Freethought & Rationalism Archive

JerryM · 10-07-2002, 01:16 PM

This is an interesting medical ethics case that was reported in this week's issue of American Medical News. Even if you're not a health care worker, it's intriguing to think about it. A bright 11 year old is admitted to the hospital with weakness and flu like symptoms. Tests reveal an advanced and very agressive malignancy, for which no treatment is available. Her prognosis is extremely poor. The father asks that his daughter NOT be told of the diagnosis and prognosis, believing this will only add to her suffering. Recognizing that a parent has a legal right to make decisions regarding a child's medical care (with a few exceptions), do people feel this request is ethical? Does anyone feel that, if they were involved in this child's treatment, they could comply with the father's wishes in good conscience?

Jayhawker Soule · 10-07-2002, 01:28 PM

Yes.

Danish · 10-07-2002, 02:01 PM

Ethical: probably. Bad parenting: probably. Well, if the kids askes daddy whats wrong with her, he should tell her.

Jesus Tap-Dancin' Christ · 10-08-2002, 06:28 AM

That father is a moron. She's smart enough to figure it out on her own, and then realize that her father knew beforehand. Imagine what that would do to you.

jaz · 10-08-2002, 07:22 AM

The girl is 11 years old. She knows she's sick. And she will realise that something is up when he refuses to tell her what is wrong. She will only assume the worse.

Whether it's ethical is a whole other ball game. It's tricky, she's at that sticky age where she's no longer a child as such, but she's not an adult, or even a teenager either. I personally belive she has a right to know.

If I was involved with her treatment, and she were to ask me directly what was wrong, I wouldn't be able to lie to her.

babelfish · 10-08-2002, 07:31 AM

How will this father say goodbye to his child when the time comes?

JerryM · 10-08-2002, 08:08 AM

I personally think the father's request is wrong. He's asking the medical team to withold medical information from a patient, which I feel is highly unethical in this setting. I do work in the health care field, though not in pediatrics. But I know that children of this age are fully capable of understanding illness and its ramifications. And children often handle a terminal illness better than adults. I agree completely with jaz--she knows something is going on. Can she really be kept in the dark? She's going to need palliative or hospice-type care. She can't be lied to. The family needs counseling to explore why the father feels this way--and to help everyone grieve and come to terms with the situation.

seanie · 10-08-2002, 08:29 AM

Yes.

I don't think I'd agree with the father's position but I'd go along with it. Put simply I wouldn't feel I had the right to second guess the father. I wouldn't have the right to override him and tell the child just because I felt it was the right thing to do. That's why you have codes of ethics. To stop people doing whatever they happen to feel is right.

The father might be wrong but then so might I be. And he has more right to be wrong than I do.

brighid · 10-08-2002, 09:13 AM

There may be personal circumstances that we are unaware of that have affected this parents choice regarding this child and the decision to withhold that information. I think we do not have enough information regarding his reasons, motives or other extenuating circumstances to pass an accurate or even adequately educated judgment regarding this choice. The parent does have the right to tell the doctor to withhold that information from the child. Perhaps he has opted to do this so that this devastating information could be presented to her by him, or the mother or another family member in a time and place that would cause the least emotional harm. The father may, at the moment feel very overwhelmed and unsure how to tell his daughter this information and as her father he may also be aware of personality issues that we are obviously unable to know at this time.

If I were the doctor I would calmly voice my concern about not informing the child of this terminal illness, but I would allow the parent a reasonable amount of time (a few days perhaps) to search his own conscience and digest this very devastating information before revisiting this issue.

I don�t see any cleared marked moral or immoral line on this one, basically due to lack of important information regarding his decision-making, his knowledge of his child�s temperament and his plans for her future life and treatment.

As a parent I can imagine the utter devastation this kind of diagnosis would cause me. How do you look into your child�s eyes and tell them they are going to die and there is nothing you can do about it? I don�t know if I could do that. Ultimately, I would be unable to keep that information from him because I believe he should be told the truth, and he should have the opportunity to say goodbye.

Is it wrong to allow your child to live his/her last days in sort of an ignorant bliss, without knowing the pain of confronting his/her mortal end and spending that time without that fear and anguish? I would venture a guess and say that the parent is doing his best to be merciful, even if it is possibly misguided. However we do not know the dynamics of that familial relationship, or the reasoning behind that decision.

Would it be possible to provide a link to the article so others could read it in full and get a better idea about this, or was this question meant to be more of a general moral situation?

Brighid

MadMordigan · 10-08-2002, 09:54 AM

How do you look into your child’s eyes and tell them they are going to die and there is nothing you can do about it?

Doesn't every parent have to tell their kid this?

10-07-2002, 01:16 PM	#1
JerryM Veteran Member Join Date: Feb 2002 Location: St. Louis, MO. Posts: 1,100	An ethical problem This is an interesting medical ethics case that was reported in this week's issue of American Medical News. Even if you're not a health care worker, it's intriguing to think about it. A bright 11 year old is admitted to the hospital with weakness and flu like symptoms. Tests reveal an advanced and very agressive malignancy, for which no treatment is available. Her prognosis is extremely poor. The father asks that his daughter NOT be told of the diagnosis and prognosis, believing this will only add to her suffering. Recognizing that a parent has a legal right to make decisions regarding a child's medical care (with a few exceptions), do people feel this request is ethical? Does anyone feel that, if they were involved in this child's treatment, they could comply with the father's wishes in good conscience?

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10-07-2002, 01:28 PM	#2
Jayhawker Soule Veteran Member Join Date: Jan 2002 Location: Chicago Posts: 1,777	Yes.

10-07-2002, 02:01 PM	#3
Danish Regular Member Join Date: Sep 2002 Location: Thorold Ontario Canada Posts: 161	Ethical: probably. Bad parenting: probably. Well, if the kids askes daddy whats wrong with her, he should tell her.

10-08-2002, 06:28 AM	#4
Jesus Tap-Dancin' Christ Veteran Member Join Date: Apr 2001 Location: Heaven Posts: 6,980	That father is a moron. She's smart enough to figure it out on her own, and then realize that her father knew beforehand. Imagine what that would do to you.

10-08-2002, 07:22 AM	#5
jaz Junior Member Join Date: Sep 2002 Location: Australia Posts: 21	The girl is 11 years old. She knows she's sick. And she will realise that something is up when he refuses to tell her what is wrong. She will only assume the worse. Whether it's ethical is a whole other ball game. It's tricky, she's at that sticky age where she's no longer a child as such, but she's not an adult, or even a teenager either. I personally belive she has a right to know. If I was involved with her treatment, and she were to ask me directly what was wrong, I wouldn't be able to lie to her.

10-08-2002, 07:31 AM	#6
babelfish Veteran Member Join Date: Oct 2001 Location: Augusta, Maine, USA Posts: 2,046	How will this father say goodbye to his child when the time comes?

10-08-2002, 08:08 AM	#7
JerryM Veteran Member Join Date: Feb 2002 Location: St. Louis, MO. Posts: 1,100	I personally think the father's request is wrong. He's asking the medical team to withold medical information from a patient, which I feel is highly unethical in this setting. I do work in the health care field, though not in pediatrics. But I know that children of this age are fully capable of understanding illness and its ramifications. And children often handle a terminal illness better than adults. I agree completely with jaz--she knows something is going on. Can she really be kept in the dark? She's going to need palliative or hospice-type care. She can't be lied to. The family needs counseling to explore why the father feels this way--and to help everyone grieve and come to terms with the situation.

10-08-2002, 08:29 AM	#8
seanie Veteran Member Join Date: Jul 2002 Location: Edinburgh. Scotland Posts: 2,532	Yes. I don't think I'd agree with the father's position but I'd go along with it. Put simply I wouldn't feel I had the right to second guess the father. I wouldn't have the right to override him and tell the child just because I felt it was the right thing to do. That's why you have codes of ethics. To stop people doing whatever they happen to feel is right. The father might be wrong but then so might I be. And he has more right to be wrong than I do.

10-08-2002, 09:13 AM	#9
brighid Veteran Member Join Date: Apr 2001 Location: somewhere in the known Universe Posts: 6,993	There may be personal circumstances that we are unaware of that have affected this parents choice regarding this child and the decision to withhold that information. I think we do not have enough information regarding his reasons, motives or other extenuating circumstances to pass an accurate or even adequately educated judgment regarding this choice. The parent does have the right to tell the doctor to withhold that information from the child. Perhaps he has opted to do this so that this devastating information could be presented to her by him, or the mother or another family member in a time and place that would cause the least emotional harm. The father may, at the moment feel very overwhelmed and unsure how to tell his daughter this information and as her father he may also be aware of personality issues that we are obviously unable to know at this time. If I were the doctor I would calmly voice my concern about not informing the child of this terminal illness, but I would allow the parent a reasonable amount of time (a few days perhaps) to search his own conscience and digest this very devastating information before revisiting this issue. I don�t see any cleared marked moral or immoral line on this one, basically due to lack of important information regarding his decision-making, his knowledge of his child�s temperament and his plans for her future life and treatment. As a parent I can imagine the utter devastation this kind of diagnosis would cause me. How do you look into your child�s eyes and tell them they are going to die and there is nothing you can do about it? I don�t know if I could do that. Ultimately, I would be unable to keep that information from him because I believe he should be told the truth, and he should have the opportunity to say goodbye. Is it wrong to allow your child to live his/her last days in sort of an ignorant bliss, without knowing the pain of confronting his/her mortal end and spending that time without that fear and anguish? I would venture a guess and say that the parent is doing his best to be merciful, even if it is possibly misguided. However we do not know the dynamics of that familial relationship, or the reasoning behind that decision. Would it be possible to provide a link to the article so others could read it in full and get a better idea about this, or was this question meant to be more of a general moral situation? Brighid

10-08-2002, 09:54 AM	#10
MadMordigan Beloved Deceased Join Date: Jul 2000 Location: Vancouver BC Canada Posts: 2,704	How do you look into your child’s eyes and tell them they are going to die and there is nothing you can do about it? Doesn't every parent have to tell their kid this?

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