Giving birth to eight children to bring the total number of family members to 16, father and mother included can be a tricky decision. This could trigger conflicting responses from all concerned subjects including close family members and friends. This is what Suleman expected when she decided to keep all her eight children when she gave birth to octoplets. After the issue became public, several steps were taken including investigating the concerned doctor to establish whether he had observed biomedical ethics during the process of planting the six embryos in Suleman’s womb. The doctor’s decision to implant six embryos and allow them to grow was quite unprofessional. He completely failed to consider the ethics before making his decisions.
Before tackling the issue, it is important to understand the four major ethical principles that govern doctors’ decision making processes. The four principles include the principle of autonomy, the principle of beneficence, the principle of non-maleficence and the principle of fairness or distributive justice (Mappes & Degrazia pg 448).
The principle of autonomy usually determines a patient’s own decision concerning medication. These are decisions that he makes and feel that are of his interest. The principle gives the patient rights to make decisions that promote his interests. It also gives the right to the patient to choose whether to accept medication or not, the kind of privacy he needs and also the issue of truth telling. The doctor is therefore placed under obligation to obey all the decisions made by the patient during decision making. The doctor’s treatment decisions are not supposed to interfere with the patient’s rights.
Under the principle of beneficence, the nurse is given the right to make decisions that will benefit others. The needs and welfare of the clients have to be given priority in every ‑decision making process. The doctor is therefore given power to make a decision which he deems fit for the patient. This is one principle that has caused debates due to its controversial status. In some instances, the principle has led to paternalism, a state that favors the decision of the doctor without putting into consideration the patient’s views. This principle places the doctor under obligation to make decisions that are sound and informed during the process of care giving and treatment. This can also happen when the patient is seen to be in a condition that will not allow him to make sound decisions due to unavoidable circumstances including illness.
The principle of non-maleficence prohibits the doctor from inflicting any harm to the patient and also protecting the patient from any form of harm. In some cases, there are situations that inevitably require some form of harm. In such instances, the doctor has to minimize such harm to the lowest possible rate. In addition, the doctor should also be in position to anticipate any form of harm that the patient is likely to face under the given circumstances. This harm does not only include physical harm but also making the patient feel powerless and helpless is a form of harm (Mappes & Degrazia pg 450). This principle can be achieved by ensuring that the there is a good communication network between the doctor and the patient. The doctor can also fulfill this principle by ensuring that he meets all the standards of care that are not below the professional level and competence. Finally, the doctor can also achieve this by ensuring that he makes accurate risk assessments and also using evidence based approach.
The fourth principle is the principle of justice. This principle gives every individual the right to be accessible to good medical and health services. Doctors should not make their decisions basing on the status of a person. For example, the rich should not be given better attention while the poor are sidelined. It is therefore the responsibility of practitioners to ensure that they champion for the rights of all members of the ‑society to access primary health care through promoting reforms in different levels of the society which will give the member from each level the access to primary medical care.
The most important issue in this case is the wellbeing of Suleman’s children. It is this issue that has led to the uproar. Putting into consideration the fact that Suleman is an unemployed graduate student and the cost of upbringing these children estimated at 135,000 dollars per month, the wellbeing of the children is put in question. It is very likely that the children will suffer because their mother will not be in position to give them basic needs. It should also be noted that the children are not in position to complain or make any decision; the issue gives the principle of justice an upper hand. The doctor has the obligation to ensure that every individual in the society is in position to access primary medical care without being obstructed by his social status. From the situation at hand, the wellbeing of the kids is threatened. It is therefore important that the doctor considers their future.
The person to blame in this case is the doctor. His main failure was failing to make an accurate risk analysis as obligated by the principle of non-maleficence. The principle of non-maleficence places him under the obligation to ensure that no harm is inflicted to his client. This is done also by closing all avenues that could lead to harm. By allowing Suleman to have 8 more children, the doctor subjected 14 people to probable harm.
This decision will be supported by the principle of beneficence. The doctor is given authority to make sound decisions that will benefit the client. In this case, the client has decided to have all the children. Bound by the principle of autonomy, the doctor might be forced to go by the patient’s decisions. But let’s view the same from this angle. This is one Suleman and there are 14 children. It is therefore the interest of one person (Suleman) versus 14 other people ‑who, due to the circumstances, can not speak out their views. It is therefore a matter of considering the numbers in question (Singer par. 2). Basing on the principle of beneficence, the doctor has the right to make sound and informed decisions sometimes without basing on the views of his clients.
In conclusion, the doctor had all the powers to help assist the children from miseries that are likely to befall them by reducing the number of children. This could have been possible if he based his decision making on the biomedical ethics by doing the correct risk analysis.
References
Mappes, Thomas & Degrazia, David. Biomedical Ethics. McGraw-Hill, 2005
Singer, Peter. Putting Practice into Ethics. The New York Sun. 2008. Web.
Sherwin, Susan, Foundations, Frameworks, Lenses: The Role of Theories in Bioethics. Bioethics, Vol. 13, pp. 198-205, 1999. Web.