Dilemma:
Stephen Dawson is a severely mentally challenged seven year old kid that requires a simple yet critical surgery. His parents give their consent for the surgery at first, yet after a day, they have a change of heart and decide to refrain from the surgery in an effort to end his suffering. After learning this, the superintendent of family and child services decided to take the case to court where custody was granted to the parents. Following a petition to the case, custody was then temporarily granted back the superintendent where the surgery was performed. Was this right? Who should decide on Stephen’s life?
Discussion:
I tend to agree with Justice Mckenzie in granting the custody of Stephen to the superintendent and promoting the life-preserving surgery. From my perspective, the parent’s decision to not consent for the surgery seems to be an effort to ease their suffering, not Stephens. Stephen is seven years old and only remained at home with an over stressed family attempting to take care of him for approximately two years. After which, he went to Sunny Hill, is a place equipped for caring for disabled children, only to be moved a year later to a foster home where the parents were told he was taking up space. He remained at that foster home for three years, until he was returned to Sunny Hill. So Stephen has spent nearly half his life in places where he was seen as a stagnant burden which may have had a negative impact on Stephen’s quality of life, yet there is some sunshine in this story. During his time at Sunny Hill, they experience a new side of Stephen that shows potential by responding to certain stimuli such as smiling at people, clapping his hands, and turning on a fan. Additionally, it is completely possible that the perspective of the parents in regard to the happiness of Stephen’s life does not accurately match Stephen’s perspective of happiness as well. Since his brain functions differently, perhaps his idea of happiness is different from ours as well. The two perspectives of Stephen paint two vastly different pictures of him. On one hand, we have a non-responsive child involuntarily clinging to life, and on the other hand, we have a child that shows promise and exhibits happiness.
I tend to think these conflicting perspectives are due to the conflicting environments Stephen was subjected to during his life. During his time in the foster home, his care was noted by the parents as sub par. In addition to this, his parents themselves complained about being unable to provide proper care for Stephen which was their reasoning for placing him under the care of Sunny Hill initially. While I do not question the parent’s values for initially placing him under someone else’s care, I do think that leaving him in the foster home with low quality care was a poor choice. The case does not list any financial drawbacks of Sunny Hill to explain Stephen’s presence in the foster home, so I wonder why he was not placed back into Sunny Hill if he seemed to have good experiences there. Nevertheless, a facility fully equipped to care for mentally challenged children is a vastly superior environment for growth compared to a overstressed home or an apathetic foster home. If Stephen actually exhibits qualities of happiness at Sunny Hill, then his care should continue under their supervision.
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.
Justin,
I really enjoyed reading your take on this case and I could not agree more with what you had to say. The best point you made here is definitely about how Stephen’s care should be put in the hands of people who know him best and have spent the most amount of time caring for him during the last few years of his life. While I also agree that the parents mean no harm in sending him to Sunny Hill and foster care, as they do have other children to care for, I do not think that they should have as strong of a say in the decision as they do.
Since this decision essentially comes down to giving Stephen a treatment or not, I think it’s important to look at the evidence in the differences between withholding and withdrawing a treatment as reasoning behind what the parents did what they did. While it is impossible for us to know about whether the parents wanted to “allow Stephen to die” (Thomas et al., 229) to end Stephen’s or their own suffering, what we do know is that “many professionals and family members feel justified in withholding treatments they never started, but not in withdrawing treatments already initiated” (Beauchamp, 158). With this is mind, I think that it is safe for us to assume that there was a bit a selfishness in the parent’s decision not to continue treatment because they would otherwise feel far less justified if they went through with it initially and stopped/removed the tube midway through.
Even though I don’t think that the parents should be the ones to make the final decision on Stephen’s life, I don’t necessarily think that the parents made this call strictly for their own good, as Stephen is their son and they have been providing care for him one way or another for many years. Though, I do see the timing of the situation being very opportunistic. In cases such as this, I believe that the most frequent care taker alongside a licensed physician should be the ones to make a final call on a completely handicapped individual’s life.
Works Cited:
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. Print.
Thomas, John E, et al. “Case 6.4: Stephen Dawson: Should Severely Mentally Challenged Patients be Treated?” Well and Good: Case Studies in Biomedical Ethics, Broadview P, 1987.
Hi Justin,
Great article! I have the same view when looking at Stephen’s quality of life. To the parents Stephen might seem like he has an undesirable quality of life. I am inferring that the parents are healthy and have never had/experienced a disability as serious as Stephen’s, and therefore have no way of knowing what Stephen is actually going through. Stephen was born with this disease and has not had any experience of anything different so his quality of life is inevitably going to be different than a healthy person’s quality of life. This means that while outsiders might see Stephen as suffering and struggling, Stephen might see himself as having the time of his life. I agree that the parents made a lot of poor choices in making decisions about Stephen’s health care. It seems as if from the beginning or at least when they had enough of taking care of Stephen, they essentially gave up on him. I understand that taking care of Stephen is a lot of work but I also feel as if they are using the excuse that he has a bad quality of life and therefore should not have the treatment to take him off of the list of things to worry about.
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.