The_Gorgonzola

Hello all. I’m not sure if this is the right forum for this, but I have an ethical question that perhaps the denizens of this forum might be able to answer.

This questions deals with the rights of a child.

Say Bob and Sue decide to have a baby, Rick. Rick is born healthy but is later diagnosed with leukemia. The only way to “cure” Rick is by a bone marrow transplant. The doctor tests Bob and Sue to see if they are compatible and the tests turn out negative. The doctor then informs Bob and Sue that a sibling of Rick, of which he has none, would be a better match. Bob and Sue then decide to have another baby, Jessica, for the purpose of saving the life of Rick.

Given this scenario and disregarding the ethics of having another child for the sole purpose of saving another, my question deals with the rights of the second child. Does she have any rights at all? As far as I know, a bone marrow donor must undergo an elective, invasive surgical procedure. If an adult is asked to donate, he or she must give consent in writing to have this done to his or her body. How can a baby consent to this procedure or does the baby not have a right to his or her own body?

Thoughts anyone?

Gorgo

ybnormal

It's certainly difficult for me to understand how a society reconciles such procedures, when in virtually every other situation, the same society claims the same child can't possibly understand what "consent" even means, until they are 18.

My first thought was another recent thread regarding the routine circumcision of over a million infant boys a year in the U.S., while all the major medical organizations seem to agree that there is NO medical reason to advocate it.

How a society can say that birthing your Jessica to save Rick is fine, but cloning research and/or stem cell research is not fine, is beyond me.

I have long been an advocate for the equal rights of children, but I've yet to discuss it too deeply without eventually being accused of advocating NAMBLA, and the discussion is pretty much over at that point, which of course was the other person's intention.

It would be interesting to me to hear from some folks outside the U.S. on this medical consent topic.

The_Gorgonzola

That is interesting. I was circumsized when I was a baby (no, I do not "miss" my foreskin) and of course no one asked my permission for this to be done. How I could have possibly given it is the question.

When you say "equal rights" are you advocating the same rights of an adult? Like the ability to enter into contractual agreements and such?

I think the issue that is bothering me is that Jessica's rights, if she has any, seems to be in limbo. She can't give consent given her age, but the life of her brother is in jeopardy if the transplant does not take place.

If it is left up to the parents (and the doctors), then it seems that short of killing her,(or permanantly damaging her) her body can be used as they see fit. This seems absurd to me, but so does letting Rick die when there is a clear way of saving him.

I don't know.

Gorgo

ybnormal

The_Gorgonzola:
When you say "equal rights" are you advocating the same rights of an adult? Like the ability to enter into contractual agreements and such? \

Heavens no. I'm talking about kids who need a court's help... someone's help... from bad parents mostly... there's way too many of'em, and so long as the xians and repubs fight to keep the law out of their male domineering families, it ain't gonna get any better for kids in general...

It doesn't seem to bother them too much to break up poor and Black and other minority families, throwing the father in jail forever, throwing the kids in juvey or some for-profit foster home(think Florida) and just throwing the Mother in the streets. I don't recall the numbers right off, but the number of Black grandmothers who are raising their grandchildren is simply staggering.

It's like, I thought we were gonna have a real break through when that 12 year old Florida boy sued his drugged up mother for his freedom... and he won... but I haven't seen another case like it... there should have been many thousands...

That's what I'm talking about... empowering kids who need it and want it...


I think the issue that is bothering me is that Jessica's rights, if she has any, seems to be in limbo. She can't give consent given her age, but the life of her brother is in jeopardy if the transplant does not take place.

I thought you were leading up to the actual US case like this one, where a couple had another baby for the purpose you described... several years back... I think pretty much everyone thought it was kind of quirky, but I think it saved her sister's life... it certainly ain't for me to say what anyone else should do, but I seriously doubt the child will have any reason to hold it against her parents... then again, I can't scream against circumcision as a human rights issue, then say, "yeah, but this is OK" without being a hypocrite... and I do everything in my power to avoid that label...


If it is left up to the parents (and the doctors), then it seems that short of killing her,(or permanantly damaging her) her body can be used as they see fit. This seems absurd to me, but so does letting Rick die when there is a clear way of saving him.

I'm under the impression that the bone marrow thing is a fairly simple, tho painful procedure, and if it literally saves another life on the spot, it's maybe easy to say, "Why not?" However, that of course leaves us with your original question... who has the right "without consent" to do that? I don't. Doctors certainly should not. Parents? I simply don't know. I try hard to know my limitations, and I'm better off sticking with the practical side of things... this debate will certainly end up being for someone with a deeper brain stem than mine...

I will say, that personally, since I feel so strongly about children's rights, that if I was called to state myself on record, one way or the other... I'd say, we have no right to do this sort of thing... what next? a kidney? half a liver?

Then again, in a society which recognized that even some 3 year olds could maybe understand something as simple as saving her brother's life, far better than we give them credit for... who knows what "consent" means? Maybe you could explore that possibility... in the case I mentioned above, I think they had to wait until the child was 2 or 3 before they could operate anyway... but like I said... I'm in way over my head...

But again... what the hell is wrong with research? When you have a demented society like ours that is so scared of medical science, you end up with no light at the end of the tunnel on questions such as this one of yours.

As a group, humans are most always a major disappointment.

Peace!

brighid

I do not believe it is unethical to conceive a child with the purpose of harvesting a small amount of bone marrow that may in turn save the life of a sibling. I think it is wrong to assume that the sole purpose of this child’s birth is something selfish and that this second child is not wanted or loved equally. Parents are legally entitled to make medical decisions for their children because children are not mentally capable (at most stages of development) of entering into contractual relationships, or determining what is the best course of action for their health, welfare, safety or education. The parents are most likely making decisions for the ill child that go against his/her will, or that the child might not want to undergo, like the painful chemotherapy. Are the parents abusing this child because they choose to undergo a respected and necessary medical treatment that will cause the ill child to be in pain? Had the child been conceived and later a sibling developed leukemia and the parents made the same decision for the young child would it be less ethical because one of the purposes of the child’s birth wasn’t to attempt to heal a sibling? I would say no.

A child is dieing and at this point in time the best chance this child has is to receive bone marrow from a sibling, but the child presently has no sibling. The parents decide to conceive earlier then planned in order to increase the chances that their beloved child will live. The new sibling undergoes a painful procedure that carries some risk to his/her health. There is no neglect, or abuse in the situation. The parents choose to donate the bone marrow of the infant to his/her sibling and the procedure is a success.

Wouldn’t it be unethical for the parents to allow the ill child to suffer a painful death when they can cure the illness by having another child whose bone marrow can save that other child’s life? Neither child was irreparably harmed by the procedure, and one child was saved. Children do not and cannot have the same rights as adults and parents are have the legal right to make medical decisions for their children. I see nothing abusive, neglectful or even detrimental to either child in this particular scenario.

Brighid

The_Gorgonzola

In this scenario it is assumed that the second child would not have been conceived if not for the illness of the first. Whether of not they go on to love the second child as the first child is not the question. In any case, I more concerned with the rights of the second child with respect to the use of its body.

I agree that if a child is ill and in need of a painful or invasive procedure to cure him then there really is no question. In Jessica’s case, however, she is not ill, she is healthy. There is no medical reason, with respect to her health and well being, that any medical procedure be administered to her.

No, see above.

I think the question remains the same.

In this case does the first child have any rights whatsoever with respect to the use of it's body?


Thats the point. The parents choose to donate something that I am not alltogether sure belongs to them. It's not like they are talking about donating their car to some charity here.

The question then is: Should any child (or human being for that matter) be treated as a means to an end or are they ends unto themselves? (or is this just a false dilemma and I am not really seeing all the subtleties involved?)

If there is no abuse or neglect or possible detrimental outcome to "Jessica" and it contributes to the saving of a life of another then it is ethical to violate her body (possibly against her will)?

(I agree that if Jessica was suffering from cancer and had to undergo painful chemo then then issue of violation becomes moot because then we are talking about saving her life. In this scenario though, Jessica is healthy.)

Why wouldn't this same concept apply to adults?
For instance, as an adult I am not required (so far) to donate anything from my body without my consent. Even if I was a perfect match for somebody else who was in need of a bone marrow transplant, I cannot be legally compelled to save that persons life by donating.

My body is my own. Nobody else can "choose to donate" (at this point in time) anything from my body. I am the only one with that choice. Why do children not have that same right with respect to their own bodies? Are they just objects in this regard?

If the issuse is not as simple as this (it probably isn't) then what if Rick needed a kidney or half a liver as ybnormal pointed out? Where would the line be drawn?

Gorgo

[ September 03, 2002: Message edited by: The_Gorgonzola ]</p>

raistlinjones

Because they can't make the decisions. They don't have the capacity for choosing whether or not to donate, nor the ability to make clear to us what that choice is. Therefore, their parents must make the choice.

So, on a choice level, I think the parents are clearly within their rights to choose for their baby. However, I don't think the argument is settled yet, because there are other reasons why it might not be all right to take the baby's bone marrow. There's something more fundamental at stake here.

As someone already mentioned (in a classical Kantian way), it's not acceptable to use someone solely as a means to someone else's end. We must take into account their intersts and needs. And even though the baby is not autonomous, able to make decisions on the issue, the baby will still have an interest in not feeling pain (which will occur in donating bone marrow). In the more extreme cases, you have to worry about the baby's interest in staying alive as well.

Now, is this interest in not feeling pain outweighed by the other baby's interest in staying alive (which will happen if they get the marrow)? Probably. And so I would probably say that it's justified to donate the marrow.

ybnormal

Sorry! Just had to make us look at the first half of your sentence as a stand-alone.

I of course want to agree with you, and if our culture took that and ran with it, that would maybe be one thing... however, I keep coming back to the hypocriticalness of allowing this, to save one child, while as a group, we are shouted down by the, this-is-playing-god crowd when it comes to research that could eventually save millions, and in turn, possibly negate this entire issue of removing body parts from those who will always be unable to give proper consent.

It matters not how many pages this thread becomes, won't you still be left to argue in favor of, harvesting something from other living humans, without their consent?

And I would be as interested as Gorgo, in his question, "Where would the line be drawn?"

Which then begs the question, "Who would draw that line?"

Parents? Parents alone?

the "do not" is a given...

but why, "Children... cannot have the same rights as adults"?

We are ONLY speaking of birth rights and then medical rights here... is there an easier area to give children the "same rights" as adults, than their medical rights?

Sorry, but again, there is absolutely nothing medically wrong with Jessica.

Is this right you speak of, not a completely different, and completely new legal and moral right, which you would now be adding to parental rights in the year 2002?

Again, this is a new "legal right to make medical decisions" for a perfectly healthy child, who is in no need whatsoever, for the historically routine, previously established, parental medical decision-making.

No, this time, new medical decision rights are being granted to parents alone, to ?force a healthy child, to undergo an unnecessary operation that admittedly is a painful procedure that carries some risk to his/her health.

The_Gorgonzola

I agree that we have no way of knowing what choice of a baby would be and that it is clear that a baby is not qualified to evaluate the various ramifications of such a choice. In that event shouldn't the decision be not to do anything to that child in this respect until it is old enough to understand what is happening? (Yes, this would entail the death of Rick).

Suppose that Jessica is older, say 6 and the question is put to her (to donate or not) and she says emphatically "NO!" Should the parents just disregard her wishes and force her to undergo this procedure?

Further, suppose that instead of Jessica, the person that matches Rick happens to be the developmentally disabled adult brother of Rick. Suppose that this adult’s name is Steve. Steve has the mental capacity of a 7-year-old, but chronologically he is 23. Does Steve have any rights here? Does he get to make this choice?

One more supposition, an adult, Mike gets involved in a car wreck. Mike is now a quadriplegic and he cannot express his wants and desires. (Yes I know that most of the time quadriplegics can communicate, but for the sake of argument suppose Mike cannot). Mike is confined to the hospital. A doctor determines that Mike is a perfect match for Rick. Should the doctor just go ahead and take from Mike the needed bone marrow?

Kant said that? I was wondering where I got that from.

I'm not sure. It seems then that it is ethical for parents to treat children like property under certain circumstances (like using parts of their bodies to save a sibling), but not under others.

Gorgo

[ September 03, 2002: Message edited by: The_Gorgonzola ]</p>

brighid

Y bnormal,

I do not abdicate harvesting living human beings for their organs, however bone marrow is not an organ. Other then some pain the person or child is not irreparably harmed and the bone marrow, just as with blood that is donated will regnerate itself.

I do oppose the crowd that screams against research that would potentially eliminate the need for anyone donating a drop of blood, DNA or an organ ever again. I support stem cell research and I would hope one day that everyone who needed a new organ, bone marrow or what not would be able to use their own DNA to generate healthy organs. However, this is not the case at the moment.

A newborn child cannot possibly be expected to make any decisions for itself. It does not have the cognitive ability to do so. I also do not think that most parents in this situation would force a 6 year old child (or one older) who said NO to donate. Although it can be argued that a 6 year old cannot see the bigger picture and is more afraid of the procedure, or is simply acting as 6 year olds do. If it was up to children they sure as the heck wouldn't undergo the normal vaccination procedures necessary to protect them from disease, or in my son's case ever open his mouth for a strep test, or endure that scary mask they had to put over his face to administer medication so he could breathe. In every case he had to be coerced to do what would, at times save his life. All of these things were against his will, should I have simply said - OK, no you don't have to get your vaccinations, or open your mouth for the strep test, or take the medication that will save your life? He wasn't ill when he received the vaccinations ...

Children do not presently have rights that are equal to or supersede adult rights. In this case I do not see how the donating child has been harmed in such a way as to allow another child to needlessly die when a viable solution is in place. Our rights, even as adults don't protect us from ever experiencing physical pain. Should they let their other child die a MORE painful death then the bone marrow procedure because the other child will experience temporary pain? Isn't it reasonable to conclude that most, if not all siblings, would be willing to undergo this procedure if they knew they could save their brother or sister? What sort of psychological damage would happen to the donating child when he/she grows older and finds out they could have saved their brother or sister, but their parents wouldn't take the necessary steps because of the temporary pain caused to said child? How would you feel knowing this?

As a child demostrates greater and greater ability to understand reality and make proper decisions their rights should increase, and they should be apart of the decision making process. But when they cannot possibly make proper decisions, adults who generally have the cognitive ability to do so are obligated to do so.

As an adult you aren't obligated to do anything and you can choose to abstain from providing a life giving donation. However, that is irrelevant to children. They cannot make decisions for themselves and they do not have the same rights for good reason.

The case has to be made that children should have the same rights. No one has made that case. Why should a child, who is unable to understand the consequences of his/her actions have the freedoms and responsibility of adults?


Brighid