Week 5 Blog- HUMN330- The Ethical Dilemma of Forced Chemotherapy on a Teen

The case of Cassandra C., a 17-year-old in Connecticut who refused to continue receiving chemotherapy to treat her Hodgkin's lymphoma, poses a genuine ethical dilemma. The dilemma stems from a conflict between two leading ethical principles. One principle, respect for autonomy, calls for respecting individuals' right to self-determination. In the medical context, that means allowing people to refuse medical treatment, even lifesaving therapy. The other ethical principle, beneficence, directs physicians and hospitals to maximize benefits and minimize harms in caring for patients.

Micrograph showing Hodgkin's lymphoma

Cassandra is still a minor which means a parent or legal guardian has the legal authority to make the health care decisions on her behalf. In this rare case the mother of Cassandra, sides with her daughters decision to not be treated. With this decision, the legal courts have the authority to overrule parent’s decision when their medical decision threatens the life or health of their offspring. On Jan. 18, 2015, the Connecticut Supreme Court upheld a lower court decision and ruled that Cassandra must continue to undergo chemotherapy against her will. Force medical treatment was given to her by the State for her to survive. They have installed a port in her chest where the drugs would be administered. It was reported that the hospital has also strapped this child on the bed by her wrist and ankles and sedated. This will be a long process of treatment, painful, uncomfortable process that Cassandra and the mother did not want to endure. In December, the state has taken custody of Cassandra and has also limited direct contact of the mother unless in the presence of a child welfare worker present, they are also not allowed to have contact by phone.

Should a 17 year old undergo such a treatment where she is forced against her will, strapped in her hospital bed and will end in a foster home because the mother choose to based her decision on the wishes of her child? Even the State who authorized the force treatment, do they really have the right to do this to a child?

Cassandra may be thankful to the state in the end if she is cured, thankful that they saved her life, thankful to the medical professionals and hospital that raised the issue. We have to wait to see what her answer is when she is completely cured.

Reference:

Macklin, R. (n.d.). The Ethical Dilemma of Forced Chemotherapy on a Teen. Retrieved April 24, 2015, from http://www.huffingtonpost.com/ruth-macklin/the-ethical-dilemma-of-fo_b_6457592.html

Week 4 Blog- HUMN330- Crowdfunding Medical Campaigns Pose Ethical Dilemma

What is Crowdfunding? Crowdfunding according to Miriam Webster is the practice of soliciting financial contributions from a large number of people especially from the online community. Wikipedia defines it as the practice of funding a project or venture by raising monetary contributions from a large number of people, typically via the internet. There are a couple articles that I have read on-line discussing the ethical issue of crowdfunding. The go-fund-me sites and other crowdfunding medical campaigns pose ethical dilemmas. Even an Ethicist, Mr. Jeremy Snyder says crowdfunding lacks transparency, only gives voice to a few people. Some online crowdfunding site like “GoFundMe” and “YouCaring” are becoming a popular way to help pay unexpected medical bills when the health-care system doesn't cover the costs.

Lynn Hume, of Burnaby, B.C., thought she would give it a try and set up a crowdfunding campaign after she was diagnosed with stage 3 breast cancer last year. She turned to the site with the goal of raising $30,000 to help her through her treatment while she is unable to work. "I set up my campaign, and then I waited. Nothing happened, and then everything started happening when I actually copied the link to my two sisters, and that's when they shared the link on their Facebook. "They emailed it to their colleagues and their clients and all of a sudden all of these donations flooded in, and so I know I'm going to be OK now."

From an ethics perspective, on the surface, there's nothing wrong with crowdfunding for medical reasons, says Jeremy Snyder, a professor in the faculty of health sciences at Simon Fraser University. "In principle it's not a bad thing. It's just another way for people who are looking for some help to raise money to get medical treatment or whatever else they might need." But also stated that he worries about how susceptible the system is to abuse. Fraud is always a possibility, he said, though he doesn't believe that's widespread.

There is also the case of a 21 year old transgender woman named Jaclyn Mae who turned to the Internet and the goodwill of strangers in hopes of funding her decision to go through with a gender reassignment surgery. "Help save a transgirl's life!" reads Mae's online crowdfunding page, which has raised $300 so far. Mae's appeal is just one of dozens of online pleas for money to help support trans men and women with the medical and other costs of their transition so they can physically present themselves, not as the gender they were born into, but as the gender with which they identify. Gender reassignment surgery cost different for each sex. For women becoming transmen, the basic procedures include surgical removal of the vagina (vaginectomy) and construction of a penis (phalloplasty), which can total $100,000. The men becoming transwomen, there is a surgery to remove testicles (orchiectomy) and create female genitals (labiaplasty), which may total $75,000. Then there is the Adam’s apple removal, breast augmentation, hair removal, a lot of out of pocket expenses still required even after the major sex organ surgery.

Some may think that this is wrong because it goes against nature. After all, we were either born with a male or female body it means that we were intended to be that way and should not be changed. The ethical consideration in this case depends on what kind of desires and values are involved. Is it right, is it human choice to change what God made us to be?

Reference:

Almanac, B. (2015, February 4). GoFundMe and other crowdfunding medical campaigns pose ethical dilemma - British Columbia - CBC News. Retrieved April 18, 2015, from http://www.cbc.ca/news/canada/british-columbia/gofundme-and-other-crowdfunding-medical-campaigns-pose-ethical-dilemma-1.2945002

The Bay Area Reporter Online |. (n.d.). Retrieved April 18, 2015, from http://www.ebar.com/news/article.php?sec=news&article=70515

Week 3 Blog HUMN330- Changes to End of Life Killed in House

Changes to End-of-Life, Killed in House

           The personal advance health directives are the instructions letting others know the type of care you want if you become seriously ill or dying. These include a living will and health care power of attorney. The living will, records your end of life care wishes in case you can no longer speak for yourself. The power of attorney gives others, who you have identified (family member, friend, or physician) to make the decision for you. If you don’t name someone, the state you live in probably has an order of priority based on family relationships to determine who decides for you.
           End of life arrangements and discussions are often times avoided. According to a recent survey, only 23 percent of people execute advance health care directives because the process is cumbersome, ("Your Health," n.d.). Every responsible adult has to plan for their end of life care decisions. It will be hard to face the idea of your own death, but we have to take time to consider how our individual values relate to our idea of a good death. By deciding what end-of-life care best suits your needs when you are healthy, you can help those close to you make the right choices when the time comes. This not only respects your values, but also allows those closest to you the comfort of feeling as though they can be helpful.

The Official House members in Raleigh, N.C. disapproved an attempt to change the rules on written health care directives to make medical and other decisions for patients who are terminally ill, comatose or otherwise near death.

The State Law requires signatures by a notary and two witnesses, House Bill 146 would have made that an either or proposition instead of requiring both.

According to Rep. Jonathan Jordan, R-Ashe and others believed patients need the security of having both a notary to verify their identity and two witnesses to attest the patient is mentally competent to sign such a document (“Changes," 2015).

"This is about the convenience of health care providers, not the protection of folks," Jordan said.

In chapter three we were introduced to Ethical Relativism, our moral differences and the idea of what constitutes decent behavior. We have read that some cultures believe it is a sin to seek medical assistance that life should be left in the hands of God.

For those member that are close to us and have not made these arrangements, we need to introduce the subject to them to help care for them and know what they want when the time comes. Encourage them to share their thoughts, there is no right or wrong plan, it is about what they want. Decision has to be made early on type of care they wish to receive, if they have decided on their own path they wish to take, our moral obligation now is to respect the decision they made.

References:

Changes to End-of-Life Regulations Killed in House: WRAL.com. (2015, April 1). Retrieved April 12, 2015, from http://www.wral.com/changes-to-end-of-life-regulations-killed-in-house/14554505/

Cancer patients 'prefer to die at home than extend life', news, Health News, AsiaOne YourHealth. (n.d.). Retrieved April 12, 2015, from http://yourhealth.asiaone.com/content/cancer-patients-prefer-die-home-extend-life

Rosenstand, N. (2013). The moral of the story: An Introduction to Ethics (7th ed.). New York: McGraw-Hill

Employee fights Ethics Charge

          Ethical violations may result in a person losing their job. This is exactly what happened to Miss Carmen Martinez of Seattle, Washington. She worked at a South Park Community Center which is located within viewing distance from her home. She worked there for 11 years until she was fired in October 2014, although the article did not specify the position she held at the establishment.

          She faces three charges before the city’s Ethics and Elections Commission. Martinez had the city pay her uncle for "instruction," according to the charging document. In another charge, it was alleged she "verified performance of community service hours," of her nephew. The last charge shows that she is accused of successfully applying for a Major League Baseball youth sports grant under the city's umbrella, without disclosing the main team involved, which was found to be named “Banditos Baseball”, a private team that lists her uncle as general manager and herself as the director.

          According to the report, Martinez does not dispute the charge. She believes the violations are a mistake, but not enough to be fired and lose her job. She believes the real reason she was fired was more discriminatory and based in retribution for a previous whistleblower complaint. "I'm not saying the violations did not happen," she said, "It was never, ever intended to gain anything personally for this. It was all with intent for the good of my heart. She also stated, “for some reason, somebody wanted me out of South Park." "For some reason, the parks department is not interested in having Hispanic people working in this community center."

          It was reported that Martinez received numerous accolades during her time at the establishment. After her departure, the neighborhood association trying to help employed a petition on Change.org that garnered more than 300 signatures.

Ethical behavior requires compliance. Ethical behavior also means recognizing, in any business situation, what is right, and what is wrong and then doing the right thing.

          Could it be that Martinez failed to determine right from wrong? We learned in Chapter one the value of Morals and Ethics. Morals as we know are the rules we follow, the values we have. Ethics is the theories about those rules we follow and it questions and justifies the rules we live by. Having the Code of Ethics signals the world that we stand by our values, understand them and ready to not only act on them but defend them with both words and deeds.


References:

Former Seattle parks employee fights ethics charges. (n.d.). Retrieved April 2, 2015,from http://www.king5.com/story/news/local/2015/03/11/seattle-parks-ethics-violation-charges/24745939/

Rosenstand, N. (2013). The moral of the story: An Introduction to Ethics (7th ed.). New York:McGraw-Hill

 

Mandatory Church Attendance

Would mandatory church lead to moral rebirth? This was the question raised by many after Republican Sen. Sylvia Allen remarked, “probably we should be debating a bill requiring every American to attend a church of their choice on Sunday to see if we can get back to having a moral rebirth.” The statement which was made during a committee meeting regarding, concealed-carry gun bill.

Sen. Allen argued that, “there’s a moral erosion of the soul of America,” that people should be allowed to carry concealed weapons in public buildings. She blamed the human soul to be corrupt with the eroding religion, thus her statement. She even explained her comment and pointed to her simpler, Allen explained the growing controversy about her comments by doubling down and invoking the simpler, considers more moral and religious era of her youth in the 1950s. "It was a different time. People prayed. People went to church. I remember on Sunday the stores were closed. You didn't go to stores because they weren't open," she stated on the senate floor.

In the article, Evan Selinger an ethics philosopher at Rochester Institute of Technology in New York stated, “It's overly-simplistic to believe that genuine moral sensitivity can be engineered,” Professor Selinger says. “People can regularly participate in religious rituals ... and still turn out to be insensitive, selfish, apathetic, and even cruel.”

This subject of religion has often been associated with good morals and behavior. Although religion may play a significant role in developing our moral values, but a philosophical investigation of moral issues must involve more than faith in a religious authority. It is believed that rational argument and reasoning can be a way of people to arrive at a decision.

Chapter 1 of our textbook discusses the subject of moral issues and religion a strong statement which I want to share is this, “a good way to communicate about ethics for both believers and non-believers is to approach the issue through the language of reason.” Today’s social thinkers believe being religious is neither a prerequisite to being moral, nor assurance that a person will be moral.

 

References:
Sen. Sylvia Allen: Would 'mandatory church' lead to 'moral rebirth'? ( video). (n.d.). Retrieved March 29, 2015, from http://www.csmonitor.com/USA/Society/2015/0327/Sen.-Sylvia-Allen-Would-mandatory-church-lead-to-moral-rebirth-video?cmpid=addthis_mailto
 

Rosenstand, N. (2013). The moral of the story: An Introduction to Ethics (7th ed.). New York: McGraw-Hill.