This paper examines moral agency—the capacity to make ethical judgments and bear responsibility for one's actions—through a practical case study involving end-of-life care. Using the scenario of Harry, an elderly stroke patient on life support, the paper analyzes the ethical tensions between medical professional judgment and family autonomy. The analysis draws on virtue ethics and Catholic social doctrine to argue that physicians should respect the family's decision-making authority, even when clinical evidence suggests continued treatment may prolong suffering. The paper demonstrates how moral agents navigate competing obligations: professional duty to relieve suffering, respect for patient autonomy, and compassion for grieving family members.
Moral agency enables people to make moral judgments based on common societal perceptions of right and wrong, and to bear accountability for their actions. A moral agent is a person tasked with this responsibility. Since ancient times, two fundamental forces have shaped human experience: good and evil, determined by the virtue or moral character of a person. In virtue-based ethics, the normative standard is the good person—someone whom people can reliably depend upon to act ethically consistently and in all circumstances (Pallegrino). Moral agents must carefully consider what is appropriate and ethical for each specific situation they encounter.
Harry is an 80-year-old war veteran living in a small townhouse who suffered a stroke that left his entire body paralyzed. He was rushed to the hospital and admitted to intensive care, where life support machines were necessary to maintain his organ function. His condition resembled a coma, and for three months hospital doctors monitored his progress and response to medication. However, his medical state did not improve; instead, it continued to deteriorate and became increasingly critical.
The medical team concluded that Harry was beyond recovery and recommended withdrawing life support, citing the complications associated with age and the limitations of current medical interventions. However, the doctors recognized they held no moral obligation to act without the patient's consent—Harry possessed a fundamental moral right to decide his own fate. Since Harry could not communicate or participate in this decision, his moral authority transferred to his next of kin. As a widower, his only surviving family member was his 43-year-old daughter, Jane, who worked as a nurse.
When asked to consent to withdrawing her father's life support, Jane refused. She believed her father was a strong man who would recover from this ordeal. Jane was aware of documented cases of stroke patients who, upon recovery, reported that they had been psychologically aware of their surroundings throughout their illness but were unable to communicate their thoughts and feelings to their physicians—a condition known as locked-in syndrome. However, the medical team knew this was not Harry's situation. His organs were not responding to medication, and they believed he would experience severe pain if he regained consciousness. In their professional judgment, withdrawing life support was in Harry's best interest, sparing him from prolonged suffering given his extremely slim chances of recovery. Jane, by contrast, was unwilling to lose her father and remained hopeful that, given more time, he would recover.
I am of the opinion that the doctors should keep Harry on life support in accordance with the wishes of his daughter, who holds the moral right to decide her father's fate. Professional medical ethics support this position because respecting patient (or surrogate) autonomy is a foundational principle. Morally, physicians are expected to demonstrate compassion and provide care, which includes giving the patient a chance at recovery, however slim those chances may be (Pallegrino). Catholic social doctrine emphasizes that every person bears responsibility for the common good of all members of society, regardless of their condition. The doctrine teaches that the common good depends on the social conditions of a particular historical period and is connected to the integral promotion of human dignity and respect for fundamental rights. It demands that all persons cooperate according to their capabilities in achieving the good of society.
"Argument for respecting family autonomy in end-of-life decisions"
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