raistlinjones

I'm not so sure. Unfortunately, time is rather of the essense here - if you wait around till the child can make the decision, there's no longer a decision to be made. The problem would likely go much differently if the decision weren't so critical to the life of one baby, so minimal in the pain to the other, and so necessary to be done immediately.

It's easy to see that, if you're only concerned with the consequences, the bone marrow should be taken. A bit of pain to one baby, the saving of the life of the other clearly weighs in favor of the procedure.

I think Steve should have the exact same rights as if he were 7 years old. I'm very much in favor of rights being granted to beings whose mental capacity allows them to make full use of them, no matter their age. Age is arbitrary; mental capacity not so.

In this case, it would be necessary for someone to try to determine what Mike would want from things he said before becoming a quadriplegic. A doctor would probably not be the best person to make that decision. His interests are still of concern, but they're impossible to have knowledge of. We can only make a good guess on what they are.

Smartass.

They're not treating the child as property. They are treating him as a being that is conscious but not self-conscious, as a being without rationality, who is also in the unique position of being able to save his brother through a small donation of his own body. I would think it intolerable for them to treat their child as property. Consistently, I also find it intolerable for people to treat animals (which are similar in many ways to the baby) as property.

The_Gorgonzola

Yes, from a utilitarian standpoint your reasoning is valid.

So, Steve is in, in essence, the same position as Jessica in this matter, although he is an adult?

So the issue is not whether the person involved is able to communicate his or her wants and desires, but more of an issue of whether that person exhibits the ability to rationally asses his or her position in the matter?

Suppose Steve is not developmental disabled, but he just doesn’t think rationally? He doesn’t trust scientist or doctors so he refuses to donate. Should he be compelled to donate then?

Hey now.


I disagree. I think they are in fact treating Jessica as a piece of property that they own (but only with respect to their present dilemma). I believe I am justified in thinking this because of the very nature of the concept of donation. One cannot donate that which he or she does not own. If Bob and Sue decide to donate bone marrow from Jessica to Rick, then they are asserting that they own that bone marrow (and hence Jessica herself). Further, I’m not so sure that a child at any age is necessarily “not self-conscious”, although I do grant that a baby is at least not trained in rational thinking. I’m also not to sure that the size of donation is relevent (obviously, in a practical matter it is, as in this case). I’m more concerned with the general principals involved.

It appears that you and brighid are using a (limited) utilitarian ethical standard whereas ybnormal and I are following a more deontological view. It is hard to argue against the utility aspect of this. It does in fact seem absurd not to save Rick on the grounds of remaining consistent with an ethical construct. Given that, I’m still concerned as to where the line should be drawn? (And as yb pointed out, who should be the one to draw it?)

Gorgo

[ September 05, 2002: Message edited by: The_Gorgonzola ]</p>

The_Gorgonzola

brighid,

This is the_Gorgonzola, I know that you addressed your post to ybnormal but I would really like to respond to it. I hope you don’t mind.

I agree that there is a quantitative difference between bone marrow and say, a kidney, but I’m not so sure there is a qualitative difference. In either case the child is undergoing a medical procedure that is not related to the health of that child.

I am in complete agreement here.


I think the motives of the child are irrelevent. Just as the motives of an irrational adult are irrelevent if he or she chooses not to donate.
I agree that it is fitting and proper to compel a child to undergo painful medical procedures if these procedures are for the benefit of that child. In this case though, the medical procedure has nothing to do with the health (present or future) of Jessica.

Shouldn’t children have a right to be secure in their own body and to not be treated as a possession? In this case, the child is not the one that is making the donation. The parents are. In essence, the parents are asserting that they own Jessica’s bone marrow and they have the right to remove this material from Jessica’s body. Further, if they own Jessica’s bone marrow, then do they not in fact own Jessica herself?

I think that the pain aspect is neither here nor there. There is a more fundamental issue involved.


I think that is irrelevent to the fundamental issue. Be that as it may, suppose that the saved child finds out that his sibling had complications with her donation and died a horrible excruciating death? How would you feel knowing that?

True, but even irrational adults do not have their rights abrogated. An irrational adult cannot be compelled to donate.

Yes they presently do not have the same rights as adults. Nor should they have the same rights of adults. However, shouldn’t they have the right to be secure in their own bodies and to not be viewed as possessions (in the sense of ownership) of their parents?

Personally, I don’t advocate that children should have the same rights as an adult. They should have rights that are appropriate for children (and some of these may overlap with those of the adults).

Gorgo

echidna

Good topic Gorg. Rights exist in an ideal world. They are social constructs, largely dependent on what can be morally, socially, technologically and economically supported by society.

Do I have a right to breathe clean air, free of carcinogens and life-threatening pollutants ? Ideally yes, however technology cannot offer us an energy solution where these carcinogens are kept from my lungs.

We accept a non-ideal moral compromises where there is no practical way to avoid the loss of my rights.

As such, in an ideal world, the child rights which you nominate, Gorgonzola, would be rigid in an absolute sense. However your OP posits a moral dilemma where the situation is no longer ideal. We are forced to make a decision where science cannot give us an easy answer. Inaction is as morally responsible as action & either way someone suffers.

I follow Brighid’s lead, while acknowledging the regrettable loss of Jessica’s rights.

That just comes down to a risk assessment & these days bone marrow donation is a relatively low-risk routine operation, something which is encouraged on a voluntary basis as blood donation although less routine, maybe even moreso at a young age. I would need medical advice.

I base my view, largely on the social value which is given to the family, which I agree with. Maybe to illustrate this, if Rick were not Jessica’s sibling, I would not support the marrow donation.

This is largely because we don’t have a good definition of “irrational adult”. Without a watertight definition, age serves as a poor but optimum approximation.

In addition, the fundamental difference between an adult and a child, is largely that the child is still in the very rapid process of “growing up”.

While this process never stops, it clearly slows as the person matures into an adult. Guiding a child is different to guiding a childlike adult, in that the adult’s personality & future development is less influenced by one’s guidance.

Not entirely. I still believe in parental control (to what age is debatable), even over bodily possession. Your 5 yearold wants to get a tattoo, I think the parent has a right to say no. But ownership where the parent can arbitrarily harvest organs, I agree with you that this is undesirable.

And yet in this case I would consent, the exception being the social value of family.

brighid

The Gorgonzola -


I believe all children should be treated in a manner that respects their individual person, but I do not believe the child is being treated as a possession because the parents choose to have said child undergo a medical treatment that will cause temporary discomfort, but will save the life of their other child. I think people confuse ownership of say a tangible object such as car, with the rights and responsibilities a parent has in respect to a child. In this case the parents have a duty to both of their children, not only physically but emotionally as well. Parents must not only look at the present moment, but they must do their best to weigh their decisions as they affect the long term as well. What is more important in this case? Jessica’s theoretical right (which she does not actually possess) to retain her bone marrow, or their obligation to their other child to do all in their power to cure a disease that will kill said child in a very painful way?

No one has yet proven that Jessica, as a child has the right to retain her bone marrow and her parents do not have the right to make this medical decision for her, even if that procedure is not medically necessary for her. Children do not have the ability to make decisions for themselves, and certainly infants do not. Therefore, the parents must make the best decision for BOTH of their children, physically and emotionally. It is reasonable to conclude that Jessica (if she was older) would want to do all she could to save her sibling. It is also reasonable to conclude that she won’t want to undergo the procedure, and that she might not want to save her sibling. I think it is more likely, when Jessica develops the cognitive ability that she would choose to undergo said procedure because it would likely save her sibling. Children tend to be a bit more altruistic then adults do So, as parents they must determine from what actions will the most good come from, even knowing that some harm will result. If they do not make the choice for Jessica to undergo this temporary procedure that will cause her physical pain, their other child will endure a very painful, not so temporary death. This child knows that their parents COULD choose to have her infant sister undergo a procedure that has a good chance of saving her life. Imagine the emotional torment that child will endure, along with the extreme physical pain a death by leukemia will cause, knowing that her parents refuse to have Jessica undergo this procedure because it violates her right to her bone marrow? Could you actually look into the eyes of your child and tell her that you are going to have to let her die because her healthy sisters rights to retain her bone marrow are more important then her right to live? Can you further imagine the emotional torment Jessica will likely endure when she grows old enough to understand the implications of that inaction?

The temporary pain that Jessica will undergo is negligible and is a risk worthy of the potential outcome. In the case of bone marrow donation where the risk to her life is minimal, and the benefits are great I cannot find it unethical for the parents to choose to have a child undergo this procedure.

If Jessica, as an infant actually had the ability to determine the best course of action for herself and how her actions will affect her family perhaps then a case could be made against her parents having her undergo this medical procedure. But at this point that argument cannot and has not been made. In this case the best choice for the overall health and welfare of both of their children is to have Jessica undergo the procedure, donate the marrow to her terminally ill sibling in the hopes that it will save her life. The result of inaction in this case will certainly result in the death of one child and sever emotional harm to another upon reaching the age she can understand the consequences of that action. It will also likely irreparably harm the parents emotionally and destabilize their marriage, thereby causing greater harm to the surviving child.

As to the retarded man that another poster presented: his body may be physically that of a grown man, but mentally he is a 7 year old child and therefore should not have the full rights of an adult as he is not capable of accepting or understanding the consequences of his actions.

Parents MUST make choices for their children. There is no way around that and as a child grows cognitively decisions can and should be made with greater interaction with the child, eventually leading to autonomous decisions by a grown child. Legally, parents cannot leave decision making up to children and for good reason, but it is incorrect to state that a child is a possession because parents can and must make difficult, or painful decisions for a child that an adult has the right to refuse.

As to how would Jessica feel if the procedure went terribly wrong and was not successful: I feel she would most likely be devastated, but she would also having the comfort knowing that she did all that she could to save her siblings life and I think the pain would be greater if she knew she could have done something to save her sibling, but her parents refuse to allow her the opportunity.

Brighid

The Other Michael

The question was raised of donation to a child who isn't part of a family.

What if the parents decide that not only is that a great idea, but they are going to have the child donate bone marrow as frequently as medically allowable, so as to save the lives of as many children as possible.

It seems like a very short step to take from donating for a sibling, to donating for a non-sib, to donation to many non-sibs.

I'll stipulate that for the purpose of this question the parents and child incur no medical expenses nor do they receive any financial benefit from the donation.

Perhaps the child should also donate blood/plasma as well as any other body products that might have benefit to someone else's health.

cheers,
Michael

echidna

I think anyone who has grown up knowing that their sibling died at an early age(such as my father), knows the sorrow and the “only-if” of missing out on the happiness and companionship which that sibling can bring.

But Brighid, extend beyond just a marrow donation. What if a kidney was needed ? Or a lung ? I think I would begin to baulk where Jessica’s longterm health would be compromised, even given that Rick’s life is endangered.

RogerLeeCooke

This is not a hypothetical case. It actually happened a few years ago. The husband had to have a vasectomy reversed. The wife got pregnant, delivered a compatible donor for the older sibling.

Whatever one thinks about it morally, it's nobody's business but the people involved. The couple say they love the baby just as much as if they'd had it for some other reason, and I believe them. If we had to pass motivational tests in order to be parents, the human race would soon die out from lack of reproduction.

brighid

I think the question becomes more complex with a life threatening surgery such as donation of a kidney, or other vital organ. A child could live with only one kidney, or donate part of a liver but those operations carry serious risks to the health of the donor and in that case I stand more on the side of saying that shouldn't be done.

I don't think humans should be harvested for organs, but in the case of bone marrow I can't find any problem. I am not even sure the medical community would perform a kidney, or other organ removal operation on a new born, or young child even if the parents wanted that course of action. Those sorts of situation bring up more serious ethical issues that I am not sure have any easy answers.

I think this whole discussion simply trumpets the importance of stem cell research and the development of tissue, organs, etc. from sources that don't require potentially dangerous surgery to living, breathing, human beings. The best case scenario would simply to borrow a blood sample from that person, or a compatible donor ( or from stem cells) and from there create the necessary human material to cure an illness or injury. Hopefully someday we will be able to achieve this.

Brighid

raistlinjones

No. Steve is in the same position as a 7 year old child, who would have considerably more rights available than a baby.

No. It's an issue of trying to act according to his/her interests. In the case of someone who cannot express his/her interests, it's necessary to try to figure out what they are from other information (like things they said before).

Absolutely not. I couldn't care less about his rationality. He's able to make decisions, and even if they're irrational, we still have to consider that decision. He has an interest in being able to make decisions about his own life; we have to respect that interest.

Maybe this is mere semantics, but it could be argued that, since Jessica cannot decide whether or not to donate the marrow, her parents are making the decision for her. Thus, she is actually donating the marrow, and they are making the decision, based presumably on any current interests of hers and future interests. This decision will not affect her future interests at all (taking bone marrow out has no permanent effects), and her only relevant interest is to not feel pain. Assuming you care about Rick's interest in staying alive, it would seem like it would win out.

When the interests of everyone involved call for you not to do the procedure. If you're removing an organ that will permanently affect the baby, like a liver, I think you could easily say it shouldn't be done. And just because you don't where to draw the line doesn't mean the clear cases shouldn't be decided. To bring in a theme from another board, would the fact that it's hard to draw the line on when a person is able to make decisions about sex prevent you from saying it's wrong to have sex with a 5 year old, and perfectly fine to have sex with a 23 year old? The line is fuzzy between those numbers, but just because it's hard to draw doesn't mean no decisions can be made on the issue.