Case Study: Fetal Abnormality
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three 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 aloud. 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 not to 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.
Moral Status: Case Analysis
After reading of the “Case Study: Fetal Abnormality” and other topic Resources, respond to the following, using only citations from the case and topic Resources:
1.Based on the case and other topic Resources, in 500-600 words, what is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
2.Based on the case and other topic Resources, in 250-300 words, which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
3.Based on the case and other topic Resources, in 250-300 words, how does each theory used determine or influence each of their recommendations for action?
4.Based on the case and other topic Resources, in 250-300 words, what theory do you personally agree with and why? How would that theory determine or influence your recommended action?
5.Based on the case and other topic Resources, in 250-300 words, how does the integration of knowledge in health care (theories, multiple ways of knowing, evidence) and knowledge from other disciplines inform and support your current or future professional health care practices and judgements?
1. Christian View of the Nature of Human Persons and Moral Status Theory (500-600 words)
The Christian view of the nature of human persons is deeply rooted in the belief that humans are created in the image of God, known as Imago Dei. This concept implies that every human being possesses inherent value and dignity from the moment of conception. According to Genesis 1:27, “God created mankind in his own image, in the image of God he created them; male and female he created them”1. This belief underscores the intrinsic worth of every human life, regardless of physical or mental condition.
This view is compatible with the theory of Immediate Imago Dei, which holds that the moral status of a human being is determined at the moment of conception. This theory asserts that human life is sacred and must be protected from the earliest stages of development. The intrinsic value and dignity of human life are not contingent upon any external factors such as physical abilities, social status, or economic contributions1.
The Christian perspective on human dignity is closely related to the concept of intrinsic human value. Since humans are made in the image of God, they possess an inherent worth that cannot be diminished by any circumstances, including fetal abnormalities. This belief mandates the protection and respect of human life at all stages, emphasizing that every person, including a fetus with abnormalities, has a right to life and dignity2.
2. Theories Used by Jessica, Marco, Maria, and Dr. Wilson (250-300 words)
Jessica: Jessica seems to be influenced by the Theory of Sentience, which considers the capacity to experience pain and pleasure as the basis for moral status. Her concern about the quality of life for the fetus indicates that she values the potential suffering the child might endure3.
Marco: Marco appears to lean towards the Theory of Relationships, which emphasizes the moral significance of relationships and emotional bonds. His insistence on telling Jessica about the diagnosis himself suggests that he values the emotional and relational aspects of the situation3.
Maria: Maria’s reaction is indicative of the Divine Command Theory, which bases moral status on the commands of God. Her immediate turn to prayer and her distress over the diagnosis reflect a belief in the sanctity of life as dictated by religious teachings3.
Dr. Wilson: Dr. Wilson seems to adopt a Utilitarian Approach, focusing on the outcomes and overall well-being. His consideration of the practical implications and quality of life for the child and the family suggests that he is weighing the potential benefits and harms of continuing the pregnancy3.
3. Influence of Theories on Recommendations for Action (250-300 words)
Jessica: The Theory of Sentience influences Jessica to consider the potential suffering of the child. This may lead her to lean towards termination to prevent future pain and hardship for the child3.
Marco: The Theory of Relationships guides Marco to prioritize the emotional well-being of his wife and the family unit. He might recommend continuing the pregnancy, focusing on the support and love they can provide to the child3.
Maria: Guided by the Divine Command Theory, Maria would likely advocate for continuing the pregnancy, emphasizing the sanctity of life and trusting in God’s plan, regardless of the diagnosis3.
Dr. Wilson: The Utilitarian Approach might lead Dr. Wilson to recommend termination if he believes that it would result in the greatest overall well-being for the family, considering the potential challenges and suffering associated with the child’s condition3.
4. Personal Agreement with a Theory (250-300 words)
Personally, I agree with the Immediate Imago Dei theory. This theory aligns with the belief that human life has intrinsic value from the moment of conception, regardless of physical or mental conditions. This perspective emphasizes the sanctity and dignity of human life, advocating for the protection and respect of all individuals.
This theory would influence my recommended action by prioritizing the preservation of life. I would recommend continuing the pregnancy, providing comprehensive support and care for the family, and ensuring that the child receives the necessary medical and emotional support. This approach respects the inherent worth of the fetus and upholds the moral obligation to protect vulnerable lives1.
5. Integration of Knowledge in Health Care (250-300 words)
The integration of knowledge in health care involves combining ethical theories, multiple ways of knowing, and evidence-based practices to inform and support professional judgments. Understanding different moral theories allows health care professionals to navigate complex ethical dilemmas and make informed decisions that respect the values and beliefs of patients and their families.
Incorporating knowledge from other disciplines, such as psychology, sociology, and theology, enriches the decision-making process by providing a holistic understanding of the patient’s context. For example, understanding the psychological impact of a diagnosis on a family can guide compassionate communication and support strategies.
Evidence-based practices ensure that clinical decisions are grounded in the best available research, enhancing the quality and effectiveness of care. By integrating ethical theories, interdisciplinary knowledge, and evidence-based practices, health care professionals can provide patient-centered care that respects individual dignity and promotes overall well-being1.
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