Discussion 1

Chapter 1: Read (or re-read) Case 1 on page three of your textbook. If you were the physician, would you tell the man’s wife (the child’s mother) that the father is a match? Why or why not?

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26 responses to this post.

  1. Posted by Michael Green on 2011/07/07 at 8:24 PM

    I would tell the mother about the match. I feel it would be my duty, as a physician, to put the options in place to assure the well being of the little girl. If the father feels so strongly that he doesnt want to do the operation, then he can take that up with the mother (and his little girl for that matter). To me, the right thing to do is to go ahead with the transplant and also for him to suck it up to save the daughter. Easy decision.

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  2. Posted by Michelle Green on 2011/07/08 at 1:41 AM

    I feel the physician should explain to the patient’s father, in private, that this is his child’s best chance at life. If I were the physician, I would sympathize with the father’s fears but also compare his feelings of doubt and anxiety to what his daughter is feeling. I would explain that though he may be feeling scared at the moment, his child is terrified, experiencing pain and fighting for her life.

    I would feel obligated to tell him that though I would have to respect his decision whether or not to donate his kidney tissue to his daughter, I also have an obligation to be honest to his entire family. I would respectfully tell him I am obligated to go over all the tissue-typing results with his wife, the child’s mother.

    I believe that this would be the right way to respect everybody involved and save the little girl’s life.

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  3. Posted by Natalie Haynam on 2011/07/10 at 1:39 AM

    When facing a medical dilemma of whether or not to tell the man’s wife, there are two distinct paths I could choose. I could tell the wife that the father is an excellent tissue match, but it breaks the trust with the father. On the other hand, I could lie to the mother and tell her that all the family members were a poor match; however, this provides the wife with false information and also her daughter’s life may be threatened. After careful consideration, and considering the benefits of both actions, I would choose to tell the mother that the father is an excellent match.
    My moral intuition would advise me to tell the wife the truth because I believe that lying to her and her family is the unfair thing to do when the father is a good match. Yes, the father has concerns and does not want to donate his kidney, but his four year old daughter’s life is at risk, and he is most likely the one who could save her. I believe if I withhold the truth from the wife and daughter, it is a violation of the patient’s rights because they are not receiving the honest truth. Also, telling the mother the truth would most likely cause happiness rather than unhappiness because it gives her daughter a chance for survival if the father realizes the seriousness of her condition and agrees to the surgery.

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  4. Posted by Carol Kines on 2011/07/11 at 12:55 PM

    I would tell the child’s mother that her husband is a match for the kidney. The husband submitted to testing to determine whether he was a match for the kidney, which shows that he had a desire to help his child. Perhaps he felt pressured or forced to submit to the test, but he did agree to be tested. Although the utilitarian theory has some flaws, I feel that this theory can be used in this case. The greater good results from the father donating his kidney to his daughter, and she will likely die without his kidney. The only objection the father verbalized to donating his kidney is fear, which doctors and other professionals can likely help to allay. The mother has the right to know that her husband can help to save the life of his daughter. In addition, Kant would say that lying is not morally acceptable under any circumstance. While Kant’s views are more drastic than I can normally support, this situation is life and death and warrants honesty. The moral thing to do is to tell the child’s mother the truth.
    CKines

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  5. Posted by Misty Bess on 2011/07/12 at 3:34 PM

    In case one that is presented in our textbook, I feel the man’s wife should be informed of his tissue compatibility. I feel this way for several reasons. First, as the acting physician in this scenario, I feel my loyalties lie with my patient first and foremost. To succeed in this endeavor the mother needs to be notified in order to encourage the father to donate. This could be an example of the Kantian Moral Theory, as at this time I am not thinking of how many will benefit from such a decision as much as I am keeping a promise to my patient to provide the best care possible to her. I also feel it is the father’s duty as a parent, to do everything in his power to provide the best care for his child, which in this case requires organ donation. This also is supported by Kant’s’ theories as I feel his participation in this case need be fully out of sense of duty as a parent as opposed to doing it for self-fulfilling reasons.

    MBess

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  6. Posted by christina on 2011/07/13 at 4:02 PM

    In case one if i was the physician i would tell the father that he should sit down with his wife and tell her that he a perfect match because a parent should always do whatever it takes to save there child his daugther need a donor and her father is a perfect match so he should tell his wife and give his child a chance to a second life cause thats what a good a parent who love there kids would do because the rest of the family did not match the father should do what any father would do for his child go head and be a donor for his child because she need this kidney.

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  7. Posted by Ashley Whitford on 2011/07/13 at 6:43 PM

    In case one, I would feel as the physician, to take a Kantian approach, and go ahead and tell the family about the outcome of the tissue matches, but not before trying to get the father to consider kidney donation to his daughter. Before consulting the family, I would sit the father down to help him understand the decision that is at hand. Explaining to the father that a person can function normally with only one kidney and that by not donating he is risking his daughters life due to his fear. After explaining this to the father, if he still feels the same way, I would go ahead and tell the family about the match. I feel as though every father should be willing to help his daughter, no matter what situation she is in. This would make me feel obligated to let the family know because of Kant’s categorical imperative. Looking at his categorical imperative formulations one would be able to see that if the situation was applied to the three maxims or formulations Kant has created, that I would be doing the morally correct thing to tell the family about the fathers match to his daughter. This would give the most amount of people the most positive outcome even though the father is consumed by his own fear. It would be morally and ethically right to go ahead and tell the family about the tissue match.

    AWhitford

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  8. If I were the physician in this case, I would definitely tell the mother of my patient all of the tissue-typing results. This was my first instinct upon reading the case a couple of weeks ago and it has been reinforced now that I have completed the reading packet on Basic Ethical Theories. The deontological theory of Ross, “Intuitionism,” and the concept of prima facie duties, not to mention the Hippocratic (or similar version) oath, all seem to support this action in this moral dilemma. “‘Ultimately, according to Ross, we must simply rely upon our perceptions of the situation…If we learn the facts in the case, consider the consequences of our possible actions, and reflect upon our prima facie duties, we should be be able to arrive at a conclusion as to the best course of action–in Ross’s view, something that we as moral agents must and can do.” (Basic Ethical Theories Reading Packet, pp-19-20) So, if I were to apply this course of action to the case in question, I find that the facts are: my 4yr old patient will die without a kidney transplant, the chance of her survival is greatest if the kidney comes from a close relative with an excellent tissue-type match, my patient’s parents and 2 older siblings all had tissue-typing tests performed and the father is the only excellent match, the father is afraid to undergo the procedure to donate his kidney, and the father has asked me to lie about his tissue-type. If I chose to honor the father’s request, I would be going against the Hippocratic Oath as well as many prima facie duties- fidelity- by lying to the family, non-maleficence- by decreasing my patient’s chances of survival if a cadaver’s kidney were used, and beneficence- by not helping to increase the happiness (and health) of my patient. By informing the entire family of the results of the tissue typing, my actual duty and obligation of saving my patient is first and foremost. Before I did this however, I would have a lengthy discussion with the father, not only to reassure and educate him about the procedure, but also to help him possibly recognize what his own prima facie duties are as a father and the best donor to save his daughter’s life!

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  9. If I were the physician in this case, I would definitely tell the mother of my patient all of the tissue-typing results. This was my first instinct upon reading the case a couple of weeks ago and it has been reinforced now that I have completed the reading packet on Basic Ethical Theories. The deontological theory of Ross, “Intuitionism,” and the concept of prima facie duties, not to mention the Hippocratic (or similar version) oath, all seem to support this action in this moral dilemma. “‘Ultimately, according to Ross, we must simply rely upon our perceptions of the situation…If we learn the facts in the case, consider the consequences of our possible actions, and reflect upon our prima facie duties, we should be be able to arrive at a conclusion as to the best course of action–in Ross’s view, something that we as moral agents must and can do.” (Basic Ethical Theories Reading Packet, pp-19-20) So, if I were to apply this course of action to the case in question, I find that the facts are: my 4yr old patient will die without a kidney transplant, the chance of her survival is greatest if the kidney comes from a close relative with an excellent tissue-type match, my patient’s parents and 2 older siblings all had tissue-typing tests performed and the father is the only excellent match, the father is afraid to undergo the procedure to donate his kidney, and the father has asked me to lie about his tissue-type. If I chose to honor the father’s request, I would be going against the Hippocratic Oath as well as many prima facie duties- fidelity- by lying to the family, non-maleficence- by decreasing my patient’s chances of survival if a cadaver’s kidney were used, and beneficence- by not helping to increase the happiness (and health) of my patient. By informing the entire family of the results of the tissue typing, my actual duty and obligation of saving my patient is first and foremost. Before I did this however, I would have a lengthy discussion with the father, not only to reassure and educate him about the procedure, but also to help him possibly recognize what his own prima facie duties are as a father and the best donor to save his daughter’s life!
    SEBayus

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  10. Posted by Mike Senchak on 2011/07/15 at 12:52 PM

    After further discussion with the husband and an explanation that I could not withhold this information from his wife, I would notify the family. The husband is obviously experiencing some anxiety regarding giving one of his kidneys. I would try my best to empathize with him but would explain the severity of the situation again and reiterate how much the little girl is counting on a kidney that is matched well. In chapter 1 we discussed moral issues and normative questions that force us to question the violation of rights and the welfare others. This issue may have a blatantly negative impact on the welfare of the child. We also discussed moral vs. law in chapter 1. However, I do not feel that this is a law issue. As far as I understand it, the law would only come into play regarding the patient as it would be covered under doctor/patient confidentiality. I do not believe that the father would be considered a patient.

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  11. Posted by Nicole Zarzycki on 2011/07/15 at 4:39 PM

    I agree with many of the previous posts. The physician’s primary responsibility is to help his patient, the little girl, to ensure her well-being. Since the father did agree to the testing he does want to help his little girl but is worried about his on well-being, which is understandable. But when men and women become parents they have made a promise to keep that child safe and healthy as long as it is in their power. Now, this father has the power to make his child better and it is his responsibility to help her. I understand that he is afraid but once the physician talks to him about the procedure and explains everything to him I am sure the father will get over his fears. The phsician has an obligation to his patient to tell the mother of the results. The father is not his patient therefore he has no laws regarding privacy with his relationship to the father. In this case the utilitarian theory applies since telling the mother will provide the greatest good for everybody involved. People work past their fears everyday, the father will just have to work past his and with the help of his family and the doctors I am sure it wil not be a problem.

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  12. Posted by Michael Sammartino on 2011/07/16 at 7:43 PM

    I believe when certain roles are taken, such as a physician, it is your responsibility to remain within that role. Therefore the physician should do what is medically best for the little girl, not what the physician feels “in his heart”. If the father realizes his role as the parent then he should have no problem donating his kidney possibly giving his life for his child. Otherwise it seems cowardly to let your little daughter die because of fear of a medical procedure. I would feel worse living my life knowing I could have saved my daughter as opposed to living the rest of my life disabled (or possibly unharmed) with my daughter alive and well.

    -msammartino

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  13. Posted by Molly Jones on 2011/07/17 at 2:05 AM

    If I were the physician I would know that is it ethically wrong to lie and I would have the obligation to report the findings to the family even though the father is asking me to lie and then it is up to the family to determine what they want to do with that information. This four-year-old girl is on dialysis which usually happens three times a week for several hours to pump the blood out of her, filter it, and pump it back in. Even if the dialysis was working I highly doubt that the father would want to see his daughter spend most of her life in the hospital especially knowing that most people can live on dialysis for years but the end result is fatal. I would remind him about his daughters fear and the high ninety percent that could save her. I would also tell him that his surgery is a simple procedure and he would undergo anesthesia and have an incision through his back to remove one of his kidneys. The only downside of his surgery would be soreness and possible risk of infection but in the future it is possible that if he were older (probably around 80-years-old) he might go into renal failure as well. I believe that both parents are responsible for the minor so both should be involved in the decision making for her care.

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  14. Posted by Leah Richards on 2011/07/18 at 2:38 PM

    As the physician, I would tell his wife that her husband is a match. Being the physician I want to help save this little girl. I would privately talk to the mother and father and explain how the father is a match, and then help him tell his wife how he is afraid. Even though the father may be scared, it is his right as a father to do whatever he can to help his daughter. He can save her life. I wouldn’t beable to lie about something that could possibly save one of my patients. Especially a little four year old!

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  15. As the physician in this case, I feel it is necessary to talk to the father individually and then talk to the family about the results. The physician should talk to the father about why he is scared and what his fears are. After finding out that information, the doctor could then explain all of the positive benefits this transplant could bring, especially save the child. This should bring the father to decide it is his moral duty to save his child and take on the minor risks he would face.
    Because all of the family agreed to get tissue testing and consented to the documentation, I feel it is the doctors duty to inform the family of their results, or even just hand them the documented results. The physician in this case will know the father stands a great chance of surviving the transplant, and will know that the transplant is the best decision for the child’s survival. The physician needs to do what is best to save a life and it seems to be the ‘right thing to do’.

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  16. Posted by Walter Bell on 2011/07/20 at 10:37 PM

    I believe the physician is to talk to the father about all of the facts, including how his daughter’s best chance of survival will come from him. However, if the father still disagrees then I would let him know that if his family asks about the results, I would not lie to them. The decision is between the family and not the physician, both the dad and the rest of the family need to be informed. The physician is not authorized to pick a side. To me, this would be morally impermissible. Even as a utilitarian, overall happiness would be attained by the physician telling his family the truth because you would have one unhappy person verse the rest of the family. Between this and the morally accepted principle of lying being wrong, I don’t believe the physician would be right to withhold truth since the father does not want to discuss the issue with his family and since he is willing to lie to his family or at least cover up the truth.

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  17. Posted by mnortey on 2011/07/29 at 12:38 AM

    i feel as if it is the physicians duty to in fact be as honest as possible with a situation that has potential to be very sensitive it is important the physician uses great communication skills. i would let the father know every aspect as to what in fact is and could potentially happen to his daughter as well as leave nothing unsaid.

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  18. If I were the physician I would tell the husband’s wife. A little four year old girl’s life is at stake. I would sit down with both the husband and wife when breaking the news about the husband being a good match. I would state the facts to the husband. Your daughter’s best chance at survival is if you donate one of your kidney’s. You can help save your daughters life. The best decision as the physican is to tell the wife so she can get the husband to donate one of his kidneys and save his daughters life.

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  19. Posted by Kimberly Bertmeyer on 2011/08/03 at 5:03 PM

    The physician should listen to the man’s concerns about donating his kidney and then explain how important this is to saving his daughter’s life. None of the other family members are matches so the success rate is very low. He should explain to the man that most people are afraid of donating and maybe suggest that he speak with someone who has been in a similar situation. He should encourage the man to tell his wife and family. His family will be there to help him get over his fears and recover after the operation.
    If the man still does not want to tell his family, I think it would be okay for the physician to tell the man’s wife and family and encourage them to help him through this tough decision. I believe that the Utilitarian approach works best in this situation. Normally we would say that it is not morally acceptable to breach a patients confidentiality. However in this case, violating the man’s confidentiality would save his daughter’s life. This option would yield the largest amount of happiness overall.

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  20. Posted by Dominic DeRose on 2011/08/04 at 1:15 AM

    My primary goal as a physician is to attempt to restore health to those who do not have it. I would do my absolute best to attempt to get that father to donate his kidney. The father’s judgement is being clouded by fear. I would attempt to persuade the father’s consent before resorting to informing the family that he is a match against his will. Eventually sitting both of the parents down to discuss what should be done. The utilitarian case is clear, that the end result will be more beneficial than the means, even if one person’s happiness is compromised for the short run. Using Kant’s Categorical imperative, it should be a general rule that all parents should do their best to save their children within reason. A small amount of fear of surgery would nearly guarantee the eventual death of the child. While a short term (yet possibly risky surgery) has the greatest chance of saving the child’s life while not costing the father his.

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  21. Posted by JScacchetti on 2011/08/09 at 9:04 PM

    I would not be able to tell a blatant lie to the family that there were no matches found with the close family. As a doctor, it is your duty to act in ways where the outcome would provide the most happiness. Sure at first the father would feel nervous and be guilt tripped by his wife to donate. But imagine the hypothetical situation where because of his donation, the little girl survives. So much more happiness all around would be generated that it would out weight any outcome of hiding the match information.

    –JScacchetti

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  22. In this case I feel l would have to use a Kantian approach, and tell the family about the results of the tissue matches. The Kantian approach follows my moral values, and it is up to me on how I deal with this moral issue. I would try to have to father consider donation, and explain to him how this is about wellbeing of his child to live a healthy life. Using the Kantian view I may make the father unhappy, I cannot justify lying to the family. I believe telling the family is doing the right thing to do and will bring about the most positive outcome to the family. If I lied to the family how could my patients keep trust in me after I have promised to give them the best care? Under Kant the moral theory do not lie is absolute it is a categorical imperative. Kant holds good will as the fundamental principle or morality.

    MTobin

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  23. Posted by NChaney on 2011/08/11 at 10:34 PM

    The utilitiarian theory can be applied to this case. The father has agreed to be testes, regardless if he felt some pressure due to the situation. I don’t believe that lying to the family is in the best interest of the doctor. If the fathger can help save the life of his daughter by donating his kidney, then he should. The fact that he may experience fear, can indeed cloud his judgement. That is why I believe the doctor should inform the family. The family can persuade the father to do was is right in a way the doctor can’t

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  24. Posted by Marc Kosec on 2011/08/11 at 10:55 PM

    The fact that this father is scared to provide a kidney to the daughter may be a natural human emotion, however, in my opinion the decision to have children make him as the father completely responsible to do anything possible to better the life of their child. The question of morality is if I as the physician should tell the rest of the family the father is a good match even though the father requested i dont. I would tell the family based on the fact the the best outcome and overall good for the family would be to give the daughter the best chance of survival. The father has had his chance to be a good father and seems to be blowing it. I tell the family and give the daughter the best chance of survival.

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  25. Posted by Philip Ciprian on 2011/08/11 at 11:07 PM

    As the physician, it would be best to inform the wife. It would be the physician’s duty to provide a means of bettering the child, since that is the primary issue at hand. While the physician can’t force the father to donate his kidney, he should definitely attempt to strongly persuade him into donating. The mother and child are just as entitled to know if there is a match or not.

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