THE MORAL ISSUE OF BIRTH DEFORMITIES  paralysis below the waist

Ma’am Mercy Dedal  no bladder and bowel control

Birth Deformities - defects, malformations, Hydrocephaly

or abnormalities of a child which are  hydro (water) + kephale (head)
present at birth.  water in the head or brain
 accumulation of fluid within the
Two Kinds of Deformities ventricles or between the membranes
1. Genetic Deformities - present in the of the brain
genetic material  abnormal swelling or enlargement of
2. Congenital Deformities - present at birth; the head
non-hereditary
Anencephaly
Causes of Congenital Deformities  an (without) + enkephales (brain)
1. Radiation  without brain
2. Biological Disease Agents  brain is partially or almost absent
3. Nutritional Deficiencies  some bones of the skull are not
4. Drugs completely formed, thus leaving an
5. Chemicals opening through which the brain
material swells out forming a sac or
Types of Deformities bag (as in spina bifida)
1. Trisomy-21 or Down’s Syndrome
2. Spina Bifida Esophageal Atresia
3. Hydrocephaly  atresia is the closing or blockage of a
4. Anencephaly normal canal or opening
5. Esophageal Atresia  closing of the esophagus
6. Duodenal Atresia  muscular tube has no opening through
which milk or food may reach the
Trisomy-21 or Down’s Syndrome stomach
 after John Down
 genetic disease which results from the Duodenal Atresia
presence of an extra chromosome in  the duodenum (upper part of the small
the genetic formation intestine), is closed off; hence, food
 affected newborn has twenty first cannot pass through and be digested
triple rather than a twenty-first pair of  surgical operation is highly successful
chromosomes
RETROSPECT
Physical Deformities  Parent’s moral decision is very crucial
1. Broad skull  Physicians should brief the parents
2. Large tongue about all pertinent information in
3. Upward slant of the eyelids (mongolism) connection with the status of the
4. IQ of 50-80 malformed child
5. Can be trained  Informed consent

Spina Biifida APPLICATION OF ETHICAL THEORIES

 opening in the spine A. Roman Catholic
 bulging sac resulting from the 1. right to life must be respected
protrusion of the membrane covering and safeguarded
of the spinal cord 2. consider the suffering of the
 spinal fluid and nerve tissue contained family, the exorbitant cost of
in the swelling protuberance medical treatment, the need for
 multiple operations and the REDEFINITION AND DETERMINATION OF
usefulness of expensive medical DEATH
care  To know and be able to determine the
exact point in time when a person is
B. Kantian Principles dead
1. If the malformed baby is a  Reason 1. widespread and increasing
person, then it possesses an use of new devices for prolonging life
inherent dignity and worth.  Reason 2. Great demand for cadaver
2. Lacks capacity to reason organs for transplantations
(rationality and to express its will
(autonomous and self-regulating THREE REASONS NOT TO ATTACT THE
will), which are the bases of human DYING PERSON TO DEVICES
dignity. 1. Avoid paying numerous expenses
2. Eliminate the suffering of the dying
C. Ross’s Ethical Principles to Resolve individual
Conflicting Duties 3. Use of these life-saving machine for
1. Prima facie duty is more patients who have better chance of
stringent survival
2. Example. The duty to have a
deformed baby be operated on for DEFINITIONS OF DEATH
spina bifida condition. 1. Physiological Definition
3. Physician’s role in informing the - a person is dead when the heart
deformed baby’s parents about the has stopped
degree of the deformity, the cost of - traditional understanding of death
multiple operations, and the 2. Religious or Philosophical Definition
consequences of whatever decision - death means separation of soul
they may arrive. and body
- soul is viewed as the principles of
PRINCIPLES OF SITUATION ETHICS by life; animates and gives form to
Joseph Fletcher the body
 Favors the expulsion of a terrible 3. Brain Death Definition
malformed fetus and to terminate - the brain is completely destroyed;
subhuman life in extremis in old age the cessation of function of all
 Endorses painless merciful and other organs are imminent and
painless killing of deformed babies inevitable
 Only the end justifies the means - loss of respiratory and circulatory
functions
UTILITARIAN - absence of receptivity and
1. Personal responsiveness
2. Social - absence of movement or
3. Greatest happiness for the greatest breathing
number - absence of reflexes

PRAGMATIST’S MORAL PRINCIPLES CELLULAR DEFINITION

 Usefulness, practicality, workability - disintegration and breakdown of
and beneficiality the metabolic processes of the
 Depends upon patients’ financial body substances
resources and sense of being - irreversible loss of neo-cortical
pragmatic or realistic and practical activity
- death is the cessation of life
IN THE MEDICAL CONTEXT PRINCIPLE OF AUTONOMY
- brain death definition is very  Right of self-determination
important  Right to act and decide by and for
- most suitable donor come from himself
patients who die from injuries or
diseases of the brain PATERNALISM
- Informed consent to avoid liability  Pater (father) or paternus (fatherly)
paternalism
ATTITUDES TOWARD DEATH  The act of being fatherly to someone
1. Cognitive Attitude  In keeping with principle of
2. Affective Attitude nonmaleficence and Menciu’s human-
3. Behavioral Attitude heartedness

Several Views of Death Types of Paternalism

1. Nikolai Berdyaev 1. As to the recipient’s welfare
- “only death can give meaning to - Pure Paternalism
life” - Impure Paternalism
2. Epicurus 2. Recipient’s defect and safety
- “either there is immortality or - Restricted
there is none - Extended
3. Martin Heidegger 3. Promotion of good and prevention
- “death is the completion of life, - Positive
unless and until one dies, one’s life - Negative
is not yet complete” 4. Patient’s sense of values
4. John the Evangelist - Soft paternalistic act
- “I am the resurrection and the life; - Hard paternalism
he that believes in me, though he 5. Recipient of the benefit
were dead shall live again; and - Direct
whoever lives and believes in me - Indirect
shall never die.” In the medical context
- Personal paternalism
APPLICATION OF ETHICAL THEORIES - State paternalism
1. Natural Law - Justification for personalism
2. Utilitarian Principles - Justification of state paternalism
3. Pragmatist - Application of ethical theories
4. Rawls’s concept of justice
TRUTH-TELLING
THE MORAL ISSUES OF PATERNALISM AND Two Approaches
TRUTH-TELLING 1. Person Centered
1. Feeling of helpfulness and 2. Problem Centered
commiseration Two Types of Relationship (Martin Buber)
2. Feeling of shame and dislike 1. I-it
3. Feeling of modesty and yielding 2. I-thou
4. Sense of right and wrong - Justifications for truth-telling
- Confidentiality
FOUR CONSTANT VIRTUES - Application of ethical theories
1. Human-heartedness 1. Natural Law
2. Righteousness 2. Ross’s Ethical Principles
3. Propriety 3. Kantian
4. Wisdom 4. Moral Principles of
Situationism