Question

8 DQ 1

 
A baby is born with anencephaly, or absence of the entire brain above the brainstem. The brainstem is intact, which means that the baby can breathe and have a heartbeat and blood pressure, but there is no chance for any human brain function or cognition, due to this birth defect. The health care team begins to educate the mother, since children with this deficit generally die shortly after birth. However, the mother is devoutly religious, and her minister has told her that if she prays hard enough to God, that God will work a miracle and her baby's brain will heal itself. She is insistent that all possible care be given to her baby, including a months-long stay in the ICU, constant care by a caregiver, regular brain scans, and other expensive modalities. The hospital, finding her adamant, asks the court for guardianship of the baby, with the medical plan to provide only maintenance care with no life-prolonging techniques until the baby dies. What are the ethical issues are involved? How do the principles of autonomy, beneficence, nonmalfeasance, and justice manifest themselves? If you were called as an ethical consultant, what would you do/recommend?

Answer 1

The ethical issues involved here are

• Though the baby has no brain but spinal cord which can keep them surviving with artificial life support ,ceasing this will kill the baby . This can lead to ethical issue of killing a life after birth against the autonomy of the baby.
• Here the autonomy of the mother can also be not acceptable in view of the poor prognosis
• Beneficence will be an issue because doing something which can most benefit the child will definitely succumb to death in few days.
• Supporting the child besides a deadly outcome is doing harm even after knowing the consequences by the healthcare professionals
• It is unfair to end a life without a proper valid reason .Doing against the mother wish can be a great psychological disturbance or illness.

Being in the place of an ethical consultant, the first priority is to be given to the beneficence of a patient after autonomy .It should be always thought from the patient perspective to make the best decision which can ease a patient problem. This can clearly make one to focus which is best life or death with a particular condition.