Background

Henrietta Lacks was a poor African American woman who died of cervical cancer in the 1950s at the age of 31. She was married and had five children. Following her death, a biopsy of her tumor was taken for research. She was given treatment for free at a public hospital and in return, samples of her cells were taken for research purposes. This was a common way in those days to obtain research. The cells that were acquired from Henrietta kept reproducing. They became the first cells to reproduce in a laboratory setting. Henrietta’s cells were used in varied ways including finding a vaccine to help prevent diseases such as polio. Scientists continued using these cells for different purposes and many businesses profited greatly from them as well.

Dilemma

There are two important ethical dilemmas presented in Henrietta’s case. The first dilemma involves whether a patient should give consent for their cells to be used for research and at the same time remain anonymous as to whose cells they are. In this situation from the 1950s, Henrietta was not asked for consent. However, today if the patient is competent, they are required to give informed consent. If they are not competent, the family of the patient is usually asked to give consent on their behalf. Therefore, consent should not be an issue today. Also, in this case, there was no anonymity. The public found out that the cells came from Henrietta Lacks and they were labeled HeLa cells. The ethical question of keeping a person’s identity anonymous is also usually not an issue today. Respect is given to a person’s privacy and people contribute their cells without labeling whom they came from. Another ethical dilemma in this case involves whether patients should be compensated for being a part of research. In this case, there was no compensation given to Henrietta or her family for using her cells in research. Today, patients are encouraged to participate in studies and are given a compensation for their time. Although some patients are offered compensation, many voluntarily donate their cells for scientific research.

Reflection

In my opinion, Henrietta Lacks’ family should have been given some compensation. Her cells went on to provide many scientific benefits in research as well as a profitable industry. One form of compensation that I feel is appropriate in this case could possibly be in the form of healthcare. Henrietta’s family was poor and their daughter stated that they couldn’t even afford to visit doctors when needed. I find this situation unfair, especially since many businesses received a profit from her cells. It was publicly known that they were Henrietta’s cells and thus, it only seems justifiable that they should at least receive something in return. Therefore, I agree with how society handles donations today in keeping them anonymous. Donors do not typically find out about findings from their specific donations. This way, scientists can objectively research and use the information to advance cures for the wellbeing of society. These donations help medicine advance to find new treatments and cures for future generations.

 Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Skloot, Rebecca. The Immortal Life of Henrietta Lacks. New York: Crown, 2010. Print.

Thomas, John, Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. N.p.: Broadview, 2014. Print.

Background

In the case, “Confronting Death: Who Chooses, Who Controls?” a man named Dax Cowart was severely injured in a propane gasoline accident. Most of his body suffered from deep burns, in addition to leaving him blind and losing the use of his hands. His father was killed in the explosion, which left him in emotional pain aside from his physical agony. He endured burn treatments the following year that were extremely painful. Dax also made two videos, one of which was entitled “Please Let Me Die.”

Dilemma

The main ethical dilemma involves whether a patient’s decision to die should be respected. Dax had wanted to stop his treatments and requested to die. Even though the psychiatrist stated he was competent, the doctors did not listen to his request. A critical issue involves at what point does the patient understand all the risks and benefits of his situation. His decision should be voluntary and based on informed consent. One side of the argument believes that although Dax had requested to die, they felt he was emotional because of his disability now and since his father had just died. On the other side, Dax was in extreme pain and was declared competent. It was his autonomous decision whether to die.

Reflection

The central issue in this case can be argued for both sides. In my opinion, the doctors felt he did not clearly understand his situation concerning recovery. As doctors, they felt it was in his best interest to continue the treatments. Doctors have a duty to take care of their patients and to help them survive if it is possible. If the doctors believed that they could improve his quality of life, then it is in the patient’s best interest to have the surgery or treatment. For this reason, the doctors did not listen to Dax’s wish to die. Additionally, I think people often become more irrational and feel as if there is no way out when they are in such pain. Was Dax in the state of mind to make these decisions correctly? In this state of suffering, the patient may only be able to see the short-term picture of the situation. The doctor is able to see the long-term picture and come to a proper decision. Dax later admitted that he didn’t understand that he could have the quality of life that he has now. If he had been in less pain when he was being treated, then he may have wanted to continue to live. He states, “Today I am happy; in fact I even feel that I’m happier than most people. I’m more active physically than I thought I ever would be” (RD p. 17). Today Dax is a practicing attorney in Texas. Therefore, I believe the doctors were correct in disregarding Dax’s decision to die. They made an ethical choice to do what they felt was in the best interest of their patient with the possibility that he could recover and live a quality life. Dax recognized that he would be “willing to forgo some of my own autonomy in the interest of better decisions being made (RD p. 24).

Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. Seventh ed. New York, NY: Oxford UP, 2001. Print.

Cowart, Dax, and Robert Burt. “Confronting Death Who Chooses, Who Controls?” JSTOR. The Hastings Center, n.d. Web. 18 Mar. 2015. <http://www.jstor.org/stable/3527969>

Background

In the case, “Relational autonomy or undue pressure? Family’s role in medical decision-making,” a man referred to as Mr. M is in the intensive care unit due to respiratory failure. Mr. M specified to the healthcare team that he would not want any particular utilized to prolong his life. However, after speaking with his wife, Mr. M changed his mind. Since they were both immigrants who spoke a different language, the healthcare team did not know exactly what was said in their conversation. The doctor believed that Mr. M’s wife infringed upon his autonomy since he was competent at the time. This case therefore displays the worry some have regarding how involved families should be in adult patients’ medical decisions.

Dilemma

The main ethical dilemma involves whether a patient should make their own autonomous medical decisions or whether the family should play a role in helping the patient make a decision. Assuming the patient is competent, one viewpoint is that the patient should be responsible for deciding their course of action. Families may add pressure concerning their own interests or priorities, which may interfere with what is best for the patient. On the other hand, some feel that patients who are closely connected with their families may find it comforting and beneficial to discuss the situation with them. Together, they can review the options and come to a decision. In either case, the doctors should abide by what the patient determines.

 Reflection

There are valid arguments for both sides of the dilemma. I feel the ultimate decision lies with the patient. However, in my opinion, family plays an important role in helping the patient make a decision. It is morally correct to assume that family is genuine in aiding their loved ones. Family support in these difficult times makes the patient feel that they are not alone. If the patient has a close relationship with their family and wants them involved, then the healthcare team should respect that decision. If the patient does not want the family to participate, then the patient should inform the doctor. Doctors sometimes believe that getting family involved may not be favorable. However, unless the patient expresses otherwise, the doctor should trust that the patient understands the situation. It should not be assumed that the family and patient will have a conflict, such as pressure from the family to come to a specific conclusion. Additionally, the doctor can communicate and discuss with the patient if the interest of the family is sincere. In doing so, the doctor can be comfortable as well. In the case of Mr. M, he had a cultural difference and possibly had trouble understanding the doctors and our culture. Therefore, Mr. M probably found it more comforting to discuss the circumstance with his wife. Even though he altered his decision after speaking with his wife, it appears that it was a sincere change of mind. As I reflect on this situation, I feel that Mr. M represents the many patients that prefer to have their family involved in their medical decisions. Thus, the healthcare team should respect when patients choose to do so.

Works Cited

Ho, Anita. “Relational Autonomy or Undue Pressure? Family’s Role in Medical Decision-making.” Scandinavian Journal of Caring Sciences 22.1 (2008): 128-35. Web.

Image Sources

Patient-Centered Care: Giving Voice to Patients and Families

http://www.helpingyoucare.com/17013/nfca-calls-for-family-caregivers-to-help-support-the-center-for-medicare-and-medicaid-innovation-under-the-affordable-care-act

Background

In Case 5.4: Protecting an “Unborn Child,” a mother referred to as “G” has an addiction to sniffing glue and using other solvents. She has already given birth to three children, who have all been given up to child services. Two of those children had mental and physical disabilities due to “G”’s addiction. Upon becoming pregnant again, child services wanted to protect her unborn child and had her placed in a treatment facility. Although the lower court agreed with child services, the Manitoba Court of Appeal overturned the decision and released her from the facility. The Court of Appeal ruled that “G” had the right to make her own decision.

Dilemma

Although there are many issues in this case, the main ethical conflict involves autonomy versus non-maleficence. Autonomy is the right to make one’s own choices. This case involves the right of “G” to care for her body during pregnancy. “G” has human rights that were infringed upon by forcing her into a treatment facility. Even if a treatment facility is the best place for her to be, she should still have the right to make her own decision. On the other side of the issue is non-maleficence, which means causing no harm to the physical body. In this case, non-maleficence concerns not harming the fetus. If the mother continues to harm her body through her addiction, the fetus could be affected as well. The ethical dilemma considers at what point the unborn child needs to be protected even if it means restricting the mother’s rights.

Reflection

The central issue in this case can be argued for both sides. In my opinion, it is important to respect “G”’s right to decide whether or not she wants to be in a treatment facility. We should respect a person’s human rights and freedom of choice. However, if “G” chooses to harm her unborn child by her addictions, then I feel the responsible thing to do is to protect the unborn child. Since the child cannot make a case for itself, someone needs to look after his or her rights. I believe that if “G” continues with her addiction, then she should temporarily be placed in the treatment facility for the benefit of the unborn child. “G” should feel that she has a moral obligation to take care of her unborn child while she is pregnant. In not doing so, she could appear unfit to be a mother. Therefore, the wisest decision is to place her in the facility so that she can receive the proper assistance. Treatment facilities have been created and are available to help in situations such as these. Child services are essential in finding cases like “G,”’s where a facility would be the correct course of action. The support of child services should be taken seriously. The ethical dilemma of autonomy versus non-maleficence is a difficult one. However, I am inclined to side with the argument that the benefits of protecting the unborn child outweighs the temporary restriction on “G”’s human rights. 

Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Thomas, John, Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. Peterborough, Ontario: Broadview Press, 2014. Print.

Image Sources

http://www.salon.com/2011/05/18/what_not_to_ask_a_pregnant_woman/

http://homeopathic-treatments.com/?attachment_id=1174