Three Ethical Dilemmas

In the first chapter of "The Elements of Moral Philosophy," James Rachels presents three real-world examples of difficult ethical dilemmas:

1. Baby Theresa - born a few years ago in Florida with anencephaly, a condition in which certain parts of the brain are missing, and life expectancy is very short - she was expected to die within a few days. Baby Theresa's parents wanted to donate her organs in order to save the lives of other infants, but Florida law prohibited donation in cases where the donor is not yet brain dead. Because Baby Theresa was only missing certain parts of her brain - other parts necessary for autonomic functions like breathing and heartbeat were still functional - she was not considered brain dead according to the law. She died a few days later, and by that time, her organs had deteriorated too much and could not be donated.

This seems like the easiest case out of the three. Both the parents and the doctors were in favor of donation - the only thing holding them back was a poorly written law. Barring some religious objections to hastening a person's death, I don't think there were any legitimate arguments against donation. For the record, those arguments were: it is wrong to use people as means to other people's ends and it is wrong to kill one person to save another.

2. Jodie and Marie - conjoined twins whose parents came from a small Island country I've never heard of (Gozo); the parents decided to have the babies delivered in England for better medical care. The doctors said that if they remained attached, the twins would die within six months. If separated, one would live and one would die. The parents were devout Catholics and refused to separate the twins on religious grounds. The hospital asked and received the British courts' permission to go against the parents wishes and perform the separation anyway.

This was a much more difficult case. The ethical question of what the decision should be is simple - of course we should save one child rather than let both die. But the ethical question of who should decide is more troublesome. Generally, parents should have sole discretion over decisions made concerning their children. But in cases such as this, and perhaps others involving Christian Scientists who similarly refuse medical care for their children on religious grounds, the line between parental discretion and child abuse is not at all clear. I'm not sure if the fact that they came to England from another country specifically looking for medical care to meet their family's needs complicates the issue. It certainly doesn't make it any simpler.

3. Tracy Latimer - a 12-year-old girl with cerebral palsy. She weighed less than 40 pounds, was described as "functioning at the mental level of a three-month-old baby," had undergone major surgery with plans for more, and was in constant pain which the doctors could not control. One morning, while her mother was at church, her father put her in the car and piped in exhaust fumes until she died.

The jury found him guilty of second-degree murder, but recommended that the judge ignore the mandatory 25-year sentence; the judge agreed and sentenced him to one year in prison followed by one year of house arrest. The Supreme Court of Canada overruled the judge's decision and reinstated the 25-year sentence.

This was also somewhat difficult. On the one hand, the girl was clearly unable to make the decision to kill herself because of her limited capacity. But if we put ourselves in her situation, most of us would probably choose death. To live in constant pain, with very little awareness of one's own surroundings is not much of an existence. Thus, the decision to live or die must be made by someone else - preferably those who are closest to her and are in the best position to make such a decision: her parents. On the other hand, we should be worried about the precedent this might set, and the slippery slope we may go down, if we allow parents the sole discretion of deciding when their children's lives are worth living.

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The three ethical dilemmas

The three ethical dilemmas presented in Micha's post are exactly that, ethical dilemmas, personal ethical dilemmas. Unfortunately, in each of the three cases, the most important principle, individual sovereignty, is being trampled in the name of ethics.

In the first scenario, the "easiest out of the three," in fact, it could be argued, that the state's interference resulted not only in the death of Baby Theresa, but in the possible deaths of infants who may have benefited from Baby Theresa's organs. The state had no business in this matter.

In the case of the conjoined twins, Micha states "The ethical question of what the decision should be is simple - of course we should save one child rather than let both die." But is it that simple? Just because you, or other individuals, think the thought processes of the parents are irrational, does that then automatically negate their rights to make the decisions that need to be made? The state contributed nothing to these conjoined twins creation. No matter how badly the state desired to be in bed at the conception of these twins, the state contributed no DNA, no sperm, no ovum. Whose property are the children? The parents. Who should make the decision? The parents. Should one live and one die, or should both die, will both die if left alone? The state no more has an inside track to answers to these questions than the parents.

In the third case, the most egregious offense discussed is the offense of Canada's supreme court denying the father the decision handed down by a jury of his peers. Not only has the court trampled the individual sovereignty of the father, they have trampled the ruling of the people who were selected to judge the father. As to if the father made the correct decision, I would state, based on the limited amount of data in the post and not having read the book, that yes he has. The fear of a "slippery slope" is just that, simply a fear. It is not a proven effect from the cause discussed.

John, I disagree with your

John,

I disagree with your claim that children are the property of their parents. In most cases, parents should have the authority to make decisions effecting the lives of their children, but this authority is not absolute. A parent's decision to kill a happy, healhy child is certainly not reasonable or acceptable to most people, including myself. Whether or not you believe the state should intervene (I don't), this does not preclude other people from intervening: doctors, neighbors, other family members, friends, etc. I don't see any good possible justification for allowing parents to kill their own children.

I said that the first case is the easiest of the three because the ethical issue is pretty clear: both the parents and the doctors agreed that the donation should take place: only a poorly written law stood in the way of what I consider a just outcome.

In the second case, why should both die if one can live? The only troubling aspect of this case, in my opinion, is the fact that parents came to England seeking help, and instead had the English authorities go against their wishes. Still, I do see something wrong with giving parents the right to let their children die.

Micha - Your point in

Micha -

Your point in regards to the killing of a "happy, healthy child" is sound. It is most assuredly unreasonable and unacceptable to do so. I also agree that if other individuals wish to intervene for a child's behalf, it is admirable, and, probably desirable since children, under a certain age, cannot soundly reason. Though the age at which children can reason soundly is very debatable.

I understand that you are not adovcating state intervention, we are in total agreement on that issue.

Regarding the second case, and your comments in response to mine, you ask "...why should both die if one can live?" A reasonable question. Though it was probable both would die, based on the opinions of the medical doctors, was it certain that both the twins would die? We cannot know this because the surgery took place.

I understand the troubling aspect of allowing of allowing parents the right to let their children die, but once again I must go back to individual sovereignty. Most parents, not all, have a love and nurturing instinct for their children. I don't have any research at my disposal but I would bet that the percentage of parents who would, or do, willfully harm their children, or desire to kill healthy, happy children, is small. Be that as it may, what is, or would be, used as the measuring stick to determine parents' ability or inability to decide their childrens' fate? Can any solution be given that does not require some type of coercive intervention?

Making the first last, if children are not the property of their parents, and I fully appreciate they are little humans, to whom do they rightfully belong? Are they wards of all individuals? Are they wards of the clans, bloodlines, from which each parent descended? Help me out.

According to what was

According to what was writting in the book, the doctors were certain that both of the twins would die, which I assume they knew based on similar cases. The twins were sharing vital organs which were strong enough to sustain one person, not two.

As for who should make the decision, I don't know. In difficult cases where it is not clear whether the child should live or die, those with an interest in the child's well-being, other than the parents, may wish to intervene, and perhaps resolve the dispute by going to some mutually agreed upon third-party to arbitrate the dispute.

This is a difficult area for libertarians, especially anarchists, which is why I blogged about it in the first place.

Micha, I still think that

Micha, I still think that the final decision belongs to the parents. The interventionists, and I do not mean to use the term negatively, even if they are non-coercive and are attempting to reason, soundly, in the interests of the child, cannot force the parents to accept, or mutually agree to accept, the decision of another third-party. The final decision is ONLY the parents. The parents are the only individuals, outside the child in question, to whom the issue has any bearing or effect. It would be a most difficult decision to make.

To whom do they rightfully

To whom do they rightfully belong?! To whom do *you* rightfully belong, Mr, Venlet?

Children are not the property of *anybody*. They are people. They are very young people who lack experience in the world, and they need adult friends (hopefully their parents) to help them. If their parents are not good friends to them, children should be free to seek out other adult friends. This is part of the reason that I think child labor laws are shockingly immoral. Why shouldn't children be allowed to work if someone is willing to hire them? If children can't legally be productive, a very promising avenue of a child's escape from a bad family situation is totally cut off.

I think the third case is very interesting, and I remember thinking when the case first became public that the father handled this awful situation with principle. He did what he thought was right, and faced the music. In a rational (i.e. free) society, he would probably be able to convince reasonable people that what he did was right thing to do. I think this points out the folly of the idea that there are any hard-and-fast "rules" that can be used to guide any and all human activities. Everything can and should be taken on a case-by-case basis.

This is not to say that there are not guidelines that are so reliable (i.e. the inviobility of individual rights) that any violation of them must be justified by very compelling arguments.

What if, hypothetically, some other person(s) (not her parents) were willing and able to take over the maintenance of Tracy Latimer's life?

I can think of many situations in which I would wish for my own life to end. Constant pain and the total inablilty to communicate would more than satisfy my personal threshold for dimunition (or total destruction) of quality-of-life, and so I judge that Mr. Latimer's action in killing Tracy is good, because it is what I (and I guess many others) would wish for if I were in Tracy's place. I hate to make any argument that smacks of democracy, or some crap like that, but what other standard can we appeal to to resolve cases like this? This sort of empathy is the basis of all human association.

Mr. Venlet, I know from reading your blog that you are a theist, and I realize that many theists have a conception of the sanctity of life that is more inclusive than the conception of many non-theists, as I understand the issues, at least. ="73you think that Mr. Latimer did the right thing?

What if, hypothetically,

What if, hypothetically, some other person(s) (not her parents) were willing and able to take over the maintenance of Tracy Latimer's life?

I don't think the father's problem was that he was unable to take care of his daughter. If that was the case, then his act was unjustified. He said that he did what he did in order to end her terrible suffering. That suffering would continue regardless of who took care of her.

Qiwi - You ask to whom do I

Qiwi -

You ask to whom do I rightfully belong? To no one, currently, but prior to realizing my own ability to reason, I would say my parents. Now, what I want to make sure is that you understand that this parental "ownership" is not an ownership of mere chattel. My parents, nor I, could ever look children in so callous a regard. And I agree with you wholeheartedly that children should be free to seek out other "adult friends," as you put it, if their parents are cruel and unjust. In fact, my wife and I are good friends with a young lady who successfully sued, here in Grand Rapids, to be freed from her onerous parents and reside with another more caring and loving family. As I tried to express in earlier comments to this thread, I think it is a small minority of individuals who blatantly regard their children as a thing which can be disposed of. The decisions needing to be made in all three of the scenarios would be gut wrenching to 99% of parents.

To answer your question as to if I think Mr. Latimer did the right thing. Yes, I think he did, based on all the information concerning, and the experience he had with his daughter over the years. I would guess that it was a most difficult event for Mr. Latimer and the state is forcing him to suffer additionally and needlessly in prison.

We are not in disagreement Qiwi except in regards to whom has the power to decide.

What if the legal guardian

What if the legal guardian of the child is allowed to make decisions for the child, including 'living-will' decisions to terminate life in cases where the child cannot rationally represent themselves?

By default, "legal guardianship" is granted jointly to parents of the child, and a child is younger than 18 years of age.

If someone doesn't agree with the decisions a guardian makes on behalf of the child, they can sue for custody and have the courts transfer guardianship to the plaintiff. A child can also petitition the courts to be emancipated as a minor, or someone can seek for another person over the age of 18 to be placed under their guardianship (presumably on the grounds that the other person is incapable of living their own life).

Doesn't this takes care of most problems regarding "ownership" of minors? It also allows guardians to have a great degree of control over those in their care. It addresses gross abuse of minors by guardians by allowing the guardianship to be contested. It does not allow the state or any other party to mandate certain care for the minor unless they are willing to take responsibility for the entire duration of the minor's care by becoming the new guardian.