'The medical profession has its rules and regulations which bind every practitioner in the profession. One of them is that the confidentiality of the patient is paramount and there should be inclusivity of the patients in the treatment or delivery of services. These are the aspect which brings integrity and respect to the medical institution.'
There are several ethical dilemmas which can engulf a person in his or her daily activities. The dilemma of a doctor who has a patient who has a father kidney donor has second thoughts on donating his kidney despite being a perfect match. The doctor is torn between agreeing with the argument of the donor that he should inform the family that there is not a perfect match in the family or inform the family members that the father is an excellent match. The situation of the patient (daughter) is critical, and kidney transplant should be done in urgency if the child were to survive, but the perfect match is hesitant and would a cadaver match would take long to find and the probability of rejection would very high. Therefore, in this case, the doctor is faced with the following ethical question, should the life of an innocent person be lost due to the self-interests of a person, who should serve as the caregiver?
The doctor should view all family members as a family and not patients, and this would mean and characterize the family members as one entity. This is because the nature of the problem which the doctor has is based on the action of all the family members. The family has one of their own sick and dependent on their help for the healing of their kin. Taking them as a family would mean that they are bound by the nature of life as a family. This calls or times when the family is facing a crisis, they should face it together. There is a sense in which when the doctor views the family members as patients; then he is bound to uphold the confidentiality of his patients and treat them as individual members. In this case, this case, the family is a factor which will influence the doctor to caution the other family members of the intention of the father.
The family is the basic social unit of the society. It is the aspect which creates a nation and perpetuates the cultures, norms, and values which are upheld by the nation. There is a sense in which one can argue the family is one entity which is bound to survive the detriments which may come and threaten its splitting especially death. Death to a family is a great loss, and all family members would do to great lengths to ensure that all the family members have great health and can survive for generations. The family bond, therefore, is stronger at situations which are critical. However, there are instances where there is that family member who does not conform to the values of the family, and self-interest is at the center of his life. This is what causes the family to have cracks and probably disintegrate.
The medical profession has its rules and regulations which bind every practitioner in the profession. One of them is that the confidentiality of the patient is paramount and there should be inclusivity of the patients in the treatment or delivery of services. These are the aspect which brings integrity and respect to the medical institution. There is a sense in which a doctor is not bound by the moral or ethical challenges which may come his way in the practice. However, he is bound by the rules and regulations of the profession.
When reviewing the matter based on the aspects which are discussed above, it is determinable that the doctor should take the case as a family matter. Taking it as real patient-doctor medical practice would surely culminate into the loss of life. This is because the donor qualifies to be his patient and therefore patient-doctor confidentiality will lead to the doctor following the directive of the father not disclose his condition to the family. However, if the doctor were to take it as a family matter, he would then have to disclose the matter to the family. This would then make the family members encourage the father to donate his kidney to his daughter. He would be reminded of his responsibility to the child and result to his acceptance to donate his kidney. The matter would be resolved, a life would be saved and the family would remain united as opposed to the viewing of the issue on a corrective lens which would respect patient confidentiality and a loss of life.
In this essence, therefore, there are several ethical and moral theories that can be billed against the dilemma which the doctor is facing. One the theories are absolutism which was propagated by the Plato. The ethical belief of moral absolutism is that the basis for the determination of activity is if it is right or wrong which is regardless of which the act is done. Therefore, according to the theory, it is either the actions are inherently immoral or moral without the consideration of the goals and beliefs of an individual, the culture or the society which engages in the act (Kadambi, 2009). Moral absolutist bears the notion that morals and inherent and bound by the laws of the universe. Morality is also bound by the will of God, the nature of humanity and other fundamental sources.
Moral absolutism, when viewed from the aspect of the doctor, would be that his professional rules and regulations would be the ones for consideration for the decision of the doctor. It would, therefore, be right for the doctor to employ the aspect of the family rather than that of his professionalism to save a life. It would not matter if it would be barraging of the confidentiality of the patient, but rather it would be based on an aspect of saving a life. One the other hand, it would be wrong for the doctor to expose the intention of the father to the rest of the family to prevent the death of the daughter. This is because the father can be subjected to backlash and might lose his role as the head of the family. The family would be betrayed by the actions of the father, and therefore, life might be saved, and a family would disintegrate.
The other theory which can be applicable here is the one of the eudaimonism which was propagated by Aristotle. It is a moral theory which implies of the situation of divine and positive sate which humans should strive and yearn to achieve. This is to the extent in which it is expected of humans to try to achieve a sate which is equivalent to that of a benevolent deity (Price, 2013). Also, it takes the concern of the being able to achieve a situation of being looked after or being protected by a benevolent deity.
When viewed in the perspective of the father and her daughter, the doctor should view it in a way the father should behave as a benevolent deity who protects and looks after his children. The father should strive to achieve the status of an earthly hero to the daughter by giving all to save his daughter. The daughter is dependent on her father and has probably grown knowing her father can do anything for her sake. In this case, the father should behave as one who benevolent, and the doctor should apply such on the matter. However, the doctor can view this from the perspective of human weakness. The human body, mind, and spirit is fragile and can be corrupted by trivial things. Therefore, the doctor can understand the situation of fear which the father is going at the time. However, such an understanding and failure would result in the loss of the live of the patient as the cadaver is being searched for, which can take long, found but the body rejects it, or a match never being found.
The other sociological theory which can be reviewed against the decision he doctor will be undertaking is the one of Natural Law which was propagated by Thomas Aquinas. The theory espouses that God instilled a divine reason in his all his creation (Charlton, 2014). In this case, the Natural Law was given to man to guide him in the performing of his actions. Nature placed the law and therefore should help a man in the making of his decisions and actions. Therefore, all creatures created by God including humans have deterministic reason abilities which are inherent to them to perpetuate life and continue living (Charlton, 2014). The principle which Aquinas emphasized on is that humans should peruse and do good, and evil should be avoided at all cost. The use of reason is therefore invoked in situations where man has found himself in choosing of several courses of action to achieve something. Doing good, therefore, should be paramount in every thread of reason humans shoulder be having while conducting their activities. In this case, the actions of a person should be base by his desire to do good and his reasoning geared in achieving good deeds.
The doctor should, therefore, apply reason in determining the best for his patient. In this case, the most appropriate good gesture is to have actions which will save the life of the patient most quickly and reliably possible. In this case, the preservation of life is paramount than all other aspects of life. The doctor should be guided by reason which will enable him to get the donor to give his kidney. This is by informing the family members of the decision of the father by leading to him being subjected or convinced to donate his kidney. However, in this case, the aspect of good is relative, reasoning is here double edged. The father of the girl will feel betrayed by the doctor by mentioning his intentions to the family members and his reasoning; the doctor would have done him an evil act. Therefore, the doctor will have to decide based on the lesser evil of the from the context of the father and the daughter. Doing good in this respect is paramount, and the context of the fathers should be understood as actions for murder.
The other theory is the pone of Deontology which was propagated by Emmanuel Kant. This is in the sense that the judgment which one should have is based on the morality of the choices in the subject and the effects. Therefore, this theory points out that the choices which one should make must not be accounted by the perceived effects which they will bring. There is a sense in which the morality of the consequences however much good; some choices are not accepted (Booth, 2008). Therefore, a good choice for this theory is one which conforms with the expected norm. This is such that every moral agent obeys each of the norm which held in authority. Therefore, in this context, the right is held supreme over what is good. If an act is nor undertaken by what is right, however, no matter how the potential of producing good results might be at the end.
When this kind of theory is applied in the case of the doctor, it would be good for the doctor to expose the fathers since his family members will encourage him to donate his kidney to her daughter. Also, it would be god if the doctor were to follow the advice of the father since not one will know and the family will not disintegrate after the discovery of the betrayal of the father. It is therefore determinable that the actions of the doctor to the father would be good, and would result in the family believing that a match was not found among them. However, on the contrary, what the doctor will be doing will not be right for the patient. What the father is doing is not right to the daughter he brought to life. Therefore, the doctor should follow what is right and come up to the conclusion that the right of the family to know that the father is a perfect match. It is right for the child to receive a kidney from someone who is her guardian. The right action here is for the father to donate the kidney, since who else expects to donate a kidney for his child. The accepted norm in the society is that the father should be the guardian of the family and should go to great length to ensure the survival of his family. This includes the actions which the father will do to save his child, and that is the consideration which the doctor should base his conclusion.
The other the theory is the utilitarianism which was propagated by John Stuart Mill. The theory bears the notion that the actions of a person will be used up if they are for the benefit of the many in the society. This is in the sense that the action should bring happiness and this is based on the majority who will be happy by the actions, and it should be the guiding principle of the actions which people make (Arntzenius, 2014). Therefore, in this context, the doctor should hold the decision which would make the majority happy, who are the rest of the family members of the family. This is opposed to the father who will be alone the beneficiary of the action of the doctor if he decides to take the advice of the father. On the contrary, if the hospital management discovers the actions of the doctor, then a majority of the members will not be happy with his decision. It is in this context that the doctor will be interdicted due to his actions which lead to a donor being coerced to donate his kidney. The donation should be voluntary, and coercion is not something which would please the majority of the hospital board.
The other theory is contractarianism which was propagated by the John Ralws, and it bears the notion that moral norms should be derived from nature of the agreement or the idea of contract (Dobrijevic, 2011). In this context, the family agrees that the family member who has a perfect match would donate the kidney to the ailing daughter. The agreement, therefore, is bound by the concurrence of the family members and any deviance would be against the common will. Also, the mutual agreement of the doctor’s rules and regulations denotes that the confidentiality of patients should be upheld by all means possible. It is therefore paramount for the doctor to consider this to make a sound decision. It is in this contest that the decision which the doctor will make will have to base on mutual agreements.
Having discussed the theories and how they apply to the decision which the doctor will have to be based on the moral convictions of these theories. The most convincing one is the use of reason as denoted in natural law. The doctor should reason out on the aspect which hill benefit all the family members. The girl deserves to have the protection and providence of the father and therefore it is necessary that the doctor takes the matter as of a family and not as patients. Therefore, the right action of the doctor is to inform the family members was a perfect match, and the little girl will have a kidney. The father should not be selfish to the extent of not providing even the most desired of things to save his family. Therefore, the reasoning of the doctor would be upholding of his Hippocratic oath of protection of health and saving of lives.
References
Arntzenius, F. (2014). utilitarianism, decision theory and eternity. Philosophical Perspectives, 28(1), 31-58. http://dx.doi.org/10.1111/phpe.12036
Booth, A. (2008). deontology in ethics and epistemology. Metaphilosophy, 39(4-5), 530-545. http://dx.doi.org/10.1111/j.1467-9973.2008.00559.x
Charlton, W. (2014). Natural law, Aquinas, and the Magisterium. New Blackfriars, 96(1063), 326-344. http://dx.doi.org/10.1111/nbfr.12108
Dobrijevic, A. (2011). Contractualism vs. contractarianism. Filozofija I Drustvo, 22(3), 27-44. http://dx.doi.org/10.2298/fid1103027d
Kadambi, R. (2009). 'The Laws of Plato': An Account of the Political and Moral Practice of Law Giving (The Laws of Plato trans Thomas Pangel). SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.1650914
Price, A. (2013). Eudaimonism and Egocentricity. The Harvard Review Of Philosophy, 19, 84-95. http://dx.doi.org/10.5840/harvardreview2013196
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