Case Study on Corrective Surgical Procedure

Introduction

Our children are the future of society and will flourish in forthcoming endeavors when given proper education, guidance, and support. Children need to be given a chance to succeed. For instance, Joe Weinstein is an 11-year-old boy with Down Syndrome who needs immediate corrective surgery but is denied consent for such surgery by his parents. If Joe were to outlive his parents, they believe that resources are inadequate and fear that Joe will become a burden to their other non-disabled children. Without Joe’s corrective surgery, he would live no longer than the life expectancy of 30 years old. As a medical practitioner, I would proceed with the corrective surgery if Joe agrees to the procedure against the wishes of his parents because of Joe’s autonomy and weak paternalism. I will also argue that I would highly recommend Joe give consent to the surgery because the overall benefits outweigh the risks.

Case Study on Corrective Surgical Procedure

In order to consider performing a surgical procedure on Joe, it is my duty to consult with the patient, as well as his parents/guardians since he is under the age of consent of 18 years old for surgical operations. I would need to assess Joe’s competency, to ensure his autonomy. Joe shows signs of adequate motor and manual skills, cognitive awareness, and can communicate verbally with his peers. According to Brock and Buchanan’s understanding of competency, Joe would be presumed competent to accept the potentially life-saving treatment that is relatively free of risk; however, he would be considered incompetent to reject it. Currently, we do not know Joe’s choice but only what his parents have decided for him. In the eyes of Brock and Buchanan, his parents would be deemed incompetent for refusing the surgery. One might argue that Joe cannot be autonomous because he has Down Syndrome, which affects his competency, and because he is not capable of grasping the severity of his situation due to his age.

Autonomy and Decision-Making

My argument is that even though Joe is only 11 years old and is nearing the primal age of puberty, he should have a say in what may affect his life. The principle of autonomy is the principle of self-determination, which declares we should promote others to make decisions and choices that benefit them. His parents are preventing Joe from being autonomous because they are making the decision without his consent. An argument may be that his parents have the complete authority to make the decision for him because Joe might not completely understand the concept of life at this age. However, I would argue that his parents are choosing to deny Joe from living a much longer and promising life.

Parental Beliefs and Paternalism

Furthermore, Savulescu and Momeyer state that being autonomous requires holding rational beliefs and making rational deliberations. Joe’s parents are holding irrational beliefs, as they are failing to hold a belief responsive to the evidence. Joe’s corrective surgery secures that Joe will live past 30 years old without performing an abrasive life-threatening surgery. However, his parents’ belief that inadequate resources and fear of Joe becoming a burden to his siblings outweigh the evidence shows an irrational deliberation. Concluding without evidence of these potential consequences questions the rationality of his parents’ beliefs and deliberations. Parents want to do what’s best for their children, even if it means interfering with their actions and decisions. In Joe’s situation, his parents made the decision to refuse the surgery because they thought it was the best choice. However, I would argue that their decision was an act of weak paternalism. Based on Mappes and Zembaty’s concept of paternalism, necessary intervention with a person’s freedom is justifiable because of reasons that will benefit them through good, happiness, needs, interests, or values of the person being suppressed.

Potential for Independence

Paternalism is considered weak when a person’s freedom is restricted in order to prevent him/her from harming him/herself. Joe’s parents are preventing Joe from undergoing the procedure to prevent harm to their other non-disabled children in the future. Even though Joe has never lived at home with his family, his parents still fear that this would be a consequence of Joe’s successful surgery. Since Joe has never lived at home, attends a special school with children similar to him, and is recommended to go to a community sheltered workshop following his education, where he will have gainful employment, he can live an independent life after the surgery with little assistance. Hence, their denial of the surgery is not justifiable because Joe would not gain anything from them doing so. Furthermore, what kind of parents would not want their child to live a long and healthy life? Focusing on how he may be a burden to others who are not like him makes one question their parental beliefs.

Bioethics Principles

Finally, the roots of bioethics principles are the principle of nonmaleficence and the principle of beneficence. These principles share a common idea that one should do good by not causing harm to others physically, emotionally, or mentally, and by promoting the well-being of others. My argument is that if Joe does not undergo the surgery, then that could cause him harm because his days would be numbered. One might argue that everyone dies eventually and living 10-20 years longer would not matter. I would argue that if the patient were older, that might be the case; however, Joe is only 11 years old and adding 40-70 more years would affect his life immensely. Furthermore, in accordance with the principle of beneficence, I would argue that going through with the surgery would be beneficial for Joe and his parents. Joe would be able to run and play like all normal children, and his parents would be able to make up for the time Joe spent away from them.

Conclusion

In conclusion, I argue that Joe should go through with the corrective surgical operation to respect Joe’s autonomy and correct his parents’ views of his handicaps. As Joe’s medical practitioner, I will do my best to provide all the information needed for my patient to make a free and informed decision with full knowledge of the corrective surgical procedure. Children with Down Syndrome may have mild to moderate intellectual disabilities, but this would just mean that Joe would have to learn at his own pace. Based on the following evidence, I, as a medical practitioner, would highly recommend Joe to give consent to the surgery because of all the benefits that will come after the successful corrective surgery. Joe is capable of living a long prosperous life despite his Down Syndrome if he receives the surgical operation and is able to reach his goals in life. He will be able to live an independent life, get a proper education, and enjoy his family when the time comes. In addition, there is only a 3-5% risk of death associated with the procedure. In order to maintain a patient-practitioner relationship, I would accept his decision no matter the outcome.

References

Brock, D. W., & Buchanan, A. E. (1989). Deciding for Others: The Ethics of Surrogate Decision Making. Cambridge University Press.

Mappes, T. A., & Zembaty, J. S. (1991). Biomedical Ethics. McGraw-Hill.

Savulescu, J., & Momeyer, R. W. (1997). "Should Informed Consent be Based on Rational Beliefs?" Journal of Medical Ethics, 23(5), 282-288.