A. Walker Resources

Walker, L.A. (1987, November 29). Seven of the toughest decisions a doctor may face. Parade Magazine.

OVERVIEW

Today’s teenagers want to discuss bioethics. This article will get a discussion going. "Technology, the sorcerer’s apprentice, has brought us incredible good, yet we’re confronted with more confusion than ever before." The author cites the anxiety of many doctors, the increase of medical insurance premiums and medical lawsuits. Issues found mostly in ponderous textbooks are here presented in a way that challenges youthful consideration. A clergyperson, lawyer, and doctor will make this a very significant discussion.

• "How do you decide when it’s time to pull the plug?" Brain-dead patients have recovered—even when the family has asked that they be allowed to die in dignity. Others in comas for long periods of time have come back to normal life. Recovered patients and family are now glad for efforts to preserve life. On the other hand, many have suffered terrible loss of dignity—at high financial cost to hospitals and family. Who and how are we to decide? How do religion and the legal system advise doctors and families?
• "What do you do when insurance companies won’t allow ample hospital time?" Dr. Jennifer Gordon of Boston Children’s Hospital says, "Some patients might be fine in the hospital after three days for a certain procedure. But some who aren’t ready to be released go home and get sicker. Then they have more complications and far more suffering. It’s crazy."
• "Who gets the one available kidney: a 45-year-old woman or a 53-year-old man?"
• "How do you feel about abortion?" One doctor admitted: "I don’t know what I would do if I knew my wife was carrying a severely retarded child."
• "What happens when patients do not want to know they have cancer?" Sometimes neither partner in a marriage will face the reality of a terminal disease. It is painful when a husband denies and refuses to discuss his wife’s cancer.
• "What about in vitro fertilization?" How far should we go in allowing people the power to choose a suitable parent for their child?
• "What do you do with a baby so handicapped there is no hope of it leaving the hospital?" Dr. Gordon describes one such case: "Each shift had as its aim keeping her (an infant with virtually no brain function or hope of survival) alive for 12 more hours, yet the entire pediatrics house staff secretly wanted her to die. In this case, medical intervention was an extremely destructive force (on divorced parents and medical staff)." This one child in a vegetative state cost the hospital hundreds of thousands of dollars. "And yet," Dr. Gordon continues, "I know that other children and adults with potential for perfectly normal lives couldn’t get care because they couldn’t afford it. All the money the hospital might have used to absorb those costs was spent on one child." On the other hand, some homes have been greatly blessed in caring for such a special child who defies medical predictions of early death and lives happily for many years.

IMPLICATIONS

1. Curious and idealistic young people are deeply interested in such issues. They want to develop an adequate life ethic, and such discussions help them to move from "privatistic" and relativistic morality to universal principles that stick.
2. Adolescent morality can become confused oversimplifications and a "black and white approach" to complex issues. Thoughtful consideration of these issues demonstrates the greys of so many real situations. It can develop a necessary tolerance for other viewpoints.
3. There are several goals of such discussions:

• • To develop a sense of compassion toward those in need.
  • To develop thoughtful skills of analysis.
  • To become involved in meaningful service projects.