Abe and Mary had an extremely difficult decision to make. The couple did indeed have a child to save the life of Annisa. It could be possible that in the future Marissa-Eve's relationship could be harmed by this truth. Eve may feel as though her sister's life is more important than her own. In many ways Eve was treated as a means to an end because her life was the only way to save Annisa. Her parents had exhausted other possibilities and did not want their child to die. However this does not mean that Abe and Mary don't also love Eve. Just because Eve's life was utilized to save her sister, this does not mean she will not be loved or appreciated within the family unit. This situation is not black and white in that manner. One child saving the life of the other has both positive and negative outcomes associated with the relationship they have with one another and their parents.
It is true that Eve had no choice in whether or not her bone marrow was utilized for the operation. Under these circumstances it does seem that her parents had a right to decide to perform the operation. The parents were not in a position wait until eve was old enough to make the decision on her own. There are many instances in which bone marrow donors are young children and there are few reports of any ill effects from such young donors. As such it seems that the parents took the appropriate risk in allowing the operation to be performed on the daughter. The parents also had an obligation to eve to do all that they could to assist her in the battle against the disease. If they had not tried using the bone marrow, Annissa might not have lived and Eve might have felt guilty about that at some time in the future.
In my opinion it is permissible to use one child to save another. This practice has been widely excepted. For the most part parents do not automatically have another child until they have considered all the possibilities associated with finding an existing donor. In most instances having another child is the last resort and people choose this when they have exhausted all other options. As a result of this action being permissible there are also other actions that might be seen as permissible. For instance in many cases when a child is conceived for the purposes of giving bone marrow to a sibling, the doctors know prior to the child's birth whether he/she will be a bone marrow match. It is likely that people will use this type of technology to create designer babies, this might become a permissible act in the eyes of some parents. In fact in some countries parents are allowed to choose which embryos to implant based on traits and genetic markers.
I do not believe that this type of action should be permissible because it can become an extremely slippery slope. People might begin to have embryos destroyed based on the sex pf the child or whether or not the child is handicapped or as some other type of challenge. The possibility for wide scale eugenics practice comes to service and therefore a line should be drawn. In addition some parents might decide that they want to utilize the kidneys of one child to save another. This type of donation would be unfathomable because there is a significant medical difference between bone marrow transplant and a kidney transplant. Bone marrow regenerates and other than the pain associated with the donation there are no lasting side effects. On the other hand a kidney transplant could be much more dangerous and painful because it requires major surgery and could result in death.
3. In This instance the virtue ethicists would grapple with whether to teel the lie or not tell the lie to the family members and what this decision says about his or her personal character. In this instance I think that a virtue ethicists would not keep this a secret because of the lives that could be destroyed if such a secret were kept. In this case an entire family could be affected. The wife is at particular risk for getting the disease or may have already acquired the disease. HIV is a disease that if diagnosed easrly enough can be treated and people can live for a long time with the virus. As such telling the wife that her husband is HI V positive would very likely ensure that she will have many more years with her children. Not telling the information and keeping it a secret will likely end in the extremely premature death of the wife.
Not relaying this information is also detrimental because it means that the children will likely lose both parents in a short amount of time. These are all issues that need to be taken into consideration as it pertains to the issue of whether to keep the HIV status of this man private.
In addition to benefitting the immediate family the virtue ethicists must also take into consideration that the man might also still be engaging in homosexual activity. If this is the case he could also infect people besides his wife if the truth is not told. The man must also face the truth about his own sexuality. In doing so he will likely free others in similar situations and save their lives in the process.
If I was a chaplain and I made a death bed promise I don't think I would give an answer that is different than one that a doctor would give. This is the case because doing the right thing is important regardless of your title in life. If I were a chaplain or priest I would want to be a liar and I wouldn't want the guilt of knowing that I could have saved or prolonged someone's life but I didn't simply because I chose not to tell the truth. In this scenario it would matter if I was a priest or chaplain I would not keep a promise of this sort.
Also if I were a chaplain or a priest I would be compelled to tell the truth in accordance with scripture. I would not stand idly by and allow someone to get hurt or sick because an HIV positive iindividual does not want to own up to his past and the problems his reckless behavior produced. I would also reveal the information because I want to treat people in the same manner that I would want to be treated. I would also attempt to be compassionate in the situation and persuade the HIV patient to reveal the truth to his family so that the appropriate steps can be taken to assist them. Keeping the HIV status a secret would do a great deal of harm to everyone involved.
The virtue ethics approach is different in that it takes into consideration the lie and whether or not the lie will cause harm. This type of ethics also allows the individual to decide how to conduct themselves based on a case by case basis. Other ethics theories do not allow for individualizing. They instead have clear cut ways of dealing with one action's regardless of the scenario. The virtue ethic approach really causes an individual to give pause before they decide how they are going to react in any given situation. In this situation it seems that sound judgment would be needed to ensure that all the individuals are properly taken care of and can stay well for as long as possible.
4. A cancer prognosis and the cancer treatlmments that follow can be a difficult scenario to confron for patients and their families. In the two cases presented there are slightly different views that the patients have. The first patient seems to be fine with not knowing her prognosis. She seemed to content that her children were aware of her health status. In the first case it seems that the family's request to withhold the truth from the patient was consistent with what the patient wanted. It wasn't as if she was kept in the dark about her prognosis even though she was extremely ill. In the second case it is apparent that the patient already knows that the prognosis is terrible and wants to talk about it with the family. In both instances the patients should have the ultimate say in what information is told unless the patient is incapacitated.
The physician can respect the family's decision not to disclose the information in certain situations. For the most part disclosure issues are a matter of law for physicians. In many instances doctors can not disclose patient health information to anyone but the patient. Unless a family member has guardianship over a patient or the power of attorney they cannot make disclosure or non-disclosure request.