Theories used in Case Study: Fetal Abnormality

Write a 250-500 word analysis of “Case Study: Fetal Abnormality.” Be sure to address the following questions:

1. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? Explain.
2. How does the theory determine or influence each of their recommendation for action?
3. What theory do you agree with? How would the theory determine or influence the recommendation for action?

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Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the U.S. for the last 3 years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant, and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted and it is determined that the fetus has a rare condition in which it has not developed any arms, and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying out loud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis, and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes, but is finding it difficult to not view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place, and urges Jessica to think of her responsibility as a mother.

Theories of moral status. (Theories used in Case Study: Fetal Abnormality)

The theory based on cognitive properties holds that it is not any sort of biological criteria or species membership (such as the theory based on human properties holds) that endows a being with moral status. Rather, for this theory it is cognitive properties that confer moral status upon a being. In this context “cognition refers to processes or awareness such as perception, memory, understanding, and thinking…[and] does not assume that only humans have such properties, although the starting model for these properties is again the competent human adult.” Notice carefully that this is claiming that if a being does not bear or express these properties, it follows that such a being does not have moral status. The theory based on moral agency holds that “moral status derives from the capacity to act as a moral agent” in which an individual is considered a moral agent if they “are capable of making judgments about the rightness or wrongness of actions and has motives that can be judged morally” . Theories used in Case Study: Fetal Abnormality

The theory based on sentience holds that the property of sentience is that which confers moral status on a being. Sentience in this context is “consciousness in the form of feeling, especially the capacity to feel pain and pleasure, as distinguished from consciousness as perception or thought.” According to this theory the capacity of sentience is sufficient for moral status (i.e. the ability to feel pain and pleasure confer upon a being moral status). The final theory holds that relationships between beings account for a beings moral status. Usually these are relationships that establish roles and obligations, one example being the patient-physician relationship. Of course, there are many types of relationships (family, genetic, legal, work, etc.), even ones in which one party in the relationship does not desire or value the other party. In such a case, a person who holds this theory may be forced to concede that a beings moral status may change, depending on the other party.

Consider also that the particular shape that each of these theories takes will be in the context of a broader worldview framework. Thus, the way in which Christianity and Buddhism would apply a theory based on human properties or a theory based on sentience would be very different. Furthermore, there may be worldview considerations that would not allow one to hold to one or more of the theories. It should be noted that while the video lecture covers a variety of views, it is not exhaustive (there a clearly more theories covered here) and furthermore seems to implicitly assume or be working in the framework of a particular worldview. What worldview could it be and what are some of the assumptions being made in the background?While they might be categorized in different ways, we will break them down into the five following view or theories commonly used by bioethicists: (1) a theory based on human properties, (2) a theory based on cognitive properties, (3) a theory based on moral agency, (4) a theory based on sentience and (5) a theory based on relationships. Each of the above theories takes a selected characteristic or set of characteristics and views it as that which confers moral status upon a being. Thus, a theory based on human properties holds that it is only and distinctively human properties that confer moral status upon a being. It follows that all and only human beings, or Homo sapiens, have full moral status. Some of the characteristics that would endow a being with moral status under this view would include things like, being conceived from human parents, or having a human genetic code. Whatever property (i.e. characteristic) the particular theory picks out is considered that which confers moral status upon a being or entity. Theories used in Case Study: Fetal Abnormality