From: Munson, Ronald. INTERVENTION AND REFLECTION.6th ED.,Belmont, California: Wadsworth Publishing Company,2000 . Page 185 Scenario #8

I had been working as a bioethics advisor at University Hospital for three months before I was called in to consult on a pediatrics case. Dr. Savano, the attending obstetrician, asked me to meet with him and Dr. Hinds, one of the staff surgeons, to talk with the father of a newborn girl.

I went to the consulting room with Dr. Hinds to Joel Blake. From what Dr. Savano had already told me, I knew that Mr. Blake was in his early twenties and worked as clerk at a discount store called the Bargain Barn. The Baby’s mother was Hilda Godgeburn, and she and Mr. Blake were not married.

Mr. Blake was very nervous. He knew that the baby had been born just three hours or so before and that Ms. Godgeburn was in very good condition. But Dr. Savano had not told him anything about the baby.

“I’m sorry to have to tell you this,” Dr. Savano said. “But the baby was born with severe defects.”

“My God,” Blake said. “What’s the matter?” “It’s a condition called spina bifida,” Dr. Savano said. “There’s a hole in the baby’s back just below the shoulder blades, and some of the nerves from the spine are protruding through it. The baby will have little or no control over her legs, and she won’t be able to control her bladder of bowels.” Dr. Savano paused to see if Mr. Blake was understanding him. “The legs and feet are also deformed to some extent because of the defective spinal nerves.”

Mr. Blake was shaking his head, paying close attention but hardly able to accept what he was being told.

“There’s one more thing,” Dr. Savano said. “The spinal defect is making the head fill up with liquid from the spinal canal. That’s putting pressure on the brain. We can be sure that the brain is already damaged, but if the pressure continues the child will die.”

“Is there anything that can be done?” Blake asked. “Anything at all?”

Dr. Savano nodded to Dr. Hinds. “We can do a lot,” Dr. Hinds said. “We can drain the fluid from the head, repair the opening in the spine, and later we can operate on the feet and legs.”

“Then why aren’t you doing it?” Mr. Blake asked. “Do I have to agree to it? If I do, then I agree. Please go ahead.”

“It’s not that simple,” Dr. Hinds. “You see, we can perform surgery, but that won’t turn your baby into a normal child. She will always be paralyzed and mentally retarded. To what extent, we can’t say now. Her bodily wastes will have to be drained to the outside by means of artificial devices that we’ll have to connect surgically. There will have to be several operations, probably, to get the drain from her head to work properly. A number of operations on her feet will be necessary.”

“Oh, God,” Mr. Blake said. “Hilda and I can’t take it. We don’t have enough money for the operations. And even if we did, we would have to spend the rest of our lives taking care of the child.”

“The child could be put into a state institution, ” Dr. Hinds said.

“That’s even worse,” Mr. Blake said. “Just handling our problem to somebody else. And what kind of life would she have? A pitiful, miserable life.”

None of the rest of us said anything. “You said she would die without the operation to drain her head,” Mr. Blake said. “How long would that take?”

“A few hours, perhaps,” Dr. Savano said. “But we can’t be sure. It may take several days, and conceivably she might not die at all.”

“Oh, God,” Mr. Blake said again. “I don’t want her to suffer. Can she just be put to sleep painlessly?”

Dr. Savano didn’t answer the question. He seemed not even to hear it. “We’ll have to talk to Ms. Godgeburn also,” he said. ” And before you make up your mind for good, I want you to talk with the bioethics advisor. You two discuss the matter, and the advisor will perhaps bring out some things you haven’t though about. Dr. Hinds will leave you both together now. Let me know when you’ve reached your final decision and we’ll talk again.”

Critical Thinking

Using the DIALECTICAL PROCESS  state what your ethical position would be and why. You are to take a position and defend it. You are to advise Mr. Blake of what would be morally correct or acceptable.  You should use some ethical principle to decide what you think is the morally correct thing to do. You must state those principles and explain how they have been applied to the situation. You should indicate that you have rejected alternative positions to your own and the reasons why you have done so.  In so doing you need to enunciate clearly the values and ethical principle(s) you are using to both reject the alternative positions and to defend or support your own.

Use this template or form to make certain that you include each part of the process-parts a to e

Label your parts with the letters a to e to make very clear that you have done each part.

Dialectical thinking: the 5 parts

  • a. Take a position on this question or issue Be as exact as you can be.  Be precise in your use of language (ethical principles and values).
  • b.  Provide the reasons why you think this position is better defended by reason and evidence than are the alternative positions Position defended using reasoning (ethical principles and values) in support of the judgment (conclusion of the  argument).  You state the reasons why the position you take makes sense and has evidence and reasons (ethical principles and values) to support it other than your feelings or personal preference or your opinion or what you were brought up to believe or what just about everyone you know thinks or believes.   Philosophers have offered such reasons (ethical principles and values) and evidence for the positions they have taken and you should consider them and if you agree you can and should so state them in support of your own position.
  • c.  State the reasons why you found the other positions flawed or less defensible than the one you are defending
  • d.  State the criticisms of your position
  • e.   Respond to the criticisms- rebuttal- how do you defend your position in light of those criticisms

____VIDEO on Dialectical Process

NOTE:  A Case Study is due for this module at the same time the written assignment is due!


I suggest that you create your assignments using your word-processing program and spell checker , then copy and paste your text-answers into the message window of an email ,and send it to the instructor by email with the text inside the email message window. DO NOT send attachments .

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