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• Friday, February 9, 2007 06:39 AM

  ethics and autonomy

  I'm jumping in to agree with everyone who said that there was a lot of medical ethics involved in this decision. The panel of people involved was a broad panel, and many of them were trained in medical ethics. So, you can't actually say they didn't attempt to consider the decision from all the ethical points of views possible. This is the best decision IN THIS CASE.

  This woman has no autonomy that can be protected by anyone other than her guardians. Her parents are the surrogate decision makers for her, and they protect her autonomy. They are proxies for her in this case, and they must imagine what she would want (if that's at all possible), and if they can't imagine it (lack of information about any kind of want of a 3-month old beyond care, nourishment, stimulation), they must do their best to decide in her place.

  What benefit is it to this woman (who has not AND will never advance beyond a 3-month-old mental state, if her prognosis is to be believed) to have menstruation, menstrual cramps, sore and bloated breasts, regular pap smears, and eventually mammograms (doesn't breast cancer run in the family, too)? Absolutely none given her condition. There is absolutely no benefit for a 3-month old to have these things. What benefit is there for her to be close to her family, and stimulated as much as she can be through interaction? Quite a bit.

  For those of you who want her to have autonomy, do you think her parents should themselves (or pay an outside worker) to stimulate her sexually once her sexual organs are fully developed? Is it in her rights to have sexual stimulation? How often? If you think that sounds weird and possibly bordering on rape, that's because this woman doesn't have full autonomy because she can't ask for or indicate that she desires such.

  I can't see how you think the parents decided this for their own benefit. Yes, they will certainly benefit by having her caretaking remain the level it is now (rather than becoming increasingly difficult), but the medical ethics panel would not support a decision for those reasons. The parents made the decision based on doing their best as surrogate decision makers in the place of a woman who cannot make a decision nor indicate her preferences (nor even form preferences about these kinds of decisions).

  —Agalma Read Agalma's other letters
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