The Anencephalic Infant; Are They People Too?

•October 11, 2012 • 10 Comments

The use of anencephalic infants as an organ source has been a hot button issue for years. Anencephaly is defined as “a central nervous system abnormality that is characterized by congenial absence of the forebrain, skull and scalp”. Infants with anencephaly do not typically live more than a few days. Death is certain in their case. Anencephaly can be determined as early as 12 weeks into the pregnancy at which point parents have the option of whether to abort the fetus or continue the pregnancy.

An Anencephalic Newborn

Many parents opt for abortion, while others opt to carry the fetus to full term in hopes of providing organs for babies who need them. There is an increasing shortage of transplant organs for infants and anencephalic babies have become a source to meet the needs of this shortage. In most cases, brain death must occur in order for organ donation to occur. However, this policy creates problems in the case of the anencephalic infant. How does a physician call time of death when the infant has a functioning brainstem and can essentially eat, sleep and cry? Is it morally and ethically sound to remove organs from these patients while they are still alive?

If we consider a utilitarian approach, then the answer is yes. The classical utilitarian approach has the aim to maximize the common utility of the beings who can enjoy happiness and who can suffer and to minimize the total harm. Here, one could argue that providing organs to babies in need is a great achievement that will benefit a great number of children. Anencephalic babies are a very small part of the population and it is certain that they will die shortly after birth.

On the other hand, there are those who believe that using anencephalic babies as an organ source is immoral and unethical. These views are often times rooted in the Kantian view that humans should not be used as means to an end and that people need to be respected. But are anencephalic infants people? Biologically the answer is yes. Anencephalic infants have the same genetic make up as any other human being. However, modern philosophy characterizes personhood by the functionality of an individual. Kant states that only a person needs to be respected, and a person is someone who possesses rational agents.

According to this analysis, it appears as if the anencephalic infant is not considered a person. If this is true, then why is there still a debate as to whether or not it is ethical to take organs from a living anencephalic patient? I believe this is because society is at odds as to whether an anencephalic infant is a person. It is hard to conceptualize the fact that an infant born alive with a functioning brain stem is not considered a human being. How can one say that a baby who looks like a baby, cries like a baby, sleeps like a baby is not a person?

If the deciding factor of whether a person is in fact a person rests on whether they possess rational agents, what are we to say about the mentally disabled, Alzheimer patients, persons with dementia and those who are in a coma? Are they no longer considered people because they have lost their ability to reason? I am not sure if we can truly come to a conclusion on this matter, however I do believe that one’s “worth” should not be determined objectively but subjectively. Making determinations on when a person is and ceases to be a person can create a slippery slope, one that can have serious ramifications on society.

When Enough is Enough

•September 28, 2012 • Leave a Comment

As technology continues to advance, people are becoming more and more reluctant to believe that Persistent Vegetative State (PVS) is irreversible and are therefore more willing to hold on longer to their loved ones. Brain imaging allows physicians to see the structure and function of the brain as well assist them in locating areas of the brain that have been affected by neurological disorders, and to find new treatments for these disorders. It is brain imaging that aids the physician in determining whether a patient is in PVS as opposed to a coma.

Even through the use of brain imaging, achieving 100% accuracy on a diagnosis of a mental state is not feasible. I believe that it is the margin of error that gives people hope that maybe something was overlooked. That like Kate Adamson, their loved one is in a “locked in state” as opposed to PVS and that they too will come back to life.

As hopeful as this all sounds, the question that comes to mind is how much is enough? If a person has been diagnosed with PVS and has been in this mental state for the last seven years, at what point do doctors refrain from administering brain-imaging tests? At what point is the feeding tube removed? How many times do we need to confirm that this patient is “brain dead”? An advocate for the patient may say that doctors and hospitals are to do whatever it takes. If you ask a detached taxpayer, they may say that it has been seven years and enough is enough.

Economics play a large role in this debate. The family wants the medical professionals to do anything and everything possible to keep their loved one alive, but the question must be asked, who is paying for these 10 years of medical services? There is no doubt that the medical technology keeping the patient alive is expensive. So who fits the bill? Another issue is whether or not the resources are being used adequately. America has been in a healthcare crisis for some time now, where people are not able to receive standard medical care because there is not enough money in the health care system. Is it fair to allocate scarce resources in this manner? Is this patient with PVS merely occupying a hospital bed that could have been used for a patient with a better quality of life?

I am not sure if there will ever be a clear and cut answer to these questions. It is a sensitive topic that involves life and death. Some would argue that the patient is already legally dead, while others would argue that the patient is very much alive and are just “trapped”. Regardless of whether or not one believes that the patient in PVS is dead or alive, there needs to be some sort of finality. One would think that the final answer was when a physician declares the patient legally dead by way of brain death, however time and time again we see that this in fact is not the final answer. If this is not the answer than what is? When is enough actually enough?

Female Sterilization the Morbid Solution to Overpopulation

•April 17, 2012 • 1 Comment

Over population has plagued the global world for decades. The earth’s resources are being depleted each and every day. Human consumption is increasing at an alarming rate; cities are over crowded which poses serious threats of sickness and disease. In response to this issue of overpopulation, some countries have decided to take matters into their own hands. Unfortunately, the method of choice involves the victimization of women. This method is called forced female sterilization.

Forced sterilization occurs when a person is sterilized without their knowledge or is not given an opportunity to provide consent. These practices are very common in third world countries where women are uneducated, poor and essentially have no other choice but to comply with the government’s demands. Forcing women into sterilization has often lead them to isolate themselves from their loved ones and society. It has provided them with a life full of grief and despair. It has also caused them to fear medical professionals, and a life full of grief and despair.

“Women from all over the world have been forced or coerced by medical personnel to submit to permanent and irreversible sterilization procedures. Despite condemnation from the United Nations, cases of forced and coerced sterilization have been reported in North and South America, Africa, Asia, and Europe. Women who are poor or stigmatized are most likely to be deemed “unworthy” of reproduction. Perpetrators are seldom held accountable and victims rarely obtain justice for this violent abuse of their rights”.1

It is alarming to see how an atrocity such as this can often times go unregulated and unpunished. How can the government turn a blind eye to perpetrators who force women into something that should be left solely to their discretion? It is undeniable that social status has always dictated in someway the mores of society. However, this issue of forced female sterilization surpasses societal mores. It is a direct human rights violation. Social status does not reduce the value of a person.

Women are coerced into these sterilization procedures because they are vulnerable. Many of these women are poor, destitute; some are widows who have no one to speak up for them. Others may come from societies where women are not valued and their personhood is based on a man. In order to ensure the effectiveness of female sterilization, many governments’ have found ways to make sterilization a precondition in obtaining employment or even receiving certain health services.

For example a young woman who is pregnant with a loathsome disease may be denied healthcare services if the young woman does not agree to sterilization. In the previous scenario the woman was given a choice and therefore gave consent to the procedure. However this consent was obtained through coercion.

The decision to have the female sterilization procedure is one that carries serious consequences. The main consequence is that a woman may never be able to produce children. This decision should be made on a voluntary basis by a woman. It should never be forced. Many countries around the world have turned to female sterilization to solve their country’s overpopulation issues. For example, in Uzbekistan, Uzbek women are forced to undergo hysterectomies, recommended to them by their doctors as an effective form of contraception. The worst part of this ordeal is that the government administers it. Under the decree, physicians must convince a certain number of women a month to have the procedure or else the physicians face fines and reprimands. Some physicians even sterilize women without their consent by secretly performing the hysterectomies when they are supposed to be doing other surgical procedures.2

Where is the autonomy? In the study of bioethics we examine four principles, one of them being autonomy. Consent is a major part of the principle of autonomy. A person should be able to accept of reject a procedure. A person should have the right to be informed about anything regarding their body or personhood.

Here, in this example of the Uzbek women, it is noted that this life altering procedure is often administered in secret and without their consent. This is a direct violation of the autonomy principle. Some may argue that there are some situations in which overriding one’s autonomy for the greater good is necessary. One may argue that the government in this situation has a compelling interest in sterilizing their woman due to the ongoing issue of over population. However, sterilizing women to reduce overpopulation without their consent does not override autonomy.

It is barbaric and inhumane to take away a woman’s right to procreate especially under such conditions. There are human rights implications for forcing female sterilizations on the vulnerable. I find it to be absolutely absurd that carrying certain disease will get you sterilized in certain countries. For example in Namibia women who have HIV are often sterilized without their consent or under coercion. She went in to deliver her baby, but was told by doctors that because the baby was “too large,” she would have to be sterilized. Doctors stated that if she refused to agree to the sterilization procedure, she would have to give birth without medical care.

Namibia is among the third world countries that subject their woman to these forms of practices. There have been many stories of women going to the doctor’s office for treatment of a disease and leaving sterilized. Many of these women do not even have children and because of this procedure, they never will.2

Where is the justice here? Is it just to deprive a woman her right to procreate? In the United States procreation is a fundamental right that cannot be taken away. However, in these third world countries, rights are not necessarily fundamental and women are left to the mercy of the government or tribe leaders. On a global level this practice is unethical.

Some may argue that bringing a child into the word with HIV is unjust to the child. Some may go further as to say that the child did not consent to live a life with HIV. Although this argument may be valid, at the end of the day the parent has the autonomy to choose whether to bring a child into this world and they have the right to be informed about any procedure regarding their body. It is unjust to take this right away. These dangerous practices violate human rights.

In essence, forced female sterilization violates human rights. It is an inhumane practice that should be viewed as a form of torture. In order to remedy this cruelty, there must be a uniform global policy that sends the message that these practices will not be accepted or tolerated. The physicians need to understand that informed consent is necessary to medical treatment. Although this may not eradicated the problem completely, it may decrease the frequency of the practice.

1. End Forced Sterilizations http://www.thepetitionsite.com/takeaction/982/811/175/
2. In Namibia, Being an HIV-Positive Woman Could Get You Sterilized http://news.change.org/stories/in-namibia-being-an-hiv-positive-woman-could-get-you-sterilized

The Right To Purchase Life

•March 22, 2012 • Leave a Comment

Imagine a vibrant young woman of 25 who has just begun her life’s journey. She has graduated from college and law school and is ready to embark on her career as a budding young attorney. She is lively with lots of friends and makes it a point to go on outings at least once a week. Up until this point in her life, she has done everything correctly and has never been in trouble with the law, not even a speeding ticket. She eats healthy and goes for her annual medical checkups.

Then one day she becomes very ill. She goes to the emergency room where she discovers to her dismay that she is in kidney failure. The doctors tell her that she has to go on dialysis. She will have to receive daily treatments for 10 hours each day. Her life is going to be severely limited. She will have to limit her daily activities. She will have to reduce her stress levels to avoid further health complications. The doctor tells her that perhaps she should even consider only working part time, severely limiting her career progression. Her only options to avoid dialysis are to not perform the treatments and accept death; or get an organ transplant. For this young woman, the first option is not even considered; the transplant is the only viable means for her.

So she asks the doctor, “How soon can I get the transplant?” His response is grim, “4 years.” Unfortunately, she is not sure that she can wait and live that long. So she asks, “Is there any other option?” That’s when he tells her that she can get a living donor and have the transplant within months. So she searches high and low, asking family members and friends. Unfortunately, no one is a match. However, she meets a young man, who is a match and willing to give her his kidney. This kidney would enable her to resume her normal life. He is willing to give her his kidney for a fee of $10,000. Now let us consider the plight of this young woman in light of the four principles of biomedical ethics.

Autonomy
In her article entitled “The Four Principles of Biomedical Ethics: A Foundation for Current Bioethical Debate” Lawrence tells us “to be autonomous requires a person to have the capacity to deliberate a course of action, and to put that plan into action.” The young woman we are discussing is an attorney, which indicates that she has the capacity to deliberate the decision to purchase a kidney and to actually do it. The young man in this scenario also presumptively has the capacity to deliberate the course of action and to put his plan to donate his kidney into action. Both parties survive the test of autonomy, so why shouldn’t this capitalistic transaction be allowed to take place?

Beneficence
In considering beneficence, the moral agent must be acting on their own free will and they are “charged with determining the “good” in a specific scenario or situation, and then weighing that good against the risk of specific actions.” The moral agent in our hypothetical situation is the potential kidney donor. He is acting on his own free will and has volunteered to give his kidney away. There is no direct coercion by the recipient, and we have already established under the principle of autonomy that he has the capacity to make such a decision. However, the situation is not that straight forward when we consider that this young man is asking for money, which may suggest that he is acting of desperation. So although the young woman may not be directly coercing him, the money that she is going to pay him might be too much of an influence to reach the conclusion that that he has been able to thoroughly weigh “the good against the risk of [his] specific actions.” However, the opposite argument to this is that the young man is acting normally because people’s decisions are influence by the prospect of earning money every day.

Nonmaleficence
Primum non nocere. What harm is the young kidney patient doing by purchasing a kidney? Some may argue that because she has the resources to purchase a kidney, she is in a sense purchasing life that another patient, who has perhaps been waiting longer for a kidney, may not be able to afford. This means that the playing field in the organ transplant game will not be level. For those who cannot afford to purchase a kidney, does this mean that they should die prematurely as a result? Is denying them a kidney because they do not have the means to purchase a readily available one not doing them indirect harm? Who is to say that the person with financial means has a life that is more valuable that one without it? The opposing argument to that is that it is very likely that but for the enticement of the $10,000 that the young man is requesting, he would not be offering his kidney to the young woman. Therefore, no one may benefit from this lifesaving donation. Those who cannot afford to pay for the kidney may die as well as those who are in a position to afford it. How is denying two people, instead of one, a life saving measure not doing any harm? Denying this hypothetical young woman a transplant now, does not increase the donor pool for another kidney patient. They will likely still have to continue to wait before they receive a new kidney.

Justice
“An unjust law is no law at all.” When considering the principle of justice, we must “addresses the questions of distribution of scarce healthcare resources, respect for people’s rights and respect for morally acceptable laws.”
Organs are indeed a scarce resource and therefore we must consider if by selling a part of your body, people’s rights are being respected. Is limiting the sale of organs by people with autonomy and no intention to do any direct harm really showing respect for people’s rights? I would argue that it is not. At the heart of respecting people’s rights, we must bear in mind that the decision to sell and purchase this organ was made by two autonomous individuals who have reached an agreement that they both believe will mutually benefit them—the buyer will be afforded the opportunity to live, while the seller will be more financially secure. In fact, by denying the right for them to engage in this transaction, we are disrespecting their right to make decisions about their bodies. People make decisions about their bodies everyday without interference, so why should the sale of organs be any different? We are allowed to choose to sell our blood or even be a surrogate for another person, without interference from the government; selling your organs should be no different.

Then we must consider the issue in justice that deals with having morally acceptable laws. It is difficult for me to understand why the sale of organs is amoral in the eyes of the law. The purpose of the law is to protect us. By inhibiting the sale of organs from living donors, what protection are we providing? Are we preventing people from cutting up their bodies for financial profit? A noble gesture, but at the same time that law may lead to the recipient’s demise. Is a law that may lead to death truly moral?

Conclusion
I would agree with John Harris that “[t]he principles are neither sufficient nor always a useful way of approaching ethics. Instead, …[the] principles become nothing more than a checklist.” An issue such as the sale of a kidney cannot be boxed into one of the four principles. There are many grey areas that do not fit neatly into this schism. I believe that people, especially those enduring life-threatening illnesses, should have a right to life. The ability to purchase a kidney would be an exercise of that right.

You Can Still Donate!!

•January 21, 2011 • Leave a Comment

Hello All,

Thank you so much to all of those who came out to support my organization, the Fordham Disaster Relief Network (DRN) for last night’s successful event – Renewal and Rebirth: A Fundraister for Haiti. If you were unable to make the event but would still like to make a contribution, we would greatly appreciate your support. No donation is too small and any support will be truly appreciated.

Please visit the following paypal site if you would like to donate:

https://www.paypal.com/cgi-bin/webscr?cmd=_donations&business=C8UZ76TZ6PCCE&lc=US&item_name=Disaster%20Relief%20Network%20%28DRN%29&currency_code=USD&bn=PP%2dDonationsBF%3abtn_donateCC_LG%2egif%3aNonHosted

For further information about the event and DRN, please see below, see the attached flyer, visit http://www.fordhamdrn.org or feel free to ask me any questions.

Happy Friday!

Haiti Relief Fundraiser Thursday January 20, 2011

•January 18, 2011 • Leave a Comment

FOR IMMEDIATE RELEASE January 17, 2011

Contacts: Ritha Pierre
718-344-7662
Diana Schaffner
571-2282283

Fordham Law School Disaster Relief Network to host, “Renewal and Rebirth: A Fundraiser for Haiti” on January 20, 2011.

In commemoration of the one-year anniversary of Haiti’s 2010 earthquake, Fordham Law School’s Disaster Relief Network (“DRN”) will host “Renewal and Rebirth: A Fundraiser for Haiti” on Thursday, January 20, 2011 from 6:30pm–10:00pm, in the Lowenstein Building of Fordham’s Lincoln Center campus. Proceeds will benefit the Institute for Justice and Democracy in Haiti (“IJDH”) and the Disaster Relief Network.

A year after the earthquake, survivors continue to live in tents, the cholera epidemic remains unchecked, and donors have failed to honor post-earthquake promises. IJDH has taken a leading role in advocating for a human rights-based approach to earthquake response. With a long-term focus on sustainable change in Haiti, IJDH partners with grassroots groups to develop an effective human rights advocacy program. Current IJDH projects cover topics including gender-based violence in internally displaced persons (“IDP”) camps and issues relating to IDP land rights and forced evictions.

The event will feature speakers, including Rodneyse Bichotte State Committeewoman for the 42nd District in Brooklyn, comedian “Haitian V,” and representatives of other organizations that aim to promote a sustainable recovery effort in Haiti. Additionally, the Vassar Haiti Project (“VHP”) will be selling Haitian paintings, handicrafts, and other artwork to benefit VHP’s school and medical clinic in Chermaitre village in the mountains of northwestern Haiti.

DRN is a public interest student group formed in 2005 in the wake of Hurricane Katrina, with a mission to serve populations affected by natural disasters. In March 2010, fourteen DRN members traveled to Haiti to run a weeklong camp for children—who were not in school because schools remained closed—in Cabaret, Haiti. DRN remains committed to assisting the survivors of the 2010 earthquake and is proud to support IJDH’s efforts to promote a human rights based approach to earthquake recovery.

Tickets to “Renewal and Rebirth,” which can be purchased at the door, are $10 for students and $15 for non-students. Donations can be made via checks payable to Fordham University School of Law (designate “Disaster Relief Network” in the memo line) at,140 West 62nd Street, Room 08, New York, NY 10023.

For questions, please contact Ritha Pierre (ritha.pierre@gmail.com, 718-344-7662) or Diana Schaffner (schaffnerdiana@gmail.com, 571-228-2283). For additional information on DRN’s Haiti Project please see: http://fordhamdrn.blogspot.com or http://twitter.com/FordhamDRN.

Give Us Free….

•October 24, 2010 • 2 Comments

Last week I went to the Fordham film festival and saw the Amistad. To sit and watch a movie about your people being tortured and sold into slavery is practically unbearable. I do not think any person of African decent can sit there without feeling an ounce of rage or a bit of sadness….

I think the part of the movie that bothered me the most was the black on black crime. Blacks selling their own into slavery. I know many people can argue that they had no choice. That it was either kill or be killed. But really though? Where was the loyalty? Was selling your brother really worth those guns? These question are rhetorical now since these occurrences took place hundreds of years ago and have no real relevance now right? It’s not like we are still selling each other into slavery…. Or are we?

The movie itself was great in my opinion. Even though it really wasnt about the slaves on the Amistad, but it was eye-opening. I still cannot skip over that scene though… The scene where Africans were capturing Africans to sell to the white man. If you think about it, the white people needed the Africans to capture the other Africans because they did not know the land or the the language. What those idiots failed to realize was that they too would soon be turned into slaves. They sold out for some guns… The same guns that the white man would in turn use to subdue them…

It almost makes me wonder if this “selling each other out” business is something that is imbedded in us. I mean think about it, we sell each other out daily. We trade each other in for money, power and respect. We tear each other down for the sake of what? A title? Five minutes of fame? We continuously make a mockery of ourselves in front of the blancos and for what?

It seems like the only time we ever band to together is when we need to “revolt” in response to some injustice… Such a beautiful thing when it’s actually done isn’t it? It almost makes you think that we finally achieved what Martin and Malcolm were fighting for. But the truth is we haven’t really overcome much have we?

Give us free! Give us free! Such powerful words. We as people are still uttering these words today… After hundreds of years of “freedom” why are we still asking to be free? Personally I thinking we are asking the wrong people to “give us free”. The better question maybe do we really want to be free? We still live in a society where believe it or not racism still lurks. A society where true freedom may never be realised. As true as all that maybe, I don’t think we need to be our own slave masters. The coonery, although cute at times, only makes us look like idiots in the mainstream. The selling out syndrome that many of us seems to have, makes us look like the savages they already think we are.

So what do we do? What lessons can we learn from the past? Off the top of my head I would say self-love and love for each other. To just think if the Ancestors had refused to trade their brothers and sisters in for weapons, if they had loved their people and their culture enough, maybe the slave trade would not have been so lucrative. It may not have prevented it, but I believe that it would have been different in some way. It’s crazy that we had the upper hand and yet we were shuckin and jivin. Look where all that dancing brought us. But what have you? What’s done is done. We are screwed up, messed up, jacked up and whole host of other things. But we do not have to continue to let the past define our present and future. Society has come a long way from the slave days. Sadly it hasn’t come far enough because we have not let go of the slave mentality. Let us not let history repeat itself again. If you really want them to “give us free” then we need to first free ourselves.

 
Follow

Get every new post delivered to your Inbox.

Join 1,322 other followers