The Ethical Dilemma of Forced Chemotherapy on a Teen

Introduction

Article Summary

What Are the Key Points to the Article?

The article is about Cassandra, a 17-year-old teenager from Connecticut. In 2015, she refused to keep receiving chemotherapy to treat the Hodgkin’s lymphoma she was diagnosed. Lymphomas are cancers that begin in white blood cells. The dilemma rises from two ethical principles. The first principle is the respect for autonomy. This principle in medicine states that specialists should always respect the autonomy of a patient. The respect is not only a substance of attitude, but it is a manner of acting and recognizing the autonomous actions of the patient. This approach allows people to refuse to undesired medical practices, even lifesaving therapies. And the second ethical principle is “beneficence,” which “directs physicians and hospitals to maximize benefits and minimize harms in caring for patients” (Macklin, PH.D., 2015). Sometimes the beneficence principle is confused with the ethical principle of non-maleficence, which says that physicians or nurses should not do harm to patients. Specialists have to protect their patients by preventing terrible situations and promoting excellent practices. 

What Conflicts or Controversies Does It Raise?

The main issue with this case is that Cassandra is still legally a minor. Her parents have the authority to make medical decisions on her behalf. Cassandra’s mother did not want her daughter to stop receiving the chemotherapies since she had hope that Cassandra could be free of cancer. So, her mother refused to her daughter’s desires. The dilemma went farther than Cassandra’s mother expected. Cassandra presented a legal request against her therapies in the Connecticut Supreme Court. The court had the decision to allow Cassandra stops the treatments or force her to keep getting the medications. The court removed temporarily the custody from her parents. Cassandra was not permitted to have a cellphone or any communications with her mother unless a guardian was present.

According to the article, the Connecticut Supreme Court on January 8 of 2015, supported the decision that the 17-year-old teen had to continue with the chemotherapy against her will (Macklin, PH.D., 2015). The court said that there was an 85 percent chance of surviving the cancer by treating with the chemotherapies. In addition, the ethical area is whether the law is violating Cassandra’s decisions as a human being or if the law is applying the beneficence principle. The article also establishes that it might be possible that a forced medical treatment would do better than harm. However, the patient is who suffers the side effects for six months. Before the court’s decision, Cassandra continued her arguments in which she established that the Connecticut Department of Children and Families had her to go through a medical evaluation and placed her in a foster home until the court date. The most unethical situation was when the hospital strapped her to a bed and sedated her.

Where Can You Offer Analysis or An Original Point of View?

Many people disagreed if the teenager should be forced to receive the medical treatments against her will and putting her in a foster home. The fact was that the 17-year-old remained in the hospital until she received her final phase of chemotherapy at the end of April in 2015 (Kedmey, 2015). Although Cassandra is still a legal minor, the unethical actions of the hospital and the child welfare cannot be justified. Connecticut has no law on this issue—no develop minor precept—yet additionally no case law. Neither has the U.S. Preeminent Court controlled on this issue. In this way, the case could change therapeutic basic leadership control for some youngsters in that state. All things considered, 18 is a discretionary cut off point. At 17 years and 356 days old you cannot settle on your choice. However, after 1 hour when you are 18, you can.

This case was an ideal circumstance for ethics conference. In an encouraged dialog, there could be an important and valuable discussion. What does Cassandra know about her condition? What does she comprehend about the medicines? What is her comprehension of the dangers and advantages? Of what is she confused? For what reason does she hate chemo (and are there steps that can be taken to lighten her concerns)? What does she think about death? What is vital to her? I think there is also the problem of a mother with the fear of failing her entitlements to choose for her daughter just because the teenager disagreed with the medical treatments. Cassandra might die without chemotherapy that is a terrible situation and the mother will feel worse for not supporting Cassandra in that case.

However, I do not think that a mother who loves her children will allow them to die because they are not been treated correctly. Mothers have amazing courage, and some people say that their love is the most similar to God’s love. Cassandra’s mother is willing to support her daughter and stand up for her. We have to think about how Cassandra’s mother will feel if her daughter dies because she gave consent to stop the treatments rather than saving her daughter’s live. She will ask to herself “what if?” for the rest of her life. “what if I did not accept my daughter’s will? She probably would be alive” So, I believe that in some ways the court allows Cassandra to fight for her live, and the mother to support her daughter in the process rather than letting her die without doing nothing about it. Cassandra’s mother would have more regrets by letting her daughter die without chemotherapy than experiencing the death of her daughter but knowing that she did everything to save Cassandra’s live. 

Create Your Own 2-4 Paragraph Dilemma

An accountant is being asked by his manager to manipulate reports for his benefits and company’s reimbursements. The employee has two options, which are: 1) to follow the rules shown by the company’s officials and bring the immorality to notice or 2) to accept the manipulation. The employee is analyzing his personal financial situation because if he accepts, he will be promoted. However, if the he does not accept, he might get fired later on by his manager for any other little things not even related to the unethical situation. He is thinking about he has a wife and a baby on board that he has to take care of. His wife does not work due to her eight-months pregnancy. So, what will he do about it? He cannot lose his job because he has a huge responsibility at home, but he is an extremely ethical employee who likes to do what is right.

However, the employee noticed that his manager is being making unethical decisions. When he was asked about manipulating the reports, he remembered that the last month his supervisor entered to his office and ask him for a check for $300.00 for expenses he tells he incurred entertaining a client that night. The manager submitted the receipt from the restaurant. However, the employee did not know at that time about his manager unethical issues, and he gave the manager the check. After a couple of hours, the manager’s wife stops by the office to pick him up for lunch, the employee heard her telling the receptionist the great time she had at dinner with the manager the night before. Now, the employee knows that the manager has these issues. What would be the best action of the accountant? Can he proceed to manipulate the reports knowing that his manager lied to him last month? Or does he have to be ethical even if it means losing his job with a pregnant wife who is not currently working?

Apply Kant’s Categorical Imperative to The Problem You invent

According to this week’s lecture Immanual Kant created the Categorical Imperative theory, which states that “people should act only according to that maxim whereby they can at the same time will that it should become a universal law” (Week 4: Lecture). Kant means that individuals should act in such a way that you treat humanity, whether in your own person or in the person. Immanual Kant also thought that if a person believes that it is wrong to lie, then the person should never lie, even if the end result is not good. He said in his theory that if lying is wrong, then it is always wrong. Therefore, Kant’s Categorical Imperative applies perfectly to the dilemma I have               invented. The problem states that the employee has been asked to manipulate some reports for the benefit of the manager and the company. Immanuel Kant would not never agree with the situation. Kant would say that if the employee is ethical, he would not accept to manipulate the reports. According to Kant’s theory, the account believes that his manager’s actions are unethical, then it will be always wrong to help his manager to manipulate the reports, even if the end result is not good. The end result in this situation is that the employee will not get promoted. He will probably lose the job having a pregnant wife at home.

If the worker does not apply Kant’s Categorical Imperative approach, he will be lying to the people in charge of analyzing the company’s report. He also will be acting conscious because of the previous situation that happened with the $300.00 check. The employee did not know about the wrong circumstance until he heard his manager’s wife talking with the receptionist. In that case, he will not be blamed by Immanuel Kant. However, the worker knows about the wrong action that the manager did last month, and the unethical practice that the manager wants to do with his help. This means that he is extremely aware of the wrong practices. Therefore, if the employee thinks that these actions are wrong, it will always be wrong to help the manager in any kind of situation to hide the truth.

Apply Any Other Method You Have Encountered in Lecture Material and The Readings

The first method I would like to apply is the John Locke philosophy. He stated that pleasure is the standard of moral judgment. Locke said that sensations of pleasure or pain lead us to reflect and wrong views of justice and goodness to develop a system of moral judgement (Ruggiero, 2011, pg.148). The accounting employee has not experienced any pleasure since he is not promoted yet. He has not felt pain because he needs to make the decision whether to help the manager or not. The second philosophy is from David Hume who thought that the standard of moral judgement is two-sided. One side of it is objective, which relates to the consequences of action in question. The other is the dominant side that is subjective with a feeling of pleasure.

According to Hume’s theory, the employee’s moral sentiment chooses what is useful. However, if the accountant decides to help his manager would be only for obtaining the promotion. This is defined by Hume’s belief of not doing what we wish. He believed that every human tends to be more pleased by benefiting others than by being selfish. It can also be viewed in another way. Let’s say that the employee does help the manager, he will be taking the decision for two reasons. First, he is very ethical and do not want to compromise his values. And second because his wife or the people who are around him advised him to do not do it. In that case, he will be pleasing everybody else.

The next philosopher is Aristotle who developed The Doctrine of the Mean. Aristotle states a kind of schematic of virtues to be contrasted with an excess of a virtue and deficiency of it. In the dilemma, the employee is not acting neither in an excess manner nor in deficiency. However, the manager is guiding his emotions in extreme and deficiency. For example, if the employee decides to manipulate the records, the manager promotes the worker. But if the employee does not agree, he most likely will fire the employee. The accountant has courage, but he is not foolhardiness. He is not cowardice because he would not accept the offer due to his personal values.

Finally, Saint Thomas Aquinas communicated that ethics has two dimensions, which are 1) the natural ethics that is based on accomplishing the virtues of hope; 2) theological ethics that describes the achievement of faith, God’s grace, eternal life with God, and charity. Hence, the manager is making the wrong decisions, which means that God will not be content with his behaviors. Aquinas’ and Kant’s way of thinking are similar to God’s laws. In the God’s rule, people should not lie about anything. So, the employee is doing his job, but he cannot agree with the wrong practices.

State Which Method You Prefer and Why

For this particular dilemma, I prefer Saint Thomas Aquinas and Immanual Kant method. If we analyze the problem by using Aquinas’ statement of theological ethics that describes the achievement of faith, God’s grace, eternal life with God, and charity, we will say that the manager actions are against God’s point of view. God’s laws written in the Bible are similar to Kant’s philosophy. Lying is listed as a sin in the Ten Commandments: “You shall not bear false witness against your neighbor” (Exodus 20:16). From the earliest of times, lying was seen as sinful. This was made evident in the condemnation of the serpent’s lie in the Garden of Eden, which is written in Genesis chapter 3, and God’s judgment upon him.

Therefore, lying is the opposite of God’s truth. The Bible says in John 2:21, “I write to you (God), not because you do not know the truth, but because you know it, and because no lie is of the truth. Therefore, the accounting employee should never manipulate or lie about the company’s records because lies are always lies. The manager’s unethical actions will be questioned by both Kant’s method and God’s rule. Kant says that lying is always morally wrong, that lying is never right. This is based on a conception of subjectivity. Indeed, he argues that all people are born with an “intrinsic value” he calls human dignity. This dignity comes from the fact that humans are rational agents, capable of taking their own decisions independently.

References

• Kedmey, D. (2015). Connecticut Teen Ordered to Stay in Hospital for Forced Chemotherapy. Time.Com, N.PAG. Retrieved from http://web.a.ebscohost.com.proxy.devry.edu:5050/ehost/detail/detail?vid=0&sid=aad4bd92-12cc-4a75-aff9-01475b3acf93%40sessionmgr4010&bdata=JkF1dGhUeXBlPXVybCxjb29raWUsaXAsdWlkJnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=101921327&db=a9h
• Macklin, R., PH.D. (January 12, 2015). The Ethical Dilemma of Forced Chemotherapy on a Teen. Retrieved fromhttp://blogs.einstein.yu.edu/the-ethical-dilemma-of-forced-chemotherapy-on-a-teen/
• Ruggiero, V. (01/2011). Thinking Critically About Ethical Issues, 8th Edition. [Bookshelf Online]. Retrieved from Ruggiero, V. (01/2011). Thinking Critically About Ethical Issues, 8th Edition. [VitalSource]. Retrieved from https://online.vitalsource.com/#/books/0077794575/
• Week 4: Lessons. (n.d.). Immanuel Kant (1724 – 1804). Retrieved from https://devryu.instructure.com/courses/32316/pages/week-4-lesson?module_item_id=3850503