Dilemma:

Stephen Dawson is a severely mentally disabled seven-year-old who was born prematurely in Canada. Ever since he was two he has been rapidly declining in health and currently he needs 10 hours of daily care to live. He cannot eat, take medicine, or do any of his basic needs by himself. Currently he is in need of a critical surgery in which a shunt has to be placed in Stephen’s brain in order to drain out excess cerebro-spinal fluid. Initial Stephen’s parents consented to the surgery but the next day they decided against it. They believe Stephen’s life is painful and unhappy and that the boy deserves to die in peace. Immediately after this decision, the superintendent of family and child services decided to get involved in order to assume custody of Stephen. They filed a petition for temporary custody, which was ultimately granted. How was this decision made? Was it right for the parents to lose autonomy over their own child? Who should have the authority to make the decision over those not competent to make healthcare decisions themselves?

Discussion:

This situation has a range of issues to be considered. For one the quality of the life of the child is an important aspect of this case. In testimonies by the parents, it is stated that Stephen has to be forced to eat, chew, and take medication. This child also has a severe seizure disorder as well as being blind and largely unresponsive to the world around him. Stephen’s family spends an average of 10 hours taking care of him a day along with having two other children around the same age. It is evident that Stephen’s quality of life is largely compromised and has been reduced to him having little to no control over his life. Secondly I think of the distinction between extraordinary and ordinary in terms of the surgery that is needed. Is this surgery largely unneeded and only a temporary Band-Aid to Stephen’s many mental disabilities or a life saving treatment that is going to ameliorate Stephen’s quality of life? Is this an extraordinary intervention or an ordinary treatment along with many of Stephen’s other medical aids? As decided by the judge, the surgery is largely extraordinary and is stated by Judge Bryne would “constitute cruel and unusual treatment of Stephen” (Thomas et al., 2014).
Using this information and the ethical concerns discussed above, I would agree with the parents in deciding that the surgery is not necessary and Stephen should be allowed to live out the rest of his life peacefully. I also think that it should be the parents’ decision to make. While it is true that the doctors and medical staff understand the technicalities of Stephen’s condition and the intricacies of the surgery, they still shouldn’t have autonomy over Stephen. The clinical stuff should be able to consult the parents on the decision as well as give them advice but they shouldn’t have autonomy to decide the fate of another person’s child.
The decision to withhold treatment for a child should be a deeply thought out and acknowledged from all angles. The staff at the foster home in which Stephen spent some time, Sunny Hill, felt as though he experienced happiness to the environment around him. The professionals at this center found Stephen to be, “a happy little fellow despite his handicaps” (Thomas et al., 2014). This shows that maybe Stephen needed to be in a more stimulating environment in order to show more of a response or improvement. This picture is different from the one depicted by Stephen’s parents. I think it is important for his parents to consider this narrative and thoroughly understand the risks and benefits of the surgery. If in the end they were to decide that withholding treatment is what is best for their son, then I think that decision should be respected.

Works Cited:

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well and good: a case study approach to health care ethics. Peterborough, Ontario: Broadview Press, 2014. Print.