Clinical and Psychosocial Facts
As it follows from the case, the most important clinical facts include the child’s critical condition, her inability to breathe, further deterioration of the child’s health, and no chances for recovery. Apart from that, there is another child in the case who needs cardiac transplantation as soon as possible.
The key psychosocial facts relate to the difference of opinions that increases parents’ stress. Obviously, the parents are the only people who represent the wishes of the patient in the case. Unlike the mother, the father sees nothing good in donating his daughter’s organs. The ethical dilemma occurs due to the conflict between parents and lies in the necessity to choose between two alternatives: remove life support to save another child or let the girl die naturally.
Alternatives in the Case
The girl’s parents are the key decision-makers in the case, and this is why the alternatives that can be taken into account represent their wishes. The mother thinks that it would be right to remove life support to help the infant to release from suffering and retrieve her organs to help another couple. Among the advantages of this position is Melanie’s ability to think about other people who need help. The above-mentioned position seems to be viable when it comes to the concept of the greatest good used in utilitarianism since the decision to apply it would save another child’s life (Collier & Haliburton, 2015).
However, in terms of disadvantages, the alternative proposed by Melanie would make her husband suffer even more. The decision to remove life support and retrieve organs within the next ninety seconds would run counter to Luke’s beliefs about how people should die. The option would not violate laws since full-aged relatives of people in critical condition are allowed to make decisions on life support removal if patients’ condition constantly deteriorates.
Luke believes that it is right to remove life support only when the person’s suffering becomes unbearable. In his opinion, making decisions about organ donation when the person is still alive is morally inappropriate. Speaking about the advantages of the decision, it supports the principles of autonomy and people’s right to natural death. However, it also has disadvantages such as the inability to help other children. Significant violations of laws are not involved, and it makes both options viable.
Relevant Values and Principles
Being a newborn, the patient is unable to support any value system. The religious beliefs of the child’s parents are not specified, but their conflict lies in different values. In this case, the father emphasizes the role of patient autonomy and informed consent, whereas the mother supports the principle of utility to transform her grief into another family’s happiness. The physician seems to stand in full solidarity with the child’s mother and tells that removing life support would be better for the girl. Thus, the bioethical principles involved in the case are autonomy and the sanctity of life.
The Conflicting Principles
The principles involved in the decision proposed by Melanie can be partially supported with the help of utilitarianism. In this theory, actions are considered right if they have more positive than negative outcomes (Collier & Haliburton, 2015). Given that the child has no chances to survive, using her organs to help another baby would make at least three people (the recipient and his/her parents) happier. To some extent, it can help the child’s parents to survive the loss of their daughter since her death would not be purposeless. Put crudely, better outcomes for at least four people outweigh the displeasure of one person. Thus, it is important to support the principle of utility.
In terms of Luke’s decision to remove life support only before the child’s natural death and do not retrieve organs, it can find support in Kantian ethics. According to it, each person has the duty of self-preservation, and the transplantation decision made by parents would, in a certain way, prevent the child from fulfilling the duty (Articulo, 2014). The principles defended by the father can be supported ethically, but rejecting them would provide benefits for the majority of stakeholders.
Recommendations
As for the first recommendation, Luke should learn more about the situation of another couple to understand that he has the power to decrease other people’s suffering. This recommendation is aimed at emphasizing the principle of utility discussed above – given that an infant heart supply is extremely low, only a miracle can save another child’s life if Luke rejects to donate his daughter’s organs. The strong points of the recommendation include an opportunity to make Luke reverse his decision and get distracted to get through grief. However, some people would regard it as an emotional manipulation, which presents a limitation.
Also, the physician can be recommended to inform Luke about the consequences of keeping the child under intensive care as long as possible. In terms of advantages, it would help Luke understand that removing life support would prevent his daughter’s unnecessary suffering and, therefore, promote the principle of utility. However, this option also aims at changing Luke’s priorities, and the physician would have to interfere in the decision-making process.
Reflection
Emphasizing outcomes, I believe both recommendations to be viable since their ultimate goal is to save another child’s life. However, I do not think that attempts to impact people’s decision-making in such cases are fully appropriate. As for the emotional impact of the story, the case study still seems shocking to me because any option would make the girl’s parents suffer since this pain is irreparable. In real life, it would be extremely difficult to give any recommendations to these parents.
References
Articulo, A. (2014) Living organ donation, beneficient helping, & the Kantian concept of partial self‑murder. Open Journal of Philosophy, 4, 502‑509. Web.
Collier, C., & Haliburton, R. (2015). Bioethics in Canada: A philosophical introduction (2d ed.). Toronto, Ontario: Canadian Scholars’ Press.