health Care Ethics. Peterborough, Ontario: Broadview, 2014. 229-35. Print.